6th March 2026
‘If this is my only child then I’ve been robbed of the experience, I don’t know what a first nappy looks like’: The Distinct Experience of GA Birth.
We are delighted to share this Voices blog, from Michelle Anderson, Wellbeing of Women Research Training Fellow, Department of Women & Children’s Health, King’s College London, about the impact of general anaesthetic caesarean section on parental and infant mental health.
Michelle Anderson, Wellbeing of Women Research Training Fellow, Department of Women & Children’s Health, King’s College London
The GABI Study
When a baby is born under general anaesthetic (GA), the mother is unconscious at the time of birth – an experience very different from most caesareans, where women are awake. Although GA births are relatively uncommon, accounting for around 4-8% of all caesarean sections [1,2], understanding their unique implications is important for providing appropriate postnatal support to families.
Caesarean sections under GA usually happen in an emergency, either before or during labour, when there is not enough time for a spinal or epidural, the spinal or epidural fails, or there are medical contraindications such as low platelets or sepsis. Because GA caesareans are usually performed in the context of an acute emergency, these births can carry additional risks, including post-partum haemorrhage for the mother or neonatal intensive care unit (NICU) admission for the baby. Additionally, in many cases, the woman’s partner is not allowed in the operating theatre, which can make an extremely stressful situation even more challenging.
To better understand the support needs of families who experience GA caesareans, I am researching its impact on parental mental health and early newborn bonding as part of my PhD at King’s College London. The study uses a mixed-methods design, combining analysis of over 18,000 caesarean records from the eLIXIR database, a national survey (with nearly 100 women participating so far), and interviews with mothers and fathers.
So far, 12 mothers and 6 fathers have taken part in the interviews. After each one, I follow up the next day with a wellbeing call or message, and many parents express how grateful they are that this research is being conducted, so their experiences can finally be understood and validated.
I also have two Patient and Public Involvement (PPI) groups, one for mothers and one for fathers. These groups provide a central voice for the study and have been involved in reviewing and piloting the national survey, as well as developing topic guides for interviews. They are now about to start contributing to the interpretation of findings!
When I first met the mothers and fathers who joined these PPI groups, they were very open and honest about their GA birth experiences. Since then, I have discovered that many more parents feel the same. Their voices can be heard through these quotes,
‘I struggled to bond with my baby; my husband was doing it all’ (PPI Mother)
‘If this is my only child then I’ve been robbed of the experience, I don’t know what a first nappy looks like’ (PPI Mother)
‘I felt like a failure as a mother’ (PPI Mother)
‘No one communicated with me, I didn’t know what was going on, I felt so scared’ (PPI Father)
One finding emerging from the data is the lack of understanding about GA birth among healthcare professionals. This extends to everyone caring for families in the postnatal period, particularly midwives and health visitors. GA is a unique birth experience with its own implications, distinct from births where the mother is awake, and it can affect the mental and emotional health of both parents.
I hope that the findings from this research will be meaningful for health visitors and help guide how best to support families as they navigate the early weeks and months following a GA birth.
The survey closes at the end of March, so if you would like to share it across your social media networks, please use the QR code or follow this link. Any mother can take part as long as she is over 18 years of age and has had any type of caesarean section in a UK hospital within the past year.
The research team involved in this study are:
- Dr Hannah Rayment-Jones, Midwife and NIHR Advanced Research Fellow, King’s College London.
- Dr Fiona Challacombe, Clinical Psychologist and Associate Professor, University of Oxford.
- Dr Sharin Baldwin, Senior Health Visitor Lead at the Institute of Health Visiting.
- Dr Sam Burton, Psychologist and Research Associate at King’s College London.
- Michelle Anderson, Midwife and Research Fellow at King’s College London
- Dr Elena Greco, Consultant Obstetrician and Gynaecologist, The Royal London Hospital
- Dr Matt Wikner, Consultant Anaesthetist, The Royal London Hospital
Further Information
- If you would like to read more about the impact of general anaesthetic birth on parental mental health and early newborn bonding, please follow the link to this article: The impact of general anaesthetic caesarean section on parental mental health & infant bonding: A scoping review
- If you would like more information about the GABI study please contact me at [email protected], or you can read more about the project here: Exploring the experiences of women who give birth under general anaesthetic | ARC South London
References
- Bamber JH, Lucas DN, Plaat F, Russell R. Obstetric anaesthetic practice in the UK: a descriptive analysis of the National Obstetric Anaesthetic Database 2009–14. Br J Anaesth. 2020;125(4):580–587.
- Bhatia K, Columb M, Bewlay A, Eccles J, Hulgur M, Jayan N, Lie J, Verma D, Parikh R. General anaesthesia for caesarean section: a cross-sectional survey of anaesthetists in the UK. Anaesthesia. 2021;76(3):312–319.
