A classical Caesarean section involves a midline longitudinal incision (vertical cut rather than horizontal), which allows a larger space to deliver the baby. However, it is rarely performed today, as it is more prone to complications, such as blood loss. It is now only used in unusual circumstances such as:
A very premature baby
A transverse lying foetus with ruptured membranes
Some types of fibroids (non-cancerous growths)
Some cases of placenta praevia (placenta very close to the cervix)
Heidi Bowman, 41, is mum to Alfie, six, and Charlie, two. She was diagnosed with a fibroid during her first pregnancy, which meant she needed a classical C-section to deliver both her babies.
When did you first think something was wrong with your first pregnancy?
After I got pregnant with Alfie, I had to start wearing maternity clothes at eight weeks because of the size of my bump. Then, at 12 weeks, we went along to our first scan. We were excited but nervous at the same time. What if it was twins - or more?
What came next was a shock but extra babies weren't the problem. The sonographer had found a 'mass' - a very large fibroid. I hadn't even known it was there and once I'd spoken to my consultant, he was amazed I even got pregnant in the first place.
How did it affect your pregnancy?
I didn't think about the fibroid too much. I knew it was there but I was in no pain and I was sure it wouldn't cause any problems. I even thought I might be able to have a water birth - but that changed when I had a meeting with my consultant.
Why, what did the consultant say?
He had only ever seen a fibroid this large once, and explained that where the fibroid was sitting was my biggest problem, not just the size. If it had been above the baby, then maybe I would have had more choices, but the fibroid was low down and basically blocked all available exits.
So a 'natural birth' of any kind was out of the question. I assumed I would have to prepare myself for a C-section - I can handle that, I thought.
But the consultant shook his head, and explained a normal C-section was out of the question as there was no way to reach the baby.
I started to feel panicky, and wondered how on earth the baby was going to come out.
The consultant explained that the only option was for a 'classical' C-section – a very rare and risky procedure that involves a midline longitudinal incision that allows a larger space to deliver the baby.
Basically I was going to be cut open straight down from just below my ribs to about two inches below my belly button. I was terrified.
How did you feel as your due date approached?
The fibroid carried on growing until it was bigger than the baby - I looked enormous and I was extremely uncomfortable.
At 32 weeks I was the equivalent of 48 weeks pregnant, with the fibroid measuring 17cm by 15cm.
As my due date grew closer, I prayed that I wouldn't go into labour early as an emergency C-section of this kind would be very dangerous.
I tried to stay calm, but I was gripped with fear and I couldn't wait for it all to be over.
Tell us about the day itself...
I arrived at the hospital in the morning, full of trepidation. At this point I thought a spinal anaesthetic was still an option, but the anaesthetist explained I was to be put under general anaesthetic.
I burst into tears, and was shaking as we walked through to theatre. Steve kissed me goodbye and went to wait on the ward.
Just then, something very odd happened: I felt completely calm. I thought I'd been given a sedative, but I think my body had just accepted what was happening.
Once all of the drips had been inserted (three in one hand, two in the other and a morphine drip in my arm), I was put under.
How did you feel when you woke up?
I came round in the recovery ward with a mask over my face and a blood pressure monitor squeezing my arm.
Steve showed me a little white bundle: he looked like he was holding a bag of fish and chips!
Our beautiful baby boy, Alfie Luca was here - 7lb, 12oz of perfection. We were both OK and the relief was immense.
And then you did it all again!
Not straight away! Recovery was incredibly hard - the pain was intense and I couldn't leave the house for six weeks. The whole experience certainly put plans for a sibling for Alfie on hold for quite a while.
Then, three years later, we discovered that I was pregnant again. We were overjoyed but obviously the fear was still there for me - I was fully aware that I would have to go through the same procedure, as the fibroid was still there.
How was the second operation?
This time I was booked in for the classical C-section just four days before my due date. As the date got closer, I prayed once again that labour wouldn't start.
I arrived at the hospital very early and Charlie Noah was delivered safely at 9.46am, weighing 9lb, 1oz.
Our beautiful second son was finally here and this time I couldn't describe the relief of waking up and seeing my family complete. It was all over.
How do you see the future?
There's no chance of the fibroid being removed without a full hysterectomy so I will just have to live with it.
I feel very blessed: Alfie is now at school, and Charlie is a toddler.
I look back at the photos and think about what I went through to get here but my little boys are my everything and I would do it all again for them.
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