Sharon Gaffka, a reality TV star and political activist, has chosen to have an elective caesarean section for her upcoming birth. In a personal essay, she explains that her decision was driven by a desire for control amid systemic failures in UK maternity services. NHS figures for 2024-25 show that planned and unplanned caesarean sections have overtaken natural vaginal births in England for the first time.
Personal Reasons for Choosing a Caesarean
Gaffka writes that pregnancy invites unsolicited advice and questions about her body, with people asking if she will breastfeed, have an epidural, or 'try naturally.' She states simply: 'The answer is because I want to.' She emphasizes that she is not arguing for everyone to have a caesarean, but wants to discuss her reasoning honestly in the context of failing maternity care.
Through her work, Gaffka has heard harrowing birth trauma stories. At a February event in parliament, women described forceps injuries causing lifelong damage. One woman repeatedly told healthcare professionals something felt wrong during pregnancy, only to later discover her baby had died. She asked for a caesarean after being told of the death, but her request was refused.
Systemic Failures in Maternity Care
Gaffka notes that the common thread in these stories is that women were not listened to. The Donna Ockenden report on Nottingham University Hospitals NHS Trust found a pattern of loss of autonomy, poor communication, and exclusion from care decisions. Valerie Amos's review of maternity services across England this week also criticized care for not adapting to older motherhood and the rise in caesareans.
A report from the charity Birthrights revealed women feel pressured to have medical procedures, including caesareans, and are denied genuine informed choice. As a British-Asian woman, Gaffka is aware that Black and Asian women experience worse pregnancy outcomes than white women. Her own maternity trust was under national investigation, which affected her thinking despite her positive personal care.
Seeking Control in an Unpredictable Process
Gaffka says the hardest part of pregnancy is losing control over her body and birth. She wanted to make one decision before everything became unpredictable. Choosing a caesarean gave her the greatest sense of calm, not because she believes vaginal birth is wrong or because she is 'too posh to push,' but as a way to mitigate risks highlighted by the Ockenden report.
She acknowledges that caesareans are major surgery with risks, but for her, it felt like the least worst option given the systemic issues. She hopes for a future where every woman feels so safe, listened to, and supported that any birth choice feels like a genuine choice, not a default. 'Surely that should be the minimum expectation, not the aspiration,' she concludes.
