Caesarean Sections

Dr Duncan offers consultant-led care for planned and emergency caesarean births, delivered at The Portland Hospital

Dr Keith Duncan is a sub-specialist in Maternal and Fetal Medicine with over 30 years' experience and more than 4,000 deliveries, in the NHS and privately. He cares for women having planned and emergency caesarean, sees you at every appointment and offers 24hr access to patients under his care, so you deal with the same consultant from your first visit through to your birth.

Elective Caesarean Section

An elective caesarean section is planned before you go into labour. A caesarean may be recommended because your baby is in an awkward position, such as transverse or breech, because the placenta is low, or because you are having twins or more. Caesarean birth is now very common in England. In 2024-25, 45% of deliveries in NHS hospitals were by caesarean (NHS England Digital).

Some women also choose a planned caesarean where there is no medical need. Whether the right birth for you is a vaginal delivery, a planned caesarean, a water birth, or hypno-birthing, Dr Duncan's role is to guide you through it safely and respect the choice you make.

Your Birth Experience

If your baby is delivered by caesarean section under regional anaesthesia, your partner will be able to sit with you in the operating theatre and share the joy and excitement of the birth. You should be able to bond with your baby immediately, with skin-to-skin contact where clinically appropriate. A planned caesarean can be a positive way to welcome your baby. With a planned caesarean, you will be able to mark a date in your diary when your baby will be born, so you can pack a bag, clear your partner's diary, and fill the freezer in advance.

Emergency Caesarean Section

Sometimes birth doesn't go according to plan. It's a complex and delicate process which can need a helping hand. Maybe labour fails to progress, or your baby shows signs of distress, or your baby is breech and labour is becoming difficult, then it can be safest for you and your baby to have a surgical birth. The word "emergency" can sound frightening, but it usually describes an operation that has not been planned in advance. This may not be the birth you described and intended in your birth plan, but the priority for everyone in the delivery room is that both you and your baby are healthy.

What Happens During a Caesarean?

1. The obstetrician will explain exactly what is going to happen, talk you through any potential problems and ask you to sign your consent to the procedure.
2. The top part of your pubic hair will be clipped or shaved away, so that hair won't stick in the wound and affect healing.
3. You will be given some antacid medication to settle your stomach. This stops anything coming back up into your throat.
4. A drip will be put into your arm, this can keep you hydrated, help the anaesthetist control your blood pressure, allow any intravenous medication to be given and enable rapid transfusion if there are any problems.
5. An anaesthetist will give you regional anaesthetic, it will numb your pelvis and legs, but you'll stay awake. This may be an epidural or a spinal anaesthetic. Either way, you should feel no pain during the operation, although you may feel some pressure and tugging.
6. When you are numb, a tube called a catheter will be put in, to drain the bladder. This means you won't have to struggle with a bedpan and urinate for yourself until you're back on your feet.
7. Your lower body will be covered with sterile sheets and a screen will be put up so you can't see the surgical procedure.
8. The surgeon will make a small cut along the top of your bikini line.
9. There will be a further cut into the womb and your beautiful baby will be lifted out into the world.
10. The placenta is removed and you'll be neatly stitched back up, in layers. The scar should heal well, leaving a fine line that will be hidden by your underwear or swimwear. The whole procedure takes around an hour.

Recovery After a Caesarean

Dr Duncan and The Portland Hospital team will review how you and your baby are recovering before you go home and agree a plan with you for pain relief, wound care and follow-up. The average length of hospital stay is 2-3 nights. At home, keep the wound clean and dry, rest when you can, and avoid heavy lifting until you have been advised it is safe. Drive again only when you can wear a seatbelt comfortably and make an emergency stop, and check your insurer's requirements. Contact Dr Duncan promptly if you develop a fever, redness or discharge from the wound, worsening pain or heavy bleeding.

Planning Your Caesarean with Dr Duncan

At your consultation, Dr Duncan will explain why a caesarean is recommended (or whether it is right for you), the benefits and risks, and the safest timing for your circumstances. He supports your choices wherever it is safe to do so. He delivers at The Portland Hospital, the UK's only private hospital dedicated to women and children, with neonatal support on site should your baby need it. For more information, read Dr Duncan's guide "Your Delivery at The Portland Hospital, London".

Previous Caesarean and Vaginal Birth After Caesarean (VBAC)

Vaginal birth after caesarean (VBAC) is possible for many women and is something Dr Duncan can discuss with you in detail at consultation. Whether it is appropriate depends on the reason for your previous caesarean, the type of incision used, and your current pregnancy. Some women prefer a planned repeat caesarean and others would like to try for a vaginal birth. Dr Duncan will go through the benefits and risks of each with you, and support the choice you make.

Caesarean Birth in Twin and High-Risk Pregnancies

A caesarean is sometimes recommended for twin and multiple pregnancies and for some high-risk pregnancies. Dr Duncan will discuss the safest timing and mode of birth with you well ahead of time, so you have an agreed plan.

What Is Included, and What Does It Cost?

All of Dr Duncan's private maternity care packages include delivery at The Portland Hospital, whether your baby is born vaginally or by caesarean section. He also offers a caesarean-only package too. Please see our fees page for what each package includes and for pricing.

Additional fees may be levied by external providers, such as The Portland Hospital, so please get in touch to discuss this further. Dr Duncan has also published an article "Private Maternity Care Costs: What You’ll Really Pay In 2026" to help you understand the total cost of your care, once all third parties have invoiced you.

Arrange a Consultation

Whether your caesarean is planned or you want to understand your options first, Dr Duncan would be delighted to look after you. We offer an initial complimentary consultation to talk through your care. Please contact us today or book online.