Exploring the experiences of women who give birth under general anaesthetic

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Adopted project
19 February 2025 — adopted January 2025

Exploring the experiences of women who give birth under general anaesthetic (GABI study)

Birth is an important, life-changing event and most women and birthing people are awake when they have their baby and can hold and bond with their babies.

However, in the UK, approximately 6,000 women and birthing people every year require a caesarean section with general anaesthetic (GACS). This means they are not awake when they give birth and do not experience the important moments following birth, when mother and baby first meet.

Every year, around 1,370 women and birthing people require admission to Intensive Care Units (ICU) and for some, this will immediately follow a GACS. Depending on the clinical situation, these new mothers may be unable to interact or emotionally connect with their newborn baby for hours, days or weeks.

6,000+
women per year require GACS in the UK

1,370
admitted to ICU annually, some immediately after GACS

Project aim

The GABI study aims to explore the mental health and bonding experiences of women and birthing people who need GACS and/or ICU admission. The research team will also explore the experiences of fathers/partners during this period.

How the study will be carried out

The study uses a mixed-methods approach across three stages:

Routine health data analysis

Using the eLIXIR database, the team will gather anonymous information on women who have experienced GACS/ICU admissions including age, ethnicity, first language, mental health history, and breastfeeding data. Women who were awake during a caesarean section will also be included for comparison.

Survey

A survey will explore the mental health and bonding experiences of women who undergo GACS/ICU admission. Women who had a caesarean while awake will also be invited to complete the survey for comparison.

Interviews

Interviews with mothers and fathers/partners will be held between 10–14 months postnatally to allow for recovery time and reflection. Interviews may be face-to-face or online as preferred.

The team recognises that some women and fathers/partners may need ongoing support, especially if they find talking about their experiences traumatic. If further support is needed, participants will be signposted to relevant support services.

How patients and the public are involved

A patient and public involvement group consisting of women with lived experience of GACS has been set up. This group will:

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Provide ongoing support and advise on the project plan, study methods and participant recruitment materials

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Help troubleshoot recruitment challenges and interpret study findings

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Discuss and plan stakeholder and dissemination activities

Potential benefits of the study

NICE (2021) guidance states that a woman’s preferences for her caesarean birth should be accommodated whenever possible — such as music playing in theatre, lowering the screen to see baby born, or silence so the mother’s voice is the first her baby hears. NICE also states that early skin-to-skin contact should be offered and facilitated between mother and baby.

However, these recommendations cannot apply to women who undergo GACS because they are unconscious during birth. This research will offer recommendations on how women, birthing people and their families can be supported immediately after GACS and throughout the postnatal period.

Additionally, there is currently no guidance on how women, birthing people and fathers/partners should be supported after ICU admission — this research will provide recommendations for postnatal care after discharge from ICU.

Planned outputs

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Co-designed postnatal information sheet for women who have experienced GACS

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Co-designed postnatal information sheet for women who have experienced ICU admission

Both information sheets will be co-produced with service users and given to women when they are discharged from hospital. They will include advice on mental health for new mothers and fathers/partners, and information on how women and their families might feel after experiencing these events.

This study is funded by Wellbeing of Women and the Burdett Trust for Nursing as part of a Research Training Fellowship. It was adopted by ARC South London in January 2025.