Today NICE released the 2011 version of their guidelines for Caesarean Section.
There are a number of significant updates. In particular:
- women wanting to request a caesarean on the grounds of fear should be offered perinatal mental health support and if, following this, they continue to want a caesarean, this should be granted
- women wanting to request a caesarean where there is no medical need should engage in a detailed discussion with their practitioners. All the risks and benefits of both vaginal and caesarean birth should be fully discuss but if, after this, the woman still prefers a caesarean this should be granted
- not all women with HIV should be automatically offered a caesarean, they should be informed that “the risk of HIV transmission is the same for a CS and a vaginal birth” in specific circumstances – read the guideline (page 6) to get a summary of the specific circumstances where this is the case
There are also new recommendations regarding: timing of antibiotic administration, the use of colour-flow Doppler ultrasound scans etc.
The important thing to note is that this is a guideline, not a directive and some hospitals may still choose to ignore some of the recommendations.