Maternal requests should be supported within the NHS

NICE have issued (subject to typo corrections) the new version of the Caesarean Section Guideline. There have been a number of significant steps forward in this version. In particular the following:

  • “Recommendation 38: For all women requesting a CS, if after discussion and offer of support (including perinatal mental health support for women with anxiety about childbirth), a vaginal birth is still not an acceptable option, offer a planned CS.” pg 12
  • “Recommendation 39: An obstetrican has the right to decline a woman’s request for a CS. If this happens, they should refer the woman to an NHS obstetrician in the same unit who will carry out the CS.” pg 12
  • NICE “agreed that it is important that women are presented with evidence based information in order that they are able to make an informed decision. The reported benefits and harms can then be discussed with each individual woman to help her make decisions based on the relative trade off between the two modes of birth interpreted in light of her own circumstances.” pg 63
  • NICE “agreed that when discussing the risks and benefits outlined in the table, the healthcare professional and woman also need to consider the woman‟s individual circumstances which affect the risks associated with vaginal birth and CS such as previous abdominal or pelvic surgery, impaired mobility from pelvic girdle pain, or care of other children. It is also important to discuss the number of future babies that the woman and her partner are planning as some risks such as placenta praevia increase with an increasing number of CS.” pg 63
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