I've just come across this outrageous news from Derbyshire - that treatment restrictions are being imposed as management looks to reduce NHS costs.
Apart from the issue of maternal request cesareans in healthy pregnancies, which continue to be a thorny (and misunderstood) issue within large parts of the NHS, this report states that cesareans "will not be routinely offered to women who have hepatitis, are pregnant with twins, have small babies or go into an early labour".
A concerned grandmother made some good points in the comments section, and this is what I've just added:
The news about caesarean delivery here is outrageous and unethical.
Why should a woman (even one with a healthy pregnancy) be forced to give birth via a TRIAL of labour?
Policy makers in the NHS constantly fail to see the obvious when they attempt cost-cutting.
Litigation following obstetric complications, the overwhelming majority of which are an outcome of a planned vaginal delivery and NOT a planned caesarean delivery (see the NHSLA website), costs the NHS more money than any other area of health litigation. Furthermore, injuries to babies and mothers during vaginal delivery (spontaneous and assisted) and emergency caesareans have to be treated, both in the short-term and the long-term (e.g. pelvic organ prolapse), yet these associated treatment costs are never included in cost comparison analysis.
Research has shown that at 39+ gestational weeks, it is safer for a baby to be born via planned caesarean delivery than to undergo a trial of labour – and while this will not be every woman's choice, for those whose choice it IS, they should not be refused on the basis of ill thought out cost-cutting efforts.
This is a disgrace, and one I continue to fight against.