Pivotal Moment in Obstetrical History - the NICE Caesarean Update

The 2011 NICE Guideline Update will ALLOW maternal request cesareans in NHS hospitals.

There are those who fear its coming, and there are those who welcome it, but in a few months' time (barring a complete U-turn), the blanket refusal of maternal request cesareans will no longer be considered acceptable maternity care.

"If a vaginal birth is still not an acceptable option to the woman, her request for a CS should be supported within the health service." (quote from May 2011 Update Draft)

In May 2011, NICE published its Draft Update, and Stakeholder organizations like my own were asked to provide comments on the content.

Here is an extract of what the new NICE Caesarean Update (draft) says about Maternal Request:

*Explore, discuss, and record specific reasons for the request.
*Where there is no identifiable reason, discuss the overall benefits and risks of CS and vaginal birth. *Facilitate a discussion with other members of the obstetric team
*For women with fear of childbirth, offer referral to a healthcare professional with expertise in providing perinatal mental health support.
*The healthcare professional providing perinatal mental health support should have access to the planned place of birth
*If a vaginal birth is still not an acceptable option to the woman, her request for a CS should be supported within the health service
*An obstetrician has the right to decline a woman’s request for a CS. If this happens, they should refer the woman to an obstetrician who will carry out the CS.