Tuesday, November 1, 2011

RCOG's response to the NICE guideline media reports

This is what the Royal College of Obstetricians and Gynaecologists (RCOG) has to say about the past few day's media headlines and stories:

"The RCOG does not comment on draft consultation documents since the content and recommendations are subject to change. 

in light of the misleading headlines on the availability of c-sections on the NHS, the RCOG would like to state that:

 •C-sections are a safe medical procedure but as with any intervention, there are risks involved.  All doctors must ensure that women are informed about the risks and/or benefits of procedures undertaken and the alternative options.  Women must have access to good quality information so that they can make informed decisions 

•Tokophobia, or the morbid fear of childbirth, may lead to maternal request for c-section.  Tokophobia is a complex rare condition and women need to be supported by a range of healthcare professionals, including midwives, obstetricians and occasionally perinatal mental health specialists, so that the most appropriate choice of delivery can be made. 

The headlines ‘Now all women have the right to NHS caesareans in hugely expensive move’ and ‘All women get right to caesarean birth on the NHS... even if they don't need it’ are inaccurate.  There is no proposal in the current NICE guidelines which state that women should have the automatic right to a caesarean section.  Indeed, the current Hospital Episode Statistics show that the c-section rate over 2009-10 was 24.8%.  This shows that the majority of women currently deliver normally or by assisted vaginal delivery depending on their circumstances.

There are well defined indications for caesarean section for both elective and emergency and these should form the basis of clinical practice.

Healthcare providers have the responsibility to ensure the safest, most cost-effective method of delivery for women and babies accepting that very occasionally women will request an elective c-section in the absence of conventional obstetric indications."

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