Friday, May 10, 2013

Hospitals 'are ignoring advice on caesarean sections

This was the headline in last week's Guardian article in which the Royal College of Obstetricians and Gynaecologists (RCOG) and the NCT criticised hospitals for not following NICE guidance on elective cesareans.

Absolutely! I agreed with them.

Just this past week I have been trying to help the latest of many women who have contacted me over the years to say their maternal request cesarean is being blatantly refused.

Not based on an individual risk and benefit, not having followed the appropriate recommendations contained in the November 2011 NICE guidance, but simply because of arbitrary or ideological reasons to reduce cesarean rates and increase 'normal' births.

Unfortunately, neither RCOG nor the NCT referred to this ongoing issue, and while the article focus on the risks of early elective cesarean delivery is a very important one, the Guardian reports that "the overall proportion of elective C-sections performed before 39 completed weeks has fallen from 61% in 2000-01 [to] 30.3% (20,674 babies) in 2011-12."

It is recommended that elective cesareans are performed at 39+ weeks in order to reduce the risks of neonatal respiratory morbidity, but evidently, there will always be cases where a doctor feels it would be safer, on the balance of individual risks and benefits, to bring that date forward.

These early elective deliveries are certainly worth our attention, but so too are the women who request a cesarean and denied support for no good reason; it would be wonderful to see the headline above in the context of tokophobic women's mental health and general birth plan autonomy.

Maybe one day soon...

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