Saturday, July 9, 2016

Inching Closer to Informed Choice...


I don't want to speak to soon, but momentum seems to be building once again, which might see a move towards greater balance in the way women are informed about different birth plan risks.

Five years after NICE CG132 guidance said maternal request cesareans should be supported, you'd be forgiven for thinking it had never been published in many areas of the country.

And though that in itself is bad enough (informed women who choose a caesarean still being denied this legitimate choice), it also impacts on women who have no particular birth preference and simply want to fully understand their (and their baby's) individual likelihood of risks and benefits with different birth plans.

So it was very welcome news this week when the New Scientist published Doctors should warn women about the real risks of childbirth, and one of its reporters, Clare Wilson, wrote the accompanying article, UK doctors may officially warn women of vaginal birth risks.

You see, Clare Wilson is one of a growing number of journalists who 'gets it'.

When I first contacted her in July last year, she'd just published Stop glossing over the risks of natural birth to cut caesareans, and within months, I'd sent her a copy of our book, Choosing Cesarean, A Natural Birth Plan.

Then just this week, another two journalists told me they're reading it too, and I can't emphasise enough what a shift this is even from as little as 4 years ago (when our book was published, not a single journalist reported on or reviewed the copy we sent to them).

Somehow the world didn't seem quite as ready back then for what our book says; the 2011 NICE guidance on maternal request was being misrepresented and misinterpreted, and 'caesarean choice' (with its perceived elevated cost) didn't juxtapose at all well with austerity cuts in the NHS.

But the Kirkup Report on Morecambe Bay, the Supreme Court Judgment (Montgomery v Lanarkshire Health Board) on birth autonomy, and a plethora of other important developments (more new research and evidence on pelvic floor impact, more focus on late term stillbirths, more MPs noticing the associated ballooning costs of litigation cases with planned vaginal deliveries, and more parents - and even coroners - realising that cesarean rate targets and the 'push for normal birth at any cost' can lead to avoidable deaths and injuries - to name but a few) has changed all that.