Saturday, July 10, 2010

NICE decides to review Maternal Request Cesareans

As you know, NICE (The National Institute for Health and Clinical Excellence) is currently reviewing its 2004 Clinical Guideline on Caesarean Delivery, and on Thursday 8th July, it published the Final Scope of what will be reviewed.


The NICE guideline on Maternal Request Cesareans is to be reviewed.
The draft scope, published earlier this year, had excluded Maternal Request as an area requiring review, but a number of Stakeholder organizations (including urged NICE to reconsider at a meeting in London, and followed up with the submission of reasons and evidence to support their position.

The Final Scope reads:

"c) The original caesarean section guideline addressed issues relating to maternal request including the prevalence of request, fear of childbirth and how obstetricians should respond to such requests. In the light of new evidence and a strong concern amongst stakeholders that this area needs to be re-examined this topic will be addressed in the update."

Also now being included is a much-needed update of a table in the 2004 guideline that compared the risks of vaginal and cesarean delivery:

"d) A great deal of support has been expressed by stakeholders for the usefulness of Table 3.1 in the original guideline summarising risks and benefits of caesarean section vs. vaginal birth. Given that this table is often used as the basis of information given to women and underpins informed consent there is a need to ensure this information is as accurate and up to date as possible and therefore it will be included in the update."

Unfortunately, I was not successful in my application to be one of the Guideline Development Group (they will now review all the latest evidence and prepare the new guideline for publication), but I genuinely hope that it takes this opportunity to look at maternal request cesarean delivery with the Stakeholders' comments and concerns in mind.

Again, you can read these in detail here.

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