I wrote: Firstly, there is actually evidence that a planned cesarean is no more costly than a planned vaginal birth - when comparisons include costs beyond the immediate intrapartum period (e.g. treating infant and maternal birth injuries, but also litigation).
In terms of choice however,the report states that women "will only be allowed to opt for the procedure at some hospitals if a natural delivery would endanger them or their baby."
That is precisely the point. Just as many doctors believe this to be true, there are women who evaluate the risks of natural birth and make the informed decision that a prophylactic cesarean at 39+ gestational weeks is the best option.They want to avoid the unpredictable nature of a trial of labor, and feel more at ease in the operating theatre with an obstetrician than they do with Mother Nature and a midwife.
Eventually these NHS Trusts will be exposed by the truth - it is just a matter of time. And incidentally, perhaps if these Trusts had to pay a greater share of the litigation costs when things go wrong during planned vaginal births in their hospital maternity wards, they'd take a very different view on what constitutes 'cost-effective' care.
Remember that in some countries, where doctors and hospitals are directly responsible for litigation costs, there are accusations that women are not being allowed the choice of a vaginal birth plan.
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