Thursday, September 29, 2011

Can I choose to plan a cesarean birth in the NHS?

This is one of the most common questions I am asked by women who visit my websites.

And up until recently, the answer was very much, "Not officially, but there are supportive doctors out there, if you can also find a supportive midwife who's willing to refer you to one."

However, finally, there may now be better news for women - whether you have a fear of labor and birth, or you've been considering a cesarean for prophylactic reasons and want to discuss your individual risks and benefits further with an obstetrician, or you have another personal reason.

This month, NICE published its draft guideline on Caesarean section (update) and in it, recommends the following:

Maternal request for CS (page 12)*
36. When a woman requests a CS because she has anxiety about childbirth, offer referral to a healthcare professional with expertise in providing perinatal mental health support to help her address her anxiety in a supportive manner.
38. For all women requesting a CS, if after discussion and offer of support (including perinatal mental health support for women with anxiety about childbirth), a vaginal birth is still not an acceptable option, offer a planned CS.
39. An obstetrician has the right to decline a woman’s request for a CS. If this happens, they should refer the woman to an NHS obstetrician in the same unit who will carry out the CS.

*Now remember that this is only draft guidance, and therefore subject to change, but NICE has stated that changes to the guideline prior to its final publication later this year will concentrate on errors and inaccuracies in the text only - thereby giving hope to hundreds and potentially thousands of women.

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