A new report reveals that some Trusts across the UK do not have policy or guidance on maternal requests for caesareans.
Birthrights, the human rights in childbirth charity, used a Freedom of Information request to ask 153 trusts that provide maternity care how they applied The National Institute for Health and Care Excellence (NICE) guidelines on caesareans.
Of the 146 that replied, 26% fully complied with the guidelines, 47% partially complied, 15% refused maternal requests outright and 12% did not seem to have a clear position.
Birthrights said it handled more requests for support from women unable to access a caesarean than any other issue.
Dr Alison Wright, Vice President of the Royal College of Obstetricians and Gynaecologists, said:
“The RCOG welcomes this important contribution. We are disappointed by the findings which suggest that some Trusts do not appear to offer women ‘maternal request’ caesarean births, with variation in Trust policy and guidance across the UK. This denies women choice about their birthing experience and highlights the importance of Trusts updating policies and guidelines to ensure women have access to safe and personalised care.
“We strongly believe that women’s voices and choices should be respected and supported to ensure a good birth. It is important women are fully aware of the risks and benefits of all methods of giving birth when considering their options during pregnancy.
“The reasons some women request a caesarean birth may include a fear of having a complicated vaginal birth, or having had a previous traumatic experience. Talking to a midwife or obstetrician and accessing support from a counsellor or psychologist, may help address any concerns they may have. Some women may still choose a caesarean birth, which should be respected and supported."
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It is important to note that having a policy or guidance may not be entirely reflective of practice. Some Trusts have made a policy statement that they do not offer maternal request caesareans, but do appear to carry out maternal request caesareans – some even more than those with an open policy of support.
Only 61% of Trusts provided data on the number of caesareans performed following a maternal request and this highlights the need for improved data collection.
RCOG information for women considering a caesarean
NICE guidelines on caesarean
The RCOG is working closely with the Royal College of Midwives, the National Childbirth Trust and maternity voice partnerships to give consistent, unbiased, evidence based information to women and their families and to provide both personalised and safe care to all.
About the RCOG
The Royal College of Obstetricians and Gynaecologists is a medical charity that champions the provision of high quality women’s healthcare in the UK and beyond. It is dedicated to encouraging the study and advancing the science and practice of obstetrics and gynaecology. It does this through postgraduate medical education and training and the publication of clinical guidelines and reports on aspects of the specialty and service provision.