Women Free To Choose Over Caesarean Sections
The National Institute of Health and Clinical Excellence (NICE) has published new guidelines stating pregnant women can choose whether or not to have a Caesarean delivery.
In the past, elective C-sections were only arranged if there was a medical need to do so – for example, if a woman had suffered extensive damage from a previous vaginal birth.
This policy, now considered out-dated, was laid out in the last set of NICE guidelines. Issued in 2004, it asserts that "maternal request is not on its own an indication for Caesarean section", stating the procedure should be declined "in the absence of an identifiable reason".
However, the new guidelines represent an overhaul of this system, as it will now ultimately be left to the mother-to-be to decide between a vaginal delivery and a Caesarean section.
The recently issued guidelines also say that those requesting a C-section because of anxiety will be provided with mental health support.
This move comes in light of research that reveals 6% to 10% of women have a phobia of childbirth. Nina Khazaezadeh, a consultant midwife at St Thomas' Hospital, says she often meets patients who are scared of vaginal delivery. She suggested that women who ask for a Caesarean often do so due to a "perceived lack of control, fears of inadequate care provision and lack of support during labour and delivery".
Ms Khazaezadeh added that in her experience, counselling will often cause a woman to change her mind. "After a discussion of all the pros and cons of both types of birth, and having been assured of one-to-one midwifery support and an individualised birth plan, they will choose to try for a vaginal birth", she said.
During these counselling sessions, a woman will be told of the risks a C-section carries, and will have an opportunity to discuss her options with a clinician. Afterwards, if a mother-to-be is still set on a Caesarean section, then her request cannot be denied.
Nevertheless, NICE was keen to highlight that it was "a very long way" from offering all pregnant women surgery. Dr Gillian Leng, deputy chief executive of NICE, said: "This guideline is not about offering free Caesareans for all on the NHS.
"It is about ensuring that women give birth in the way that is most appropriate for them and their babies. Offering these women a planned Caesarean section in these circumstances is a very long way from saying that Caesarean section should automatically be offered to every woman."
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