Women to be allowed to choose a caesarean birth

Women who are scared of natural childbirth will be offered the chance of opting for a caesarean after mental health counselling, according to new guidelines.

Women who are scared of natural childbirth will be offered the chance of opting for a caesarean after mental health counselling, according to new guidelines.

The guidelines, issued by the National Institute for Clinical Excellence, state that fear of childbirth should be taken seriously and that women can opt for a caesarean if, after counselling, they still don’t want to give birth vaginally.

The guidelines also say that it is not necessarily the case that once a mother has had a caesarean she always has to have one as evidence shows the same risk of fever, bladder injuries and surgical injuries for women who have had up to four caesareans and women who have delivered vaginally.
 In addition, they state that women with HIV should be offered the option of vaginal birth. The recommendations, developed following the emergence of new evidence, say that women who are HIV positive should be told that, in certain circumstances, the risk of transmission of HIV is the same for a caesarean as it is for a vaginal birth. As a consequence, such women should not be offered a caesarean section on the grounds of HIV status to prevent transmission of the disease to their baby.

Another major change contained in the updated guidelines is that they advise that women should be given prophylactic antibiotics before surgery rather than after it.

Around one in ten women who have a caesarean section suffer infections after surgery, and this new recommendation could help to reduce the rate of infections by as much as a third without having any effect on the baby, they state.

Dr Gillian Leng, NICE Deputy Chief Executive, stressed that the guideline was not about offering free caesareans for all on the NHS and could actually reduce the rate by highlighting women who do not need to have the surgery.

“For a very small number of women, their anxiety about childbirth will lead them to ask for a caesarean section. The new recommendations in this guideline mean that these fears will be taken seriously and women will be offered mental health support if they need it.

“If the woman’s anxiety is not allayed by this support, then she should be offered a planned caesarean section. Offering these women a planned caesarean in these circumstances is a very long way from saying that caesarean section should automatically be offered to every woman.”

Malcolm Griffiths, Consultant Obstetrician and Gynaecologist at Luton and Dunstable Hospital and Chair of the Guideline Development Group, added: “Caesarean section is major surgery which most pregnant women want to avoid if they can. We want women who do not need to have a caesarean section to be able to avoid such surgery.”





Post a comment

Your email address will not be published. Required fields are marked *