Women who are pregnant often don’t have the option to schedule a caesarean delivery, even though they were granted this right by national guidance a decade ago.
In 2011, the National Institute for Care and Health Excellence, Nice stated that women should have the right to elect a caesarean even when there are no medical reasons.
The ruling came as the NHS was engulfed by a scandal involving the deaths of mothers and babies in Cumbria because midwives were obsessed with a so-called ‘normal’ birth.
Nice said: ‘For women requesting a caesarean section, if after discussion and offer of support… a vaginal birth is still not an acceptable option, [NHS Trusts should] offer a planned caesarean section.’ But an investigation using Freedom of Information reveals that dozens of hospital authorities in England and Wales are still obstructing such requests.
Women who are pregnant often don’t have the option to schedule a caesarean delivery, even though they were granted this right by national guidance a decade ago (stock image).
Analysis of responses shows only around a third of hospital trusts and boards allow unfettered access to ‘maternal request caesarean sections’.
A similar number offer maternal request caesarean ‘partially’, with some saying ‘maternal choice alone’ is not sufficient reason.
These findings were compiled by Tees Law solicitors, who was asked to do so after becoming dismayed about the number of cases in which medical negligence involved women denied a Caesarean.
This follows an identical study by Birthrights in 2018, which revealed that only 39 out of 138 NHS Trusts and Boards in England and Wales provided maternity services. They did not offer a maternal request caesarean in accordance with Nice guidelines.
When Tees Law went to the remaining 99, it found just four could be added to a ‘green list’ of those complying. It classed 43 as ‘amber’ because they offer caesarean ‘partially’ or had ‘concerns’ about the way they provided them.
Janine Collier, head of medical negligence at Tees Law, said: ‘While there have been some improvements, Birthrights’ summary of the situation in 2018 still holds true. It is still a daunting task to ensure that all women are able to choose their birth method.
National Institute for Care and Health Excellence (Nice), in 2011, stated that women should be allowed to have a caesarean even when there are no medical reasons (stock image).
‘It’s vital that women are fully supported to come to an informed conclusion about how they would like their baby to be delivered, and for Trusts to respect that choice.’
Jen Hall, of birth injury charity MASIC, said: ‘We hear from many women whose request for a caesarean was denied and they live on a daily basis with the long-term complications of birth injury.’
Dr Jo Mountfield, Vice President of the Royal College of Obstetricians and Gynaecologists, said: ‘The reasons why some women request a caesarean birth includes fear of having a complicated vaginal birth or of physical damage to their bodies, or having had a previous traumatic experience.
‘Talking to a midwife or obstetrician may provide reassurance. However, if a woman decides a caesarean birth is the right option, that should be fully respected.’
Over 90% of all caesareans can be performed solely for clinical reasons.