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Some hospitals tell women requesting caesareans to go elsewhere

Majority of hospitals make the process of requesting a caesarean lengthy and difficult

Ingrid Torjesen

Wednesday, 22 August 2018

Most hospitals make the process of requesting a caesarean lengthy, difficult or inconsistent, research by the charity Birthrights has found.

Official National Institute for Health and Care Excellence (NICE) guidelines states: "For women requesting a caesarean section, if after discussion and offer of support… a vaginal birth is still not an acceptable option [trusts should] offer a planned caesarean section."

However, a Freedom of Information investigation by the charity found that pregnant women in some regions who ask about the procedure are simply told to go elsewhere.

The research found that 15% of trusts have policies or processes that explicitly do not support maternal request caesarean, and 47% of trusts have policies or processes that are problematic or inconsistent. Only 26% of trusts offer caesareans in line with NICE best-practice guidance.

Lawyers, acting for the charity, expressed concern that at least one trust may be acting unlawfully by only offering the procedure on medical grounds.

Maria Booker, programmes director at Birthrights, said, “Trusts are bound by human rights duties to offer individualised care. Any statement or policy from a trust that caesarean would only be granted on medical grounds may be incompatible with trusts’ obligations to have an open, supportive, two-way discussion that explores all reasonable options. If such a policy is then applied in a blanket way then it could be incompatible with human rights law.”

Rebecca Schiller, chief executive of Birthrights, said: “Maternal request caesareans are the number one reason women contact the Birthrights advice service. The women we support have endured previously traumatic births, mental ill-health, childhood sexual abuse or have carefully examined the evidence available and made informed decisions that planned caesareans will give them and their baby the best chance of an emotionally and physically healthy start.

“It is clear that women requesting caesareans meet judgement, barriers and disrespect more often than they find compassion and support. We are concerned that this lack of respect for patient dignity could have profound negative consequences for the emotional and physical safety of women.”

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