Tuesday 1 November 2011

Should All Expectant Mothers Have a Right to a Caesarean?

This has been hot news this week, all major papers are reporting that NICE (National Institute of Clinical Excellence) are about to change their guidelines in relation to caesarean sections, stating that all expectant women will have a right to one, should they want it.

Some of the commentary I have read on this has verged on the ridiculous. Usually accompanied by a picture of Victoria Beckham, "victory for too posh to push brigade" has been stated more than once, by a number of newspapers. It's made me extremely angry, to be honest.

Some of the comments about those of us who have had caesareans has bordered on the abusive, and certainly could be classed as ignorant. I've seen comments like "people should not be allowed to have caesareans for cosmetic reasons". Just what is cosmetic about a caesarean? It's hardly a boob job or a tummy tuck now is it?

There are a few points I'd like to raise. Firstly, NICE guidelines are guidelines, that is best practice in written form that hospitals and doctors can choose to follow, they do not have to. For example there is a NICE guideline that talking therapies should be offered as first line treatment for depression. When I went to see my GP about depression earlier in the year, she got the prescription pad out immediately, and laughed when I said I wanted talking therapy. There is no guarantee that women will automatically be granted sections just on the asking.

A caesarean section is major abdominal surgery, and not a procedure that any woman would enter into lightly. Currently I know a number of women who want caesareans for very sound reasons who have to fight for them. Some of these reasons are tokophobia (a fear of childbirth), previous still births, and previous difficult vaginal delivery.

Expecting a child is a difficult time for many mothers, and for many of them the first time they have had to deal with hospitals and doctors.

I do believe, very much, in the empowerment of patients to make sound decisions, but so often in the ante natal system, there aren't time for these discussions, and much less for serious reassurance and explanations to be given.

If the most this guideline does is open up the lines of communication, then that to me is a good thing. Yes caesareans cost an additional £800 compared to a lambing end delivery, but in many situations they are warrented, and complicated deliveries, particularly those that end badly, with damage to the mother and baby, can cost much more.

It saddens me that childbirth is so competitive, that people make assumptions, and do not listen to all sides of the argument.

I am unsure that I would agree that all expectant mothers should have a right to a section, but I believe all expectant mothers should have the right to ask for one, and have the right to be listened to, and to be spoken to with regard and respect. 

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