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Women being denied childbirth choices

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Alice Sanderson, August 24, 2018

New research has revealed only a quarter of hospitals follow NHS guidance that women’s choices on how to give birth should be respected by the NHS.

Guidelines

In 2011 The National Institute for Health and Care Excellence (NICE) issued guidance that, for the first time, said the NHS should respect women’s choices on how to give birth. Charity, Birthrights, investigated how many NHS hospitals are following the guidelines. They requested information from all NHS maternity units on their policies for caesareans, using Freedom of Information laws. They received responses from 97 per cent of the units.

The guidance says that women should first be offered a discussion of birthing options, and any woman fearing childbirth should be offered help. If the woman then still wished to have a caesarean, this should be offered to her.

Investigation

Birthrights’ data reveals that only a quarter of hospitals follow NHS guidance on a woman’s right to choose, and one in seven explicitly refuse this choice, using the excuse of reducing medical intervention.

One such hospital is the John Radcliffe Hospital in Oxfordshire, where the policy in place refuses all caesareans requested by the mother. Lawyers for the charity have written to the hospital asking for more information on the policy.

A further 44% of trusts had vague, inconsistent and ‘sketchy’ policies surrounding caesareans, meaning patients were confused whether the option was available to them.

’Judgmental attitudes’

Rebecca Schiller, chief executive of Birthrights, said: “It is clear that women requesting caesareans meet judgmental attitudes, barriers and disrespect more often than they find compassion and support.”

The revelations follow the recent end of a decade-long campaign by the Royal College of Midwives, that backed ‘normal birth’ without interventions. They felt that the campaign made women feel like failures if they had their baby through a caesarean.

The vice-president of the College, Alison Wright, said the failure to offer birthing options “denies women choice about their birthing experience and highlights the importance of Trusts updating policies”.

A spokesperson for NICE said: “If a woman decides a c-section is the best option for her and there is no clinical reason for it not to be, we should all work to support her choice.”