National Institute for Clinical Excellence Guidelines (NICE)
The media press coverage of the latest NICE guidelines has given the distinct impression that they will offer a caesarean section to any woman who wants one. It has even been reported by some as offering a caesarean on demand for the so called "too posh to push". That interpretation of the guidelines however is untrue and in fact what they do set out are the medical circumstances where one is recommended, as well as where one is not. What they also stipulate is that medical professionals should discuss all the options with a woman who has a preference for undergoing a caesarean birth.
In particular a pregnant woman should be given all of the evidence-based information about caesarean sections. This will include information about the reasons why a caesarean section might be used, as well as what the procedure involves. Importantly risks and benefits associated with a caesarean section must be explained by a doctor, together with any implications the procedure may have not only for the current pregnancy, but also for future pregnancies and births.
The guidelines go on to state that the clinical decision about whether or not to carry out a caesarean section should specifically take into account a woman's circumstances, together with her concerns and priorities.
In short, a pregnant woman should be fully informed about her option of a caesarean birth. She should know all of the implications that arise from her decision whether or not to have a caesarean section not only for that delivery, but also for any future delivery.
Cerebral Palsy
It is a recognised risk that when a woman, who has previously had a caesarean and in a later pregnancy subsequently undergoes an induced delivery, that her caesarean scar may rupture. If this happens then the baby may be deprived of oxygen and possibly develop cerebral palsy as a result.
Unfortunately this risk has not always been explained or explained properly to pregnant women when deciding how to give birth. Accordingly those pregnant women have been unable to make an informed choice about whether to decline an induced birth or elect for a caesarean birth instead.
It is hoped that the recent NICE Guidelines will now ensure that women are much better informed of their options so that they can decide for themselves what is the best and safest delivery for their own child.
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