FOI Request
- Disclosure ID
- FOI/02107
- Request Date
- December 20, 2017
- Subject
- Caesarean Sections
- Description
- Advise how many maternal request caesarean sections with no obstetric, medical or significant psychological reason were carried out by each obstetric unit within your Trust between April 2016 and April 2017.
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We do not routinely record the requested level of detail. To determine if we hold this information and retrieve it would require a manual trawl of patient case notes which would exceed 18 hours. This information is therefore exempt on the grounds of cost (Section 12(1)).
Provide a copy of any locally agreed guidelines, staff guidelines and patient information leaflets that explain how requests for maternal request caesarean sections will be handled by the Trust. - Please provide an explanation as to how you specifically meet NICE CG132 1.2.9.5 and if you are not, please provide the reason.
- Response
- We do not routinely record the requested level of detail. To determine if we hold this information and retrieve it would require a manual trawl of patient case notes which would exceed 18 hours. This information is therefore exempt on the grounds of cost (Section 12(1)).
- The Trust Caesarean Section – Pre Operative, Intrapartum And Postpartum Management Of Pregnant Women Guideline OBS/GYNAE/GUID/017 and updated guideline are currently awaiting final approval. The updated guideline has an added section on maternal request for caesarean section.
Our Trust also has a patient information leaflet. Patients are signposted to the NHS choices website section on information on Caesarean section which has contains section on Asking for a caesarean section.
3.2.5 Maternal request for Elective Caesarean Section
All women who request a caesarean section without a clinical indication should be seen in pregnancy for counselling of the risks and benefits by 2 different consultants. An appointment with a second consultant should be
requested as early in pregnancy as possible, to allow time for the appointment to occur before delivery (ideally at the first opportunity that the patient makes this request).
The NHS choices website advises women they can ask for a caesarean section as follows
Asking for a caesarean:
Some women choose to have a caesarean for non-medical reasons. If you ask your midwife or doctor for a caesarean when there aren’t medical reasons, they will explain the overall benefits and risks of a caesarean compared with a vaginal birth.
If you’re anxious about giving birth, you should be offered the chance to discuss your anxiety with a healthcare professional who can offer support during your pregnancy and labour.
If after discussion and support you still feel that a vaginal birth isn’t an acceptable option, you’re entitled to have a planned caesarean
Please see attached policy document.
http://www.bfwh.nhs.uk/wp-content/uploads/2015/08/PL197.pdf
http://www.bfwh.nhs.uk/wp-content/uploads/2015/08/PL818.pdf - NICE CG132 1.2.9.5 For women requesting a CS, if after discussion and offer of support (including perinatal mental health support for women with anxiety about childbirth), a vaginal birth is still not an acceptable option, offer a planned CS. [new 2011]
This has been addressed in the updated Caesarean Section – Pre Operative, Intrapartum And Postpartum Management Of Pregnant Women guideline (attached) with the addition of a section on maternal request for caesarean section as below. This policy has been approved within the division and is currently awaiting pharmacy approval.