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NICE urges more info on pros and cons of C-section

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Healthcare workers have been urged to alert pregnant women to the pros and cons of elective caesarean sections, officials said.

The number of C-sections has increased “dramatically” in the last 30 years, now accounting for around a quarter of all births, but experts say that some women are “confused” about the procedure.

New advice from the National Institute for Health and Care Excellence (NICE) states that women who request a caesarean section should have a “documented discussion” with their maternity team about the risks and benefits of the operation.

Pippa Nightingale, head of midwifery at Imperial Trust in London, said: “As a midwife working in a busy London hospital, I know that some women request a planned caesarean section because of fears that their care will not be good enough and concern that they will not receive enough support during labour and delivery.

“However, after a discussion of all the pros and cons of both types of birth, and having been assured of one-to-one midwifery support and a personal birth plan, many will often choose to try a vaginal birth. Ensuring women are fully informed about their birth options is important, and I am sure this quality standard will be a helpful tool for all involved.”

Jane Munro, quality and audit development advisor at the Royal College of Midwives, added: “It is particularly important that any discussion with the woman on the risks and benefits of caesarean section and the implications for future pregnancies are documented. We are confident that when women are fully aware of the evidence they will not be asking for inappropriate caesarean sections.

“It is also critical that women who have anxieties about birth be referred to a health professional with expertise in providing perinatal mental health support. We know that when such individualised support is offered in consultant midwives’ clinics, these anxieties can be allayed for many women.”

Dr Gillian Leng, director of health and social care at NICE, said: “NICE has developed this standard because up to a quarter of women are now having caesarean sections, and we want to ensure that women who may need or may have had a caesarean section, or are simply asking about them as an option for delivering their baby, have the most up-to-date information about the quality of care they should receive.”


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