NICE has published an update to its existing guidelines on caesarean section (CS) in light of new published evidence and changes in clinical practice.
The updated NICE guideline contains several new and updated recommendations on various aspects of the procedure, but recent media speculation has been wrong to suggest that NICE is saying that all pregnant women should be offered the option of an elective CS. Dr Gillian Leng, NICE deputy chief executive, said: “This guideline is not about offering free caesareans for all on the NHS; it is about ensuring that women give birth in the way that is most appropriate for them and their babies. For a very small number of women, their anxiety about childbirth will lead them to ask for a CS. “The new recommendations in this guideline mean that these fears will be taken seriously and women will be offered mental health support if they need it. If the woman’s anxiety is not allayed by this support, then she should be offered a planned CS. For women who ask for a CS in the absence of any clinical indication, physical or mental, the guideline says they should be asked why they are requesting the operation, and be provided with full information about the risks and benefits. “They should also be offered the opportunity to discuss the procedure with other members of the obstetric team. If, after this, they still want to have a CS, they should be allowed to have one. Offering these women a planned CS in these circumstances is a very long way from saying that CS should automatically be offered to every woman.”
