Health experts relax guidelines over Caesareans despite costs

A review said women who are anxious about childbirth should have their “fears taken seriously” and be offered mental health support.

If a woman still wants a section after receiving counselling and weighing up the risks of the operation, she should be granted one.

And those women who do not have medical or mental health reasons for wanting sections should also be given them, according to the guidance from the National Institute for Health and Clinical Excellence (Nice).

These women should first be given full information on the risks and benefits and as well as opportunities to discuss their views with members of their obstetrics team.

Just under one in four births in the UK are by Caesarean sections with between half and two-thirds being carried out as emergencies because of birth problems. The rest are planned, and these include women who have had complications in pregnancy, such as low lying placentas, but most are women who have had previous Caesareans.

Experts said they believe the recommendations will lead to fewer Caesareans.

Planned Caesareans cost the NHS an average of £2,369 while vaginal births each cost £1,665.

Overall, experts expect the guidelines, including the cost of counselling women anxious about childbirth, to cost £503,900 in England.

Nice deputy chief executive Dr Gillian Leng 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.”

She said the guidelines were largely reflecting current practice in many organisations and said they had no experience of women requesting a Caesarean because they were “too posh to push”.

Belinda Phipps, chief executive of the National Childbirth Trust (NCT), said: “When women are treated with respect, and are offered support and information tailored to their concerns, very few of them will choose a Caesarean birth unless there are clear health reasons. However, our services fail women badly at the moment, with midwifery numbers well below the level required to guarantee safe and satisfying care. We hear from too many women who have found their experience traumatising in some way.”

The guidelines came as a report from the Royal College of Midwives warned maternity services in England and Wales had been “overwhelmed” by more births.