Caesareans on demand?

The NHS may give women the automatic right to caesarean, if new draft guidelines from the National Institute for Health and Clinical Excellence (NICE) are approved.

The current rate for the procedure is 25%, which has doubled over the last 30 years and is higher than the 15% recommended by the World Health Organisation.

Emergency caesareans cost twice as much as natural births, which are £3,042 and £1,512 respectively. Planned caesareans cost £2,369. The extra money is needed as caesareans require an operating theatre, more staff and a longer stay in hospital.

Guidelines by the National Institute for Health and Clinical Excellence currently state: “Maternal request is not on its own an indication for Caesarean section” and that: “An individual clinician has the right to decline a request for Caesarean section in the absence of an identifiable reason.”

The recently updated document states: “For all 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.”

Patrick O'Brien, consultant obstetrician working in London, told the BBC: “It's laudable what they've done, I'll support it. I don't think it changes practice a whole lot. It is formalising what was informally happening in most hospitals.”

If the changes are approved, the updated NICE guidelines will be published at the end of November.