Majority of maternity units deny women the choice of a caesarean, charity warns

WOMEN at three quarters of maternity units are being denied the right to choose a caesarean section birth, research suggests.

Guidelines from the National Institute for Health and Care Excellence state women who ask for a caesarean should be offered one if, after support and discussion with a doctor, they feel it is best for them. But a report by Birthrights, the childbirth charity, found only 26 per cent of trusts were abiding by the guidelines and many women faced delays and difficulties in requesting a caesarean section on non-medical grounds.

Experts raised concerns that women who had previously undergone traumatic births would be unable to access the care they need.

The charity said it feared that women who may have been through sexual assault or were vulnerable due to language barriers, mental health problems or learning difficulties were being forced to undergo unsafe vaginal births. Overall, the charity’s research found that 47 per cent of trusts had inconsistent or confusing policies.

It found 28 per cent of women requesting a caesarean section did so because they had an underlying health problem, such as pelvic pain, that did not meet the medical threshold for requiring a caesarean section.

Rebecca Schiller, the chief executive of Birthrights, said: “Women requesting caesarean sections meet judgmental attitudes, barriers and disrespect more often than they find compassion and support.” She said some women were denied the procedure on cost grounds. A caesarean section costs about £700 more than a vaginal birth.

Lucie Tidman, 32, said she was refused a caesarean section despite pleading for one for the birth of her second child. When she gave birth to her first child, six years ago, she had a serious haemorrhage. The second delivery resulted in another haemorrhage and the baby was sent to neo-natal intensive care. The Royal Cornwall Hospitals Trust, where Ms Tidman gave birth, said: “If a woman requests a caesarean section when there is no clinical indication, we follow the guidelines, but only after thorough exploration of all the issues.”

Prof Baskaran Thilaganathan, from the Royal College of Obstetricians and Gynaecologists, said: “I don’t think there is any circumstance under which, if you feel a woman has been informed, understands her choices ... that you could deny her the right to that.”

Gill Walton, the chief executive of the Royal College of Midwives, said: “Women must be given the information to explore their views and feelings about caesarean birth, to enable them to come to an informed decision about their preferred type of birth.”

The Department of Health said: “It is vital that women feel informed and supported in making safe choices around childbirth and we expect doctors and other NHS staff to work closely with mums-to-be to make sure they are given the right options where appropriate.”