New guidance to reduce epidurals and to achieve a CS target rate of 20%

[HmmThinkingAboutIt]

New guidance to reduce epidurals and to achieve a CS target rate of 20% is apparently being issued by the RCM, RCOG and the NCT.

I'm try to find the original source to be able to read exactly what is proposed, but this is my source at the moment (its a pdf) www.electivecesarean.com/images12-aug-24%20rcog%20ccg%20press%20release%20final.pdf

On the face of it, I'm utterly appalled by this. It seems to be in direct opposition to what NICE, NHSLA and others are saying. And the trouble with targets is they completely neglect individual care, and create a conflict of interests for doctors & midwifes - and ultimately put woman last.

Has anyone else heard about this/got a better source to confirm EXACTLY whats been said before I get too upset about it?

I'm damn sure this is going to upset a few people here...

OH MY GOODNESS. Its the SECOND story on their homepage! Only Kate and Wills second honeymoon comes first.

Its a fairly decent write up (by DailyFail standards ahem). I bet the comments will be interesting though. Its already got 300 - so I guess that says the story is generating interest.

Warning DailyFail Link

www.thesun.co.uk/sol/homepage/news/politics/4513147/Foreign-motherland-1-in-4-new-mums-were-born-overseas.html

So...playing devils advocate reading this article also - can I ask where womens rights - choices come into play when our services are swamped - no measures in place to reduce the numbers of people coming here...

Personally I think women who are denied c sectoins for valid reasons including fear etc should kick up a huge stink - chain themselves to railings if neccasry - its a disgrace, BUT as I said before, its a simple question of numbers.,

Its very easy to say - it should not be about cost.

Of course it shouldnt but with the combined effects not only of health tourism, chaos within the NHS meaning that people dont pay us for their treatment - trusts owed thousands....AND open doors to the EU....

You have shortage anyway of MW's, of resources, you have a hospital that can cater to say 20 labouring women but your turning away many more than that and you will get slated for that....

where on earth CAN womens choices and rights fit in!

They are in crisis, they have too many " service users" with no end in sight..what can they do.

You can talk about womens choices and rights and feelings but there are number crunchers out there trying to come up with ways to reduce cost of a mass population boom.

You do two things, you start to get vocal about immigration and you start to get vocal about not being the easily picked on group with which to cut costs with.

Eliza I read a similar article yesterday from another paper.

My feeling with regard to immigration is that we NEED it and I do take issue with foreigners being blamed. If they are contributing to the economy I don't have a problem with it at all, and the majority of immigrants DO - what you are doing is making the assumption that they don't. With respect, I find comments about immigrants being to blame in hard times, particularly distasteful and ignorant when you look back to the history of the 1930s.

The problem isn't necessarily with immigration - its with PLANNING for immigration and planning for an increase in the birth rate - which hasn't just been restricted to immigrants. There is no flexibility in the system, which is worrying. If we had some sort of epidemic or emergency it makes you wonder how we would cope if we can't manage it on a longer term basis when it was obvious this was going to happen. The baby boom didn't just happen overnight. There was enough time to make provision for it.

The UK has always relied on new blood. Its what makes us strong, not weak. And given how low the birth rate was for British born women a few years ago, and the problems that could have caused, we certain shouldn't necessarily see 20% of the female fertile population being foreign as being bad. Japan is the classic example of how an aging population is a real problem.

No only that, but the problem of immigrants giving birth here, is very very regionalised - in some areas it accounts over 50% but in others its less than 5%. And yet the same restrictions are being talked about in areas which are able to cope. Don't forget, that the fertile population is the working population so the group most able to pay tax rather than tax from the system.

I think its a totally different debate and one for another thread as it rather detracts from this one.

If it reduces the EMERGENCY c/s rates while improving maternal and neonatal outcomes then I'm all for it.

As long as they achieve this reduction in the following way:

• by increasing access to waterbirth
• by increasing access to one to one care in labour
• by increasing access to out of hospital birth
• by reducing rates of routine induction for post dates pregnancy

All these things result in fewer REQUESTS for epidural pain relief.

Please god they don't just take the easy and cheap route to reducing epidural use by restricting availability in CLU's.

Sadly government penny pinching makes the latter more likely than the former.

Reducing routine anything would be good - so that care is tailored to the woman in question.

Shag, the use of epidurals is restricted already in CLU's because of high activity and insufficient staffing.
There is no 'target' in hospitals to reduce this number.

'Maternity wards should not be running at crisis management levels on a regular basis'
But thats it, they are. In realityou can't pull extra staff in all the time. The trusts don't want to pay for the extra staff. And if they do, whos going to replace them on the next 12 hour shift? Its unsustainable.

Couvelaire I agree it is unsustainable and given the funding through taxation there isn't an excuse for the trusts not to pay for the extra staff. There is a problem with recent immigrants having children in the UK. I was shocked that the NHS was happy to cover me coming to the UK from the US five months into a pregnancy.

In addition, when we were looking at moving back DH was advised that he would be non-dom for the first 3 years so would be able to deduct rent from his income and would not pay national insurance. This should not be allowed as the taxes pay for services such as the NHS and education.

The RCM have issued this statement in repsonse to the negative attention.
www.rcog.org.uk/what-we-do/campaigning-and-opinions/statement/rcog-statement-response-joint-commissioning-document

Nice clarifications. That's not what they said at all!

The RCOG statement is a great improvement on what went before. This Doula statement was posted on the feminism board thread about Csecs and epidurals - I was encouraged that they acknowledge that maternal choice is important.
Well done everyone, for raising awareness of this issue!

doula.org.uk/content/doula-uk-responds-new-guidance-normal-birth