RCOG is standing by its controversial document - statement released Thursday
PMHull · 07/09/2012 11:49
Extract: "It was removed from the RCOG website for a week for further scrutiny following misleading media reports but has now been reinstated." You can read the full statement here.
I don't think it's misleading to warn women that the RCOG, RCM and NCT say it's important for there to be more 'normal births', even if that means more "antenatal, delivery or postnatal complications (including for example post partum haemorrhage, perineal tear, repair of perineal trauma, admission to SCBU or NICU)".
As a start, I'm going to request that the last word in this sentence is changed to advisable: "The RCOG supports patient choice in the place of birth but reiterates that choice is not always feasible."
But what do others think - do you feel that choice is in danger of being promised but not delivered? And shouldn't we be striving to achieve outcomes that are actually better than 'normal' (as defined here)?
Sioda · 07/09/2012 18:54
Ugh what a bunch. Of course having issued it they couldn't lose face by abandoning it. I love this bit:
"The RCOG supports the concept of ?normal birth? for women where clinically appropriate. Normal birth refers to birth without medical intervention."
That's not how it's bloody defined in the document as they well know and as you've pointed out. And the document does not say they just 'support' it where clinically appropriate. Concepts don't care if you support them or not. It says they think it's important to increase the rate of it. And to make midwife-led care the default for low risk women. As if it's just a matter of 'nomenclature' to say that it's important to increase rates of birth without medical intervention regardless of the actual outcome. A blatant attempt to reframe what they said without amending the damn guidance. And the results of this nonsense is clear every single day on the Childbirth forum - women being refused caesareans and epidurals on a daily basis, women spending their entire pregnancies in fear that they won't be 'allowed' a caesarean.
As for this 'guide' vs. 'target' distinction - who are they trying to fool? Are they trying to pretend that this is the first time anyone has attempted to define an ideal rate for caesareans and how that worked out? More blatant reframing. How is a 20% guide any better than a 20% target? Shouldn't the guide be what's most appropriate for each patient on an individual basis, with no reference to some arbitrary nice round overall number? Or has some genius done extensive research and found that 19% is too few caesareans and 21% is too many? Goldilocks logic applied to women and babies' health and lives.
And of course they totally ignore the issue of choice of mode of birth other than to fob it off back to NICE as if there was no conflict between that and his guidance. God forbid women should ever be allowed to choose intervention.
Waffle written by their PR hacks. Didn't expect any better unfortunately. The RCOG serve the bean counters not their patients.
KatMumsnet · 10/09/2012 08:59
Hi, we've moved this into Childbirth at the OP's request. Thanks.
Ushy · 10/09/2012 10:30
Definitely, Kat, this is all about saving money at women's expense. For normal read cheap.
If you read some of the horror stories about maternity care on mumsnet, you read words like 'barbaric' 'traumatised' 'horrific' 'terrified'
Sorry, the whole 'normal' rhetoric makes me sick. So called normal birth has been the biggest killer of young women since the dawn of time.
It is a disgrace that the best the NHS wants to offer is a sound proof room where your screams won't be heard and a base line service that won't leap into action until you and the baby are half dead.
DolomitesDonkey · 10/09/2012 10:48
What a shame they're doing this - I'm sure "normal birth" is better - but fear their report will be used to bully women in to a situation unsuitable for them.
I used RCOG guidelines (with the backing of my consultant) to argue my case for elcs.
Badgerina · 10/09/2012 12:11
Are they going to be improving antenatal care in order to prepare women for "normal birth"??? I'm guessing this refers to the reduction in availability of epidurals? Simply making them less available isn't going to make them any less needed by some women. Better antenatal care and preparation, including continuity of care during labour would though! They are going about this ALL WRONG
Jules125 · 10/09/2012 14:31
I just think we should be trying to improve outcomes for women and babies (less stillbirth, premature delivery, operative complications of any kind etc). Any incentives should be for this, and not for the process (i.e. reducing caesareans or pain relief). I don't fully understand why all the rhetoric seems to so be focussed on how women give birth (rather than how they and their babies are afterwards)? I think that focus is to a large extent ideological (and not just mainly about cost). The RCOG statement reads better to me than the original document (but is no good on its own if they won't alter the document).
To comment on this thread you need to create a Mumsnet account.