Birthrights.org, Maternal Request C Sections and NHS Trusts refusing them

[RedToothBrush]

Thought a few people might be interested in this

In May Birthrights.Org launched a campaign to try and engage with NHS Trust who do not allow maternal request c-sections.

www.birthrights.org.uk/2017/05/do-i-have-a-right-to-choose-a-caesarean-section/
Do I have a right to choose a caesarean section?

They have been pro-active in trying to get this changed to reflect better care to women.

They have been trying to take on Oxford University Hospitals over it.
www.birthrights.org.uk/2017/07/do-i-have-a-right-to-a-c-section-update-on-oxford-university-hospitals/
Do I have a right to a c-section? Update on Oxford University Hospitals

They are encouraging anyone having trouble with their request for a C-Section to contact them or to make them aware of Trusts with blanket bans.

This is not being pro-CS. In fact they have experience in finding this approach to reducing CS is actually counter productive.

SimonMehigan, who is a senior midwife with experience in the field explains in this article:

www.birthrights.org.uk/2017/09/how-should-health-care-professionals-handle-a-maternal-request-for-caesarean/
How should Health Care Professionals handle a maternal request for caesarean?

Saying no initially to a women’s request for an elective caesarean section creates an antagonistic starting point for discussion and doesn’t reduce the overall caesarean rate.

His experience is really interesting and perhaps surprising.

I just wanted to try and spread the message about this, as there so many regular posts on the subject looking for help and advice. The more awareness there is on the subject the better and perhaps it can help change the approach of hospitals who are being so regressive in their policy.

The midwife interviewed in the last link speaks so much sense. I wish there were more midwives like this.

I'm at Kingston (23 weeks with my first) and so far they have been supportive of my ELCS request. I am having such a positive experience with them.

This is really interesting reading Red - thanks for posting! I know that being pushed back by the midwives and consultant when I made my request only caused me lots of stress and strengthened my resolve to get it signed off

Sadly it's often out the hands of the midwives, doctors and even the hospitals.

Don't know if it still happens but pre CCG days the local commissioning group at Derby would not pay Derby hospital for a section undertaken on a woman unless there was a medical need. Maternal request didn't count so if a consultant agreed to one they'd be bollocked as the hospital wouldn't be paid. And we all know accountants run the NHS.

So it might be that this campaign needs to be aimed at the CCGs, they are the ones who have to pay for any treatment a pregnant woman has. The more intervention she has the more they have to pay.

Did you read the articles? It about how reducing maternal requests often is about just saying no. It's also about how the request is handled. If done sensitively it can also reduce demand.

Maternal is often for mental health reasons. CCGs still fall under the NHS charter which states that people have the right to the most appropriate care.

The argument here is that the system is in part making that was and can inflame mental health issues. Making anyone denying requests in this particular way part of the problem not the solution.

The campaign is about trying to point out this problem with the system and ways to address flawed thinking which is actually potentially driving requests up and not down.

If hospitals can make this case in this way then CCGs are going to find more difficult to refuse.

In addition there have been changes to the formula and funds for this area if care which includes extra for mental health.

It's about changing how the whole thing is approached by actually understanding the problem rather than making assumptions based on flawed understanding.