A report on the variations in practice and procedure across NHS Trusts in the UK
At Tees, we are increasingly supporting women who, despite requesting a caesarean section or raising concerns about vaginal delivery, have been counselled in a way that steers them toward a vaginal birth.
Many of these women are unaware that nearly 40% of births in the UK involve either instrumental assistance or a caesarean section. For first-time mothers, this figure rises to 50%. Furthermore, around 4% of women experience third or fourth-degree perineal tears during childbirth, which can result in life-changing, long-term issues with bowel control and incontinence.
Sadly, many go on to endure traumatic births, often leading to serious and lasting physical and/or mental health problems. In some cases, their babies also suffer injury.
The copyright in this report belongs to Tees Law. Tees Law gives permission for extracts from the report to be used provided a suitable credit to Tees Law is given and a link to the full report published.
In 2018, Birthrights – a charity dedicated to promoting women’s rights in childbirth, published a report into Maternal Request Caesarean (MRCS). These are planned caesarean sections requested by pregnant women without a medical indication.
The report revealed that, despite NICE Guideline CG132, nearly 75% of NHS Trusts did not have written policies supporting a woman’s right to choose a caesarean.
It concluded that “the majority of Trusts in the UK made the process of requesting a caesarean lengthy, difficult or inconsistent, adding anxiety and distress to women at a vulnerable time.” The report called for greater transparency around the variation in policies and procedures between NHS Trusts.
Three years have passed since the Birthrights report was published. With no further research on this issue that we were aware of—and with our Medical Negligence team continuing to support women like Niamh and Anna, who have faced disempowerment and difficulty when giving birth—we undertook our own investigation in May 2021. Our goal was to assess whether practices and procedures regarding MRCS had changed across NHS Trusts since 2018.
