New Research Argues Against Maternal Request Bans in NHS

CBCAN Nicola Prentis - Quote - fought long and hardNew research argues that “resource pressures should not be used to justify limitations in the CS rate” and warns that women whose caesarean request is refused “may be more likely to litigate if there are adverse outcomes.

The paper, which has a great title (my bold) Caesarean section rate and postnatal bed occupancy: a retrospective study replacing assumptions with evidence, was published in the BMC yesterday.

Authors Subhadeep Roy and L Montgomery Irvine work in the Departments of Obstetrics & Gynaecology at Watford General Hospital and Cambridge University Hospitals NHS Foundation Trust.

Here are some highlighted extracts:

2018 Caesarean section rate and postnatal bed occupancy- a retrospective study replacing assumptions with evidence - extract 1 border

2018 Caesarean section rate and postnatal bed occupancy- a retrospective study replacing assumptions with evidence - extract 2 border

2018 Caesarean section rate and postnatal bed occupancy- a retrospective study replacing assumptions with evidence - extract 3 border

2018 Caesarean section rate and postnatal bed occupancy- a retrospective study replacing assumptions with evidence - extract 4 border

2018 Caesarean section rate and postnatal bed occupancy- a retrospective study replacing assumptions with evidence - extract 5 border

* * * * *

Lastly, I would add one piece of additional information to the study.

The authors write, “We are not aware of any change in policy regarding timing of discharge post-Caesarean locally or within the wider NHS that would specifically account for the fall in length of stay.

There is in fact an “Enhanced recovery after planned caesarean section programme” in place at a number of NHS maternity hospitals.

The 2016 example above is from University Hospital Southampton NHS Foundation Trust, and says it “aims to have you fit and well enough to go home the day after your caesarean section.

This 2017 Norfolk and Norwich University Hospitals NHS Foundation Trust guideline is another example: Trust Guideline for the Management of Enhanced Recovery for Caesarean Section Patients.

I particularly like the statement here on Patient Selection: “Patient needs to be fully engaged in the enhanced recovery process and willing“.

These recovery programmes are also referred to in a number of CQC inspection reports.

 

  • Written author and journalist by Pauline Hull 

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