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The Ockenden Report - the caesarean option.

View profile for Kim Daniells
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One issue that is highlighted in the Ockenden report is that of women being discouraged from having caesarean sections. This appears, at least at one time, to have reflected wider concern against child birth becoming overmedicalised and about the risks associated with surgical delivery.

Woman who put their faith in medical professionals were advised and encouraged to deliver babies “naturally” as part of a policy intended to mark out the Trust as one that was ahead of the curve. 

In fact, in Shrewsbury and Telford women in urgent medical need of a caesarean section were still encouraged to go through with vaginal delivery of their babies.  Babies died.

Although the systemic issues at Shrewsbury and Telford might not have occurred elsewhere, all too often we hear stories of women who have good and genuine reasons for wanting caesareans but are persuaded and encouraged that a caesarean is not necessary and that a vaginal delivery will be better for them and better for baby. Thankfully, in most cases, there are no long term adverse consequences for mum or baby.

However, for women who suffer the physical injury of fourth-degree tear or the psychological trauma that haunts their waking and sleeping moments for years to come, there may be no option of looking back and thinking that 'all’s well that ends well'.

For families who face the loss of a baby in childbirth or whose babies face a lifetime of disability because of avoidable hypoxia, there may instead just be an opportunity to reflect on what might have been, and sometimes an entirely unjustified, but nevertheless, genuine feeling that if only they had said more, complained more, argued more, things might just have turned out differently.

The law makes it clear that patients should consent to treatment and that consent should be informed.  We no longer live in a world where it is difficult to access information about maternity and childbirth issues and women are increasingly embarking upon pregnancy and child birth having taken time to learn about and understand what to expect.  

What is needed now, and especially in light of Ockenden, is for women to be included in the discussions and decisions in relation to their care.