Maternal request for caesarean section

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At Milton Keynes University Hospital (MKUH) we recognise that women need to be supported to make sure the reasons for their request for a caesarean section are explored and that a comprehensive discussion of the risks and benefits of caesarean section occurs.

There are many reasons why you may want to choose to deliver by caesarean section. This may be due to a previous traumatic birthing experience, physical reasons following a previous delivery or an extreme fear of pregnancy and childbirth (Tokophobia). If you suspect you have Tokophobia we can offer you a referral to Talk for Change where you will receive psychological and prenatal support from a healthcare specialist so that we can support you through your decision-making process. This can enable you to make a fully informed choice that is right for you.

I am thinking about having a caesarean section – who do I need to speak to?

Speak to your community Midwife or obstetric Doctor initially. Any woman who makes a request for an ‘Elective caesarean section for maternal request’ will be referred to the Birth Options Clinic in the first instance, ideally early on in the pregnancy so the reason for requesting a caesarean section can be explored.

Here, you will be offered focused midwifery support where the rationale and reason for your request is explored. We will discuss and document in your personalised care plan the specific reasons for your request and take into account your circumstances, concerns, priorities and plans for future pregnancies.

Advice will be given on the risks and benefits of both a caesarean section and a vaginal delivery and you will be provided with the Royal College of Obstetricians & Gynaecologists (RCOG) ‘Choosing to have a caesarean section’ patient information leaflet. The information given at this appointment will enable you to make a fully informed choice regarding your birth options.

I still feel that a caesarean section is the right choice for me – what happens now?

If you are certain that you do not want a vaginal birth and you understand the risks of a caesarean section and the impact on future births, a referral will be made to a Consultant Obstetrician. Here a member of the obstetric team will discuss your decision for a planned caesarean section.

If you have no medical or obstetric clinical indication for an elective caesarean section and the Consultant Obstetrician feels that they cannot agree with your request of a caesarean section, then you will be referred to another Consultant Obstetrician. The decision to perform an elective caesarean section at maternal request needs to be agreed by two consultants before it can be confirmed and booked.

More information on caesarean section: