Psychiatric help to be offered to women too scared to give birth naturally
Psychiatric help to be offered to women who insist on a caesarean because they are too scared to give birth naturally
3:00 AM on 24th May 2011
Overcoming fears: The counselling will try to persuade women to give birth naturally
Women who ask for a caesarean because they are too frightened to give birth naturally will be offered psychiatric counselling under guidelines from the health watchdog.
They will also be informed about all the risks of a c-section – including damage to their organs or even death of the newborn – in an attempt to make them change their mind.
The NHS is trying to curb the soaring rate of caesareans, which now account for nearly a quarter of all births, more than twice as many as 30 years ago.
There are concerns among leading doctors and midwives that many healthy women are choosing to have the procedure because they are worried about the trauma of birth and the physical effect on their bodies. The syndrome has been labelled ‘too posh to push’.
Under draft guidelines issued by the National Institute for Health and Clinical Excellence, expectant mothers who are very worried about labour will be referred to counselling sessions with a psychologist, psychiatrist or doctor.
It is hoped the sessions will help women overcome their fear and decide to try to give birth naturally.
If, despite the counselling, they are adamant they want the operation they will still be able to have it carried out on the Health Service.
There is some evidence that growing numbers of women are so put off by their experience of giving birth the first time round they decide to have a caesarean when having subsequent children.
Last year, birth trauma clinics offering special counselling sessions reported that the number of expectant mothers using their services had doubled over 12 months.
There are concerns that women afraid of giving birth are increasingly given caesareans when in the past they used to be carried out in emergencies only. The operations account for 23 per cent of all labours compared with just 9 per cent in 1980.
Research shows that they are far riskier than natural births, with some studies showing babies are twice as likely to die.
Riskier than natural births: Rates of caesarean section have been rising in developed countries over the past four decades
Women often find it harder to bond with the newborn while recovering from surgery and they tend to stay longer in hospital than those with normal deliveries.
The procedures are also far more expensive, costing the NHS around 2,500 each compared with 750 for a natural birth.
Christine Carson, programme director for the Centre for Clinical Practice at NICE, said: ‘Rates of caesarean section have been rising in developed countries over the past four decades. In England, the rate was 13 per cent in 1992, whereas in 2008/9 it was 23 per cent .
‘Recent evidence shows that a caesarean section is not necessarily the best course of action in some cases, for instance, where the mother has had previous caesareans, or is HIV positive.
‘This new updated guideline includes revised recommendations for these scenarios.’
Elizabeth Duff, senior policy adviser at the National Childbirth Trust, said: ‘When a woman’s needs are more complex because of a medical complication, a caesarean section may be necessary.
‘But when a woman’s pregnancy is normal and there are no medical complications there is good evidence that most women want to give birth with minimal intervention. A normal birth is safer for both mother and baby.
‘Referral to a healthcare professional to help address a woman’s fear of childbirth is a good way of providing support and enabling the mother to have a positive experience of birth.’