Request for information relating to Maternal Request Caesarean Section

The request was successful.

Louise Robinson

Dear Royal Free London NHS Foundation Trust,

Please can you provide me with the following information:

• How many maternal request caesareans were carried out in your Trust between April 2019 and April 2020 with no other significant medical, obstetric or psychological indication?

• What were the total number of caesarean sections carried out in your Trust between April 2019 and April 2020?

• Please confirm how your Trust complies with the revised NICE guideline [NG192] in relation to Maternal Request for Caesarean Birth points 1.2.25 – 1.2.31 – published March 31 2021 https://www.nice.org.uk/guidance/ng192/c...

• Please can you provide information relating to the following questions:

1. Do you have an explicitly stated policy not to offer Maternal Request Caesarean Sections (MRCS) in your Trust?
2. Do you have a written guideline for Maternal Request Caesarean Sections (MRCS) in your Trust? If yes, please provide a copy of the written guideline
3. Do you require a compulsory mental health appointment in order for a Caesarean Section to be offered?
4. Do you have a policy which states the number of weeks into pregnancy the decision for a Caesarean Section would be made? If yes please state number of weeks
5. Are there any other conditions which must be met in order to be offered a Maternal Request Caesarean Section in your Trust? If yes, please provide a copy of the conditions

Many thanks in advance for providing this information.

Yours faithfully,

Louise Robinson

FOI, Rf (ROYAL FREE LONDON NHS FOUNDATION TRUST), Royal Free London NHS Foundation Trust

Dear Ms Robinson

Thank you for your request under the Freedom of Information Act. The reference for this request is noted in the subject header above.

You will receive a response from us within 20 working days of receipt or an explanation as to why this is not possible.

Yours sincerely,

The Freedom of Information Team
Royal Free London NHS Foundation Trust

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FOI, Rf (ROYAL FREE LONDON NHS FOUNDATION TRUST), Royal Free London NHS Foundation Trust

2 Attachments

 

 

   

[1]http://freenet/docs/Comms/Toolkit/020%20...

Royal Free London Group Headquarters

Anne Bryans House

77 Fleet Road

London NW3 2QH

                                                                                                                                                                                                                                            
                               
                                                                                                                                                                                                                                                                                         

 

Dear Louise Robinson

 

 

Thank you for submitting a request for information under the Freedom of
Information Act 2000.  Please find the response below.  This response
covers the hospitals and services managed by the Royal Free London NHS
Foundation Trust, namely the Royal Free Hospital, Barnet Hospital and
Chase Farm Hospital and associated group services.  

 

The response

 

 

•       How many maternal request caesareans were carried out in your
Trust between April 2019 and April 2020 with no other significant medical,
obstetric or psychological indication?

235 Caesarean sections were maternal request

 

•       What were the total number of caesarean sections carried out in
your Trust between April 2019 and April 2020?

2934 total number of Caesarean sections carried out in the trust between
April 2019 to April 2020.

 

•       Please confirm how your Trust complies with the revised NICE
guideline [NG192] in relation to Maternal Request for Caesarean Birth
points 1.2.25 – 1.2.31 – published March 31 2021

 

 

[2]https://www.nice.org.uk/guidance/ng192/c...

 

Please see attached document

Maternal request for caesarean birth

1.2.25

When a woman with no medical indication for a caesarean birth requests a
caesarean birth, explore, discuss and record the specific reasons for the
request. [2011, amended 2021]

Page 3 – maternal request guideline

1.2.26  

If a woman requests a caesarean birth, discuss the overall benefits and
risks of caesarean birth compared with vaginal birth (see the section on
planning mode of birth) and record that this discussion has taken place.
[2011] Page 4 – maternal request guideline

1.2.27

If a woman requests a caesarean birth, offer discussions with the woman, a
senior midwife and/or obstetrician and other members of the team if
necessary, for example an anaesthetist, to explore the reasons for the
request, and ensure the woman has accurate information. [2011, amended
2021] Page 3 - maternal request guideline

1.2.28

If a woman requests a caesarean birth because she has tokophobia or other
severe anxiety about childbirth (for example, following abuse or a
previous traumatic event), offer referral to a healthcare professional
with expertise in providing perinatal mental health support to help with
her anxiety. See the NICE guideline on antenatal and postnatal mental
health for more detailed advice on providing mental health services for
pregnant women. [2011, amended 2021] Page 3 – maternal request guideline

1.2.29

Ensure healthcare professionals providing perinatal mental health support
to women requesting a caesarean birth have access to the planned place of
birth during the antenatal period in order to provide care. [2011, amended
2021]

1.2.30 YES

If a vaginal birth is still not an acceptable option after discussion of
the benefits and risks and offer of support (including perinatal mental
health support if appropriate; see recommendation 1.2.28), offer a planned
caesarean birth for women requesting a caesarean birth. [2011, amended
2021] Page 3 – maternal request guideline

1.2.31

If a woman requests a caesarean birth but her current healthcare team are
unwilling to offer this, refer the woman to an obstetrician willing to
perform a caesarean birth. [2011, amended 2021] N/A

 

•       Please can you provide information relating to the following
questions:

 

1.      Do you have an explicitly stated policy not to offer Maternal
Request Caesarean Sections (MRCS) in your Trust? No

 

2.      Do you have a written guideline for Maternal Request Caesarean
Sections (MRCS) in your Trust? If yes, please provide a copy of the
written guideline Yes, please see attached

 

3.      Do you require a compulsory mental health appointment in order for
a Caesarean Section to be offered? Dependent on individual reason for
request and current care

 

4.      Do you have a policy which states the number of weeks into
pregnancy the decision for a Caesarean Section would be made? If yes
please state number of weeks Approximately 36 weeks gestation

 

5.      Are there any other conditions which must be met in order to be
offered a Maternal Request Caesarean Section in your Trust? If yes, please
provide a copy of the conditions Please see guideline

 

 

Your appeal rights

 

I hope that this response deals with your enquiry to your satisfaction,
however if not you have two options:

 

·        If you do not feel that we have provided you with the information
you requested, you may contact us again and state what information you
still require.  However if you ask for additional and/or different
information this will be dealt with as a new request.

 

·        All applicants have the right of appeal and can request an
internal review.  The internal review must be focused on the original
request and should identify how the trust’s response failed to answer your
information request and explain what you would like us to review.  Appeals
should be made in writing, within 40 working days of the date of the
response, and addressed to Ms Emma Kearney, chief communications officer,
Royal Free London NHS Foundation Trust at [3][email address] .

 

If you are not satisfied with the internal review, you can appeal to the
Information Commissioner.  The contact details are: Information
Commissioner's Office, Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9
5AF, telephone 01625 545 700 or see [4]www.ico.org.uk

 

Open Government Licence

 

The trust allows you to reuse this information under the Open Government
Licence found at the following [5]link. 

 

Yours sincerely

 

 

 

The Freedom of Information Team

Royal Free London NHS Foundation Trust

 

 

 

 

 

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