Caesareans offered to labour-wary

Caesareans offered to labour-wary London - Arabstoday Maternity wards are relaxing the rules on caesarean births amid concerns that some expectant mothers are so afraid of childbirth they seek abortion.Under new NHS guidelines, pregnant women who are very anxious about labour will be able to have the operation even if there is no medical justification. Currently they are only offered a planned caesarean in certain circumstances, such as if they are expecting twins or triplets, they have high blood pressure or diabetes, or the foetus is in the wrong position. But under the guidelines from the National Institute of Health and Clinical Excellence, women with ‘mental health issues’ including fear or anxiety will also be eligible. Senior doctors and charities say that some women are so afraid of giving birth naturally they are having their pregnancies terminated. This fear of childbirth is known as tokophobia and it is estimated to affect one in ten expectant mothers. Malcolm Griffiths, consultant obstetrician and gynaecologist at Luton and Dunstable Hospital, said he did not think it was ‘uncommon’ for women to ask for terminations following previous bad experiences giving birth. He said he had recently seen one woman who had undergone two very traumatic labours and had asked to be referred for an abortion because she could not bear the thought of going through it all again. The current shortage of midwives is also ‘a factor’, he added. Mr Griffiths said: ‘It’s fair to say caesarean section is a major operation. It’s about as major as a hysterectomy. ‘It’s not a major operation that most pregnant women are interested in or want to have.’ In some cases tokophobia is brought on by previous traumatic experiences but in others it is simply an irrational fear with no apparent cause. Dr Gillian Leng, deputy chief executive of NICE, insisted that the guideline was not about ‘offering free caesareans for all’. ‘For a very small number of women, their anxiety about childbirth will lead them to ask for a c-section,’ she said. Dr Leng added that these women would first be offered counselling. If their fears were still not allayed they would be offered a planned caesarean. The guidelines only refer to planned or ‘elective’ caesarean sections. Thousands of other women are forced to have emergency procedures because of complications which develop during the labour. The latest figures show that 24 per cent of women give birth by caesarean, up from 12 per cent in 1990. NICE estimates that a planned caesarean costs the NHS an average of £2,369 while a natural birth costs £1,665.