NHS axes targets for natural births as C-section limits are dropped to improve standards of care
Hospitals will no longer be encouraged to promote ‘natural births’ over C-sections under plans to improve care for mothers and babies.
The NHS has abandoned targets aimed at limiting caesarean rates which assessed maternity units based on the number they carried out.
There were concerns these targets led to women pursuing natural births when a C-section would have been more appropriate, jeopardising their safety.
Previous advice in 2012 from the Royal College of Obstetricians and Gynaecologists (RCOG) advised NHS trusts to stick to a caesarean rate of around 20 per cent.
The NHS has abandoned targets aimed at limiting caesarean rates which assessed maternity units based on the number they carried out
But a letter sent to maternity units by Jacqueline Dunkley-Bent, NHS England’s chief midwife, instructed them to ‘stop using total caesarean section rates as a means of performance management’.
It added: ‘We are concerned by the potential for services to pursue targets that may be clinically inappropriate and unsafe in individual cases.’
The letter, reported by the Sunday Times, follows a series of high-profile NHS scandals that have led to the avoidable deaths of dozens of mothers and babies.
In some cases, these have been blamed on maternity wards pushing natural births over other means of delivery.
Shrewsbury and Telford Hospital NHS Trust, which is at the centre of the largest maternity scandal in NHS history, had the highest natural birth rate in England for five out of the eight years between 2010 and 2018. A report looking into 1,862 cases of poor care at the trust – including dozens of baby deaths – will be published next month.
In July a report by the Health and Social Care Committee found that a ‘debilitating culture of blame’ has prevented the NHS learning lessons from previous tragedies.
The report added that pressure for vaginal births has put women at risk, saying: ‘It is deeply concerning that maternity units appear to have been penalised for high caesarean section rates.’
Dr Jo Mountfield, vice president of the RCOG, welcomed the plans to abandon the targets.
She said: ‘These targets are not appropriate in individual circumstances. Both vaginal and caesarean births carry certain benefits and risks, which should be discussed with women as they choose how they wish to give birth.’
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