A midwifery-led care pathway for women requesting caesarean sections

Abstract

The caesarean section rate in the UK has increased dramatically in the last 20 years. Subsequently, there has been a rise in caesarean sections for maternal request (CSMR) without medical indications. In 2011, the National Institute for Health and Care Excellence (NICE) added to their guidance, that if after discussion and support, a vaginal birth is not acceptable, elective caesarean should be offered. This article proposes the implementation of a midwifery-led care pathway for women requesting caesarean section without medical indication. The care pathway includes group psychoeducational therapy which has been found to reduce CSMR, emergency caesarean sections and negative birth experiences. The challenges and barriers that may be faced when leading developments in maternity services are discussed, with reference to political, economic, social and technological factors.