Abstract
An audit was undertaken in a maternity unit in 1996. The caesarean section in the unit studied in 1996 was 21.7% compared to a UK national rate at that time of 13%. The unit staff believed the main reason for these figures was the influence of maternal request. The aims of the study were to: identify factors influencing the CS rate, assess physiological and psychological implications to both the mother and baby, make recommendations to reduce the rate both safely and effectively, and identify resource implications. Recommendations made include the need to introduce multi-professional evidence-based guidelines on the management of fetal distress, trial of labour with history of previous CS and the use of external cephalic version in the cases of the uncomplicated breech presentation. The need to ensure that women electing to have a CS are fully informed of the risks related to CS was also highlighted.
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