Protecting human rights in childbirth

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Update on maternal request caesarean at Oxford University Hospitals

Elizabeth Prochaska and Maria Booker from Birthrights, met with Sir Jonathan Montgomery (Chair of Oxford University Hospitals NHS Foundation Trust (OUH)) and Professor Meghana Pandit (Chief Medical Officer, OUH) on the 15th October 2020.

This followed a meeting earlier this year on the 18th May to discuss OUH’s policy on maternal request caesarean (MRCS). At this meeting OUH promised a substantive response to our letter of 3rd January 2019 by 15th June.

We received a response from Sir Jonathan Montgomery in mid-June which stated that:

  • The Gloucestershire referral pathway, which had been closed due to COVID, was expected to re-open shortly.
  • Consultant obstetricians at OUH had recently been consulted. 13/16 were present at the meeting and all those present who expressed an opinion were in favour of maintaining the current policy of not offering MRCS at OUH.
  • The Trust would be seeking the views of the Clinical Ethics Advisory Group to inform next steps.

Shortly after this meeting, Birthrights discovered that the referral pathway to Gloucestershire Hospitals NHS Foundation Trust, which OUH were using on to fulfil their obligations under NICE guideline CG132 had not been formally agreed with the Executive team at Gloucestershire. OUH have since been in discussions with Gloucestershire to reach formal agreement on this. In the meantime, individual requests for caesarean have been dealt with on a case by case basis.

On the 3rd July, the issue of maternal request caesarean was discussed by the Clinical Ethics Advisory Group to which Birthrights submitted this paper. Following this meeting, OUH’s plan is to continue to refer women who request maternal request caesarean to Gloucestershire in the short term if a formal arrangement can be reached. However, in light of the discussion at the Clinical Ethics Advisory Group, Oxford University Hospitals has committed to ensuring that where women are unable to access care in Gloucestershire, particularly vulnerable women and those with other underlying significant health problems – a caesarean section will be offered locally. OUH has agreed that Birthrights can flag up any women contacting us about a maternal request caesarean at OUH direct to Professor Meghana Pandit. Birthrights and OUH will meet again in February to review the situation.

All correspondence between Birthrights and Oxford University Hospitals NHS Foundation Trust can be found here.

Don’t forget that the NICE consultation on its revised caesarean guideline closes tomorrow (26th November) at 5pm.

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