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Caesareans: should women have the right to choose?

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Women in England and Wales may soon be given the right to choose to have a caesarean on the NHS, even if there is no medical reason for them to do so.

A draft report by the National Institute for Health and Clinical Excellence (Nice) recommends that pregnant women should have the right to choose whether they give birth naturally or not.

Currently, women are generally only offered caesareans on the NHS if they experience complications during pregnancy or if giving birth naturally poses a risk to their health.

Nice changed its guidelines because caesareans are now much safer than they used to be.

Consultant obstetrician Dr Bryan Beattie, who helped draw up the report, hailed the move as "a huge development in allowing women to make an informed choice."

Under the new measures, expectant mothers will be able to talk through the options available with health professionals before making a final decision on how to deliver their baby.

"We are confident that when women are fully aware of the evidence they will not be asking for inappropriate caesarean sections," said Cathy Warwick, general secretary of the Royal College of Midwives. "We agree with the Nice suggestion that if, after proper counselling, natural birth is still not acceptable, then caesarean section should be possible."

"Women who fit into this category are usually those who have had a very difficult previous birth," she added.

Around quarter of women in the UK currently give birth by caesarean. Around 12 percent of women who plan to give birth naturally undergo emergency caesareans.

The new guidelines mean that doctors who do not want to perform a caesarean for non-medical reasons must refer women to other doctors who are willing to carry out the procedure.

The proposal has received criticism from some commentators, who believe the cost of the operation (up to £1500 more than a natural birth) will be an unnecessary drain on the NHS and take away from funding for midwives helping with natural childbirth. They also point to medical side effects such as scarring.

What do you think? Should women have the right to choose a caesarean for non-medical reasons? Or are there better ways to invest NHS money in maternity care? Let us know your thoughts in the comments section below, or on Twitter.

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