Is the NHS favouring vaginal delivery over Caesarean sections?
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The tragic case of Kristian Jaworski has recently been reported in the news. Five days after his birth at North Middlesex University Hospital, Kristian died as a result of significant brain damage, occurred during a prolonged and traumatic labour.
Tracey Taylor, Kristian's mother had advised staff that due to a difficult and complicated birth with her first child some three and half years earlier due to a narrow birth canal, she would need a caesarean section for any subsequent birth.
Mrs Taylor's concerns and previous medical history appeared to have been overlooked by the hospital and repeated attempts were made to try and deliver Kristian without recourse to a caesarean, including the use of suction and forceps. Kristian's brain was starved of oxygen and he sustained brain damage.
The hospital has accepted liability for Kristian's death.
An inquest was held and although the Senior Coroner did not make a finding of negligence, he sought confirmation from the Department of Health that the decision to opt for a "prolonged and extended instrumental delivery", rather than a caesarean section was not made on the basis of cost. The average cost to the NHS of a natural delivery is said to be in the region of £1,985 whereas the cost of a caesarean section is £3,781. Only 26% of annual births take place via caesarean section.
The Department of Health now have a short period within which to provide a formal substantive response. In the interim, Health Minister, Ben Gummer has stated that
"Treatment decisions in maternity care should always be made by clinicians in full consultation with women. These should be based on woman's individual clinical needs and in line with National Institute for Health and Care Excellence (NICE) guidelines in terms of best practice."
However, in some cases, the above mentioned approach is not adopted leading to tragic consequences.
A blog on the Department of Health's response will follow in due course.
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