Background In November 2011, NICE released new guidance for Caesarean Sections in the UK. The new guidance stated that “for women requesting a CS, if after discussion and offer of support, a vaginal birth is still not an acceptable option, offer a planned CS”¹. This audit will look into whether this has increased CS rates at COCH.

Method 40 sets of patients notes were selected to represent a snapshot of elective CS from January 1st 2012 to June 30th 2012. Data collected included documented indication for delivery, actual indication for delivery as well as elective CS rates for 2010, 2011 and 2012.

Results The overall elective CS rate for the hospital increased by 2% between Jan–June 2011 and 2012 compared to only a 1% rise between 2009–2011. The overall maternal request rate has increased from 0.5% of total deliveries in 2010 and 2011 to 1.4% in Jan- September 2012. Within the cohort the maternal request rate was 7.5% for Jan to June 2012 compared to 5.5% in 2010. There was a large disparity between documented and actual indication for delivery of 30%.

Conclusion From the results of this audit we can see that elective CS rates due to maternal request are on the increase. This suggests that the NICE guidance released in November 2011 has had an impact, to what degree is difficult to say however we can better substantiate this with annual figures.

Reference

1. NICE. CG132 Caesarean section: full guideline. 23 November 2011 [Online]: Available from: http://guidance.nice.org.uk/CG132/Guidance/pdf/English