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Had a good day in the world of #obstetricAnaesthesia I was lucky enough to help 2 of colleagues bring their babies into the world. One chose an elective section the other an epidural. Both had the birth experience they wanted. Such a privilege to be part of their story. It doesn’t matter how you deliver as long as you & your baby are both safe and well. #obstetricAnaesthesia #Epidural #Spinal #ElectiveSection #ChristmasBabies #lucky #FriendsAndColleagues
@Hypnotic elective c/s guidance—ACOG Committee-Dec 2007. C/S delivery on maternal request is defined as a primary c/s delivery at maternal request in the absence of any medical/OB indication. Risks: longer stay, baby respiratory problems, incres complications in next pregnancies (ex. uterine rupture, placental problems). Not before 39 weeks. Not for women desiring several children, bc of risks of placenta previa, placenta accreta, and the need for gravid hysterectomy increase with each c/s del.
@RebeccaPRN all deliveries have risks including; traumatic delivery, shoulder dystopia, fetal hypoxia, unexpected IUD/ & stillbirth, adverse effects on maternal mental health including PTSD (mostly resulting from at attempt at a “normal” delivery) Over 30% of attempts at primip vaginal delivery result in emergency section higher if you include assisted delivery. Maternal choice is paramount, elective sections are an equally safe option and a valid choice for women.
@Hypnotic do you counsel women on the risks and benefits of obstetric care? Or do you provide anesthesia? Maternal choice is great / paramount but it is up to the patient and her OB care provider. That’s why there are committee opinion guidelines - of course people can choose against the guidelines but that would be for a good reason and well documented. Also there is nothing to say your pt. wasn’t counseled- I sure it was a great. Just making a comment.
@RebeccaPRN I am a consultant anaesthetist, specialising in Obstetric Anaesthesia. Anaesthesia is central component of maternal care, I counsel women about Anaesthesia but I also work with midwives & obstetricians to provide enhanced maternal care, maternal critical care as well as anaesthesia/analgesia choices for Labour and delivery. UK guidelines are updated with new evidence every 3-5 years with amendments in the interim. I didn’t realise you were US based.
@Hypnotic do you use up to date in the UK. The references have both NICE and ACOG in there, https://www.uptodate.com/%7B%7D - anyway staying friendly- I am in perinatal quality improvement - nice to meet you.
@Hypnotic that link didn’t seem to work anyway, it’s this one: uptodate: Cesarean birth on maternal request
Author:Errol R Norwitz, MD, PhD, MBASection Editor:William Grobman, MDDeputy Editor:Vanessa A Barss, MD, FACOG
@RebeccaPRN We do at work, but I don’t have personal access. Our main sources are NICE, Royal College Guidelines, Association of Anaesthetists & we have the Obstetric Anaesthetists association as well.
@RebeccaPRN also guidance from 2007! As healthcare professionals we should not be referring to antiquated medical guidelines. 
@Hypnotic are there more updated guidelines from ACOG re: maternal elective c/s? I may have missed it- please share. If it was last updated in 2007 and there are no updates then yes, those are the current guidelines. Have a nice day!