Review decision date: July 2014

Review decision: 

This guideline will shortly be checked to see if it needs updating, please register as a stakeholder to be informed about the decision.

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Next review: January 2017

This clinical guideline updates and replaces NICE guideline CG13 (published April 2004). It offers evidence-based advice on the care of women who:

  • have had a caesarean section in the past and are now pregnant again
  • have a clinical indication for a caesarean section or
  • are considering a caesarean section when there is no other indication.

New and updated recommendations have been included on:

  • the risks and benefits of planned caesarean section compared with planned vaginal birth
  • care of women considered at risk of a morbidly adherent placenta
  • appropriate care and choices for women who are HIV positive
  • care of women requesting a caesarean section without a clinical indication
  • decision-to-delivery intervals to be used as audit standards
  • timing of the administration of antibiotics for caesarean section
  • appropriate care and choices for women who have previously had a caesarean section.

August 2012: Recommendations and have been removed from this guideline. See changes after publication for further details.

Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The application of the recommendations in this guideline is not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.

Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.

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