Quality standard

Quality statement 4: Consultant obstetrician involvement in decision making for planned caesarean birth

Quality statement

Pregnant women who may require a planned caesarean birth have consultant involvement in decision making.

Rationale

Consultant obstetricians are best placed to advise a woman who may need or want to plan a caesarean birth about the potential benefits and risks for each option based on their specific circumstances and needs. The involvement of a consultant is intended to ensure that the best possible outcomes are achieved for the woman and the baby.

Quality measures

Structure

Evidence of local arrangements to ensure that pregnant women who may require a planned caesarean birth have consultant involvement in decision making.

Data source: Local data collection.

Process

The proportion of pregnant women who may require a planned caesarean birth who have consultant involvement in decision making.

Numerator – the number of women in the denominator who have a consultant involved in decision making.

Denominator – the number of pregnant women who may require a planned caesarean birth.

Data source: Local data collection.

Outcome

Women's satisfaction with the decision-making process.

Data source: Local data collection.

What the quality statement means for different audiences

Service providers ensure that systems are in place for pregnant women who may require a planned caesarean birth to have consultant involvement in decision making.

Healthcare professionals ensure that pregnant women who may require a planned caesarean birth have consultant involvement in decision making.

Commissioners ensure that they commission services that have systems in place for pregnant women who may require a planned caesarean birth to have consultant involvement in decision making.

Pregnant women who may need a planned caesarean birth have a consultant obstetrician involved in making the decision.

Source guidance

Caesarean birth. NICE guideline NG192 (2021), recommendation 1.3.3

Definitions of terms used in this quality statement

Pregnant women who may require a planned caesarean birth

This includes both women who have medical indications that would suggest that a planned caesarean birth would be the safest way of delivering the baby, and women who request a caesarean birth when there are no medical indications. [Adapted from NICE's guideline on caesarean birth, section 1.2 and expert opinion]

Decision making

The nature of the decision-making process and the extent to which the consultant will need to be involved in the process will vary between each woman and will depend on the complexity of their specific circumstances. [Expert opinion]

Equality and diversity considerations

Good communication between healthcare professionals and women who may need a caesarean birth is essential. Treatment and care, and the information given about it, should be culturally appropriate. It should also be accessible to women with additional needs such as physical, sensory or learning disabilities, and to women who do not speak or read English. Women who may need a caesarean birth should have access to an interpreter or advocate if needed. For women with additional needs related to a disability, impairment or sensory loss, information should be provided as set out in NHS England's Accessible Information Standard or the equivalent standards for the devolved nations.