A cross-site audit of women referred for maternal request caesarean section

Objective

• The demand for maternal request caesarean (MRCS) birth has risen both locally and nationally.

• This audit aims to evaluate:

• How women intend to birth following their consultation with the birth choices team

• Birth outcomes for all MoB

• Factors that influence choice regarding MoB

Audit standard and design

• Audit of all women referred to the birth choices clinic for discussion regarding MRCS at two London hospitals; Chelsea and Westminster (CW) and West Middlesex (WM) over a one-year period.

• No clear audit standards, hence, recommendations adapted from NICE caesarean birth (2021)1, and Ockenden Report (2022)2.

• Choice is supported

• Relevant information is shared to support decision making

• Birth choices guideline (local guidance):

• Referral criteria

• Continuity of care – information given

• Continuity of care – midwifery continuity

• Records for all women attending Birth choices clinic at CW and WM from Jan - Dec 2023, for a discussion regarding MRCS/ MoB were reviewed.

• Referrals were recorded in Microsoft Excel throughout the year, and electronic patient records held on Cerner and K2 platforms were reviewed for each patient

• Women were excluded if they were not accepted by/ seen by the service/ changed mind prior to consultation