Question (and I will explain why I am asking after a few responses)

If a woman asks to have a homebirth or birth centre birth when they have risk factors that mean their doctor has strongly recommended a CS... should she be subjected to additional psychiatric screening?

I think it’s time to explain why I tweeted this. I have recently had it brought to my attention that women who request a c section are subjected to additional mental health screening and assessment.

She may find herself being asked to complete additional questionnaires about her mental health or referred to mental health services for assesssment.

Where she doesn’t meet criteria for mental health care provision, she may find herself offered pseudoscience based psychological “techniques” from midwives who have done a few days training. A practice my profession has enormous concerns about.

For an example of the sort of attitudes we are talking about here see this from a recent review article about the effect of maternal request cs on women’s anxiety

Article here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5477251/

Much energy has been spent trying to figure out how to help women requesting cs with their anxiety - most of which seems to assume efforts to edge them towards a vaginal delivery and only when she proves herself utterly resolute in her request is the cs granted

Women asking for CS are seen as highly anxious, possibly mentally ill and in need of a great deal of support. Yet it seems to me that few have stopped to consider whether the obstacles put in their way are not the source of at least some of this anxiety

So here’s the deal folks ... we need to start acting like we believe women have agency to make informed medical decisions including those women who are asking for CS as a result of anxiety and/or previous trauma

And we can stop the age old misogyny of characterising women (especially mothers) who don’t conform to the narrow constrains of what society or the medical establishment expects them to be as mentally ill

When every pregnant person is asked what their concerns are re birth, presented with all reasonable options for their birth, a tailored discussion about the benefits & risks of those options & asked what type of delivery they want to plan for, then we will have autonomy

Anything less is paternalism or paternalism in a skirt.