Maternal request for caesarean — DRCOG MCQ

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HardLabourMaternal request for caesareanDRCOG

A 33-year-old primigravida at 34 weeks requests caesarean birth because she is very frightened of vaginal birth. There is no obstetric indication. She asks her GP to arrange it. What is the most appropriate management?

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Correct answer: E — Refer for obstetric discussion and support for tokophobia

The best answer is “Refer for obstetric discussion and support for tokophobia”. Maternal request for caesarean should prompt discussion of reasons, counselling about risks and benefits, and support such as perinatal mental health input if tokophobia is present. The request should not be dismissed. A GP does not directly book operative delivery. Benzodiazepines are not an appropriate primary response to birth fear. Antenatal decisions combine gestation, maternal stability, fetal risk and whether care can safely remain in the community. Screening, diagnostic testing and urgent assessment are not interchangeable. The UK pathway should be followed with clear safety-netting whenever symptoms may evolve before the next routine appointment.

Reference: NICE NG201: Antenatal care: https://www.nice.org.uk/guidance/ng201/chapter/recommendations