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Maternal request caesarean section — DRCOG MCQ

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HardIntrapartum CareMaternal request caesarean sectionDRCOG

A 28-year-old primigravida at 39 weeks requests an elective caesarean because she is terrified of vaginal birth after a previous sexual assault. There is no obstetric indication. She has not yet had a detailed counselling appointment. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Offer supportive counselling and discuss birth options including caesarean

NICE recommends exploring reasons for maternal request, offering support and discussing risks and benefits of birth options, including caesarean if the request persists. A trauma-informed approach is essential. Refusal without counselling is inappropriate, while induction does not address the fear. The pearl is that consent and shared decision-making are central to mode-of-birth discussions.

Reference: NICE NG192; NICE NG235