Last month North London Senior Coroner, Andrew Walker, posed this question to the Department of Health following the tragic death of Kristian Jaworski, aged 5 days old. In a strongly-worded report to the Department of Health, Mr Walker warned there was a "presumption in favour of vaginal delivery based partly of cost", although the hospital denies this was the case.
Following the birth of her first child, Kristian's mother, Tracey Taylor was found to have an unusually narrow birth canal and required a forceps delivery. Doctors advised that in the future, she would need a caesarean to avoid any further complications. However, this was not recorded in her notes. During her second pregnancy with Kristian, Miss Taylor notified the hospital of this fact on several occasions, but despite this, was forced to have a vaginal delivery. She describes the experience as being made to feel like she was an “over anxious woman who was too frightened to give birth.”
As a result of significant delays in Kristian’s birth whilst medics tried to deliver him using suction and forceps, before an emergency caesarean, his brain was starved of oxygen and he sadly died in July 2015, after suffering catastrophic brain injuries. Mr Walker told an inquest into Kristian’s death that there appeared to be a financial reason for the NHS favouring a vaginal delivery “that needed to be rebutted”.
Natural deliveries cost the NHS half as much as caesareans, which involve a number of theatre staff. Official NHS figures show that vaginal deliveries cost the health service £1,985 each. In comparison, caesarean sections cost £3,781.
The hospital has accepted legal liability for Kristian’s death, although it has said that cost was not a consideration during his birth.
It is no secret that the NHS is under an enormous amount of pressure to cut costs and it is clear that caesarean sections cannot be offered to every woman. However, a caesarean clearly should have been offered in this case, where there was an obvious clinical need for one. Mr Walker commented “there is a risk that future deaths will occur unless action is taken".