What are the current NICE guidelines for the indications of elective caesarean sections?

Current NICE guidelines on indications for elective caesarean sections include:

• Elective caesarean birth should not be routinely performed before 39 weeks of gestation to reduce the risk of respiratory morbidity in the baby.
• Women with a previous caesarean birth and a previous vaginal birth should be informed that they have a higher likelihood of vaginal birth compared to women with a previous caesarean birth but no vaginal birth.
• Planned caesarean birth is recommended for women with primary genital herpes simplex virus (HSV) infection occurring in the third trimester to reduce neonatal HSV infection risk.
• Planned caesarean birth is advised for women co-infected with hepatitis C virus and HIV to reduce mother-to-baby transmission.
• Planned caesarean birth is not recommended solely for hepatitis B or hepatitis C infection without co-infection with HIV.
• Body mass index over 50 kg/m2 alone is not an indication for planned caesarean birth.
• Women with placenta accreta spectrum should have their care planned in specialist centres with multidisciplinary teams.
• Shared decision-making is emphasised, ensuring women receive evidence-based information and respect for their views and culture, and they have the right to decline caesarean birth even if it may benefit their or their baby's health.

These recommendations reflect the importance of individualised care and consideration of specific clinical indications rather than routine elective caesarean sections without clear medical reasons.

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