Post-publication correspondence
Following publication of the guideline, we received a request from BJOG
to respond to a letter they planned to publish. The letter was from
Birth Trauma association members and repeated the same point about
planned caesarean section they had made during the consultation
process.2 The letter had the heading
“Montgomery is missing from RCOG’s AVB guideline ” and they
asserted that the omission of planned caesarean birth from the guideline
“could have serious legal consequences” . We responded in
keeping with our previous response.3 We received a
request to respond to a second letter from an Australian gynaecologist
(affiliated with a Birth Trauma association) who stated that the
guideline “conveys a pro-forceps bias that does little to help
clinicians make informed choices ” and “is potentially exposing
the RCOG to substantial medicolegal liability ”.4Following our response to this letter we received a third letter from a
Dutch and Australian gynaecologist, again accusing the guideline of
failing to meet the expectations of the Montgomery ruling and supporting
practices that “unnecessarily place women at risk of pelvic floor
trauma ”.5 We brought this body of correspondence to
the attention of the RCOG executive as we had concerns that there was an
agenda to influence the guideline in a particular direction.