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.