Caesarean births are now running at around 25% of all deliveries in the UK and leaders of the Royal Colleges of Obstetricians and Gynaecologists (RCOG) and Midwives (RCM) are questioning whether this is harmful.
While the majority of women continue to deliver their babies vaginally, there has been a steep increase in babies born by caesarean. In the 1980s, it was only about 1 in 10 births and now that proportion is 1 in 4.
In 2013 – 14, three quarters of all caesareans were emergencies but around a quarter were elective.
There are a number of reasons for the increase.
- More obese women giving birth
- Older first time mothers
- Fear of delivery which increases stress hormones and can inhibit a more straightforward labour
- A small number of mothers asking for the procedure
- An increasing fear of litigation
First time mothers though are increasingly coming under scrutiny because once a mother has delivered by caesarean it increases the likelihood of her doing so in future pregnancies.
At a time of limited resources, staff cuts and austerity measures within the NHS, the question is whether the reason for the debate now is all about money. The cost of a birth with medical intervention (also involving an anaesthetist, Obstetrician and Paediatrician) is significantly higher than a midwife assisted vaginal delivery.
However, given the many reasons for the increase, reducing the number of interventions has to start at an earlier stage with better education and preparation for labour during pregnancy.
Measures taken to improve information available for mothers to be will not prevent all cases of emergency intervention but it might make a difference to some of them. Any reduction would also trickle down to future pregnancies and this is why reduction in this group of women in particular could result in significant savings.
As with all these things setting guidelines needs to be viewed with a degree of caution. Where there is a medical need for intervention in delivery then that is the priority. However, where education can and will assist then that should be encouraged.
We are highly experienced in dealing with cases relating to birth injury. If you or a member of your family needs advice relating to care during pregnancy or labour please contact a member of our Clinical Negligence Team on 0800 316 8892.