Family Health Advice

"Too many" babies are still being born by caesarean section

Figures for 2004/05 show one in four women still deliver by Caesarean - the rate has doubled in two decades.

The Royal College of Midwives warns women and babies may be exposed to unnecessary risk.

National guidelines were issued in 2004 saying that pregnant women should be discouraged from having a Caesarean if they do not need one.

In 2004/05, 23% of women delivered by Caesarean compared with 22.7% in the previous year - around half were emergency Caesareans.

Over the past five years the proportion of women delivering by Caesarean has increased from one in five deliveries to one in four.

"If they feel it's safe it's difficult to dissuade women that they shouldn't have one" Professor James Walker, expert in high risk births

Experts say they want to reduce the number of women who have operations they do not need - often dubbed "too posh to push"

The World Health Organization says the rate should be between 10 and 15%.

The rate varies between different hospitals in the UK - from 15 to 30%.

Just under half of women have a 'normal' delivery with no surgical intervention, no use of instruments, no induction, and no epidural or general anaesthetic.

Too many

The Royal College of Midwives said the figures were disappointing as one in four babies being delivered by Caesarean was "simply too many".

Deputy General Secretary Louise Silverton said: "Women may choose Caesarean section due to their fear of the labour, because it is suggested by a doctor, or they see media stars having caesareans as a 'lifestyle choice'.

"Although Caesareans are comparatively safe, they do involve major abdominal surgery and can mean that a new mother women may not be able to fully enjoy the first few weeks of their baby's life, as they cope with the realities of having had a major operation with an abdominal scar, the after effects of an anaesthetic, and possible complications from the surgery, such as wound infection and more seriously - bleeding, blood clotting and bladder injuries."

Guidelines from the National Institute of Health and Clinical Excellence say women should be told that, although they would avoid labour pains, and complications such as bladder problems or prolapse of the womb, women who have Caesareans are more likely to have a blood clot or need further surgery.

Professor James Walker, consultant obstetrician at St James University Hospital in Leeds, said some areas of the country had been more successful than others in cutting caesarean rates.

"The changes are patchy, some areas have relaxed their efforts."

He said the rate was probably "not necessary".

"But it's not just the hospital, it's the women and it's society - if they feel it's safe it's difficult to dissuade women that they shouldn't have one."

A Department of Health spokesman said: "The caesarean section rate remains the same and the rate of births with no intervention has increased by 2%.

"There has been an increase in ceasareans over the last 20 years, due in part to increased safety in the procedure and technical advances which have enabled clinicians to identify complications earlier.

"Government policy, in line with the NICE guidelines, recommends that clinical interventions, including elective caesarean section, are only performed if there is clinical evidence of expected benefits to the mother or baby and that a consultant is involved in the decision to undertake any caesarean."