Concern at rise
in Caesarean deliveries
By Alison Healy

Concern has been expressed at the rising number of Caesarean section deliveries in this State.

Figures published in today's issue of Medicine Weekly show that more than 20 per cent of Irish births are now by Caesarean section. As the statistics come from a 1999 study, the real figure is likely to be higher, due to the growing trend. The World Health Organisation recommends a rate of 15 per cent.

The increase is partly explained by the growing number of women opting for the procedure because of their unwillingness to have a vaginal delivery, consultants report.

Fear of the birth process is one reason for women to seek Caesarean sections in what has been dubbed the "too posh to push" syndrome in Britain.

Yesterday, Dr Declan Keane, Master of the National Maternity Hospital in Holles Street, said he would hate to see this State following cities such as Rio and Milan, where Caesarean sections accounted for half of all
deliveries.

While the Holles Street Caesarean section rate was under 15 per cent, most Irish hospitals would exceed that rate, he said.

Dr Keane said obstetricians could, and did, refuse women's requests for unnecessary Caesarean sections. However, women could go to another hospital and find a consultant willing to carry out the procedure, he said. He encouraged women to think carefully before opting for such a procedure.

"People forget that it's still a surgical intervention and has immediate and long term effects on the mother," he said.

"It does concern me and it's difficulty to know how it will plateau out. The rate is going up ever year. "In some cities in Brazil and Italy, the rate is 50 or 60 per cent. I would hate to see that happening over here."

Mr Donal Duffy, Assistant Secretary General of the Irish Hospital Consultants Association agreed that more women were opting for the procedure out of choice, rather than necessity. He said fear of being sued was also encouraging obstetricians to carry out a Caesarean section where the labour was not straight-forward. Other factors included the increasing age of mothers and the increasing percentage of first-time mothers.

While the rate might exceed the World Health Organisation's recommendation, Ireland was still one of the safest countries in the world in which to give birth, he said.

Mr Duffy pointed to the significant decrease in baby deaths in the past ten years. Between 1990 and 1999, the number of neo-natal deaths fell by 28 per cent while the stillbirth rate reduced by 12 per cent. A 1998 survey of maternity hospitals carried out by Cuidiú - the Childbirth Trust found the greatest percentage of Caesareans were performed at St Luke's Hospital, Kilkenny (25 per cent). Other hospitals confirming high Caesarean rates included St Munchin's, Limerick (24.58 per cent), Mount Carmel, Dublin (23.4 per cent) and Cavan General Hospital (24 per cent).

© The Irish Times