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Last Updated: Thursday, 1 April, 2004, 09:50 GMT 10:50 UK
More women having natural births
Pregnant woman
Fewer women are having induced births
The proportion of women having natural births has risen, official statistics for England have shown.

The rise has come about because Caesarean rates stayed the same - for the first time in 20 years - and the number of induced births fell.

Experts hope Caesarean rates will now start to fall.

NHS guidelines to be published shortly will say women should not have the operation just because they are "too posh to push".

Legal action fears

The figures, published by the Department of Health, show that the proportion of natural births rose from 45% in 2002 to 47% last year.

The first thing was to stop the rise. Now we hope that will lead to a fall.
Mary Newburn, National Childbirth Trust
The proportion having Caesareans remained at 22%.

Experts say the fact the number of Caesareans has not risen is particularly significant because it has consistently risen by around 1% each year since the 1980s.

The rise was thought to be due to doctors recommending the operation to "speed up" labour, to cope with staff shortages and to reduce the possibility of legal action in the event of birth complications.

Women who did not want to go through a natural childbirth were also believed to have opted for Caesareans as an "easier" way of having a baby.

But the National Institute for Clinical Excellence, the government's NHS watchdog, is bringing in guidelines from the end of this month advising doctors there must be a medical reason for women to be given a Caesarean on the NHS.

Women will also be informed of the potential complications following the operation, such as wound infections, blood clotting and bladder injuries.

Babies born by Caesarean are also more likely to suffer breathing difficulties compared to those born by vaginal delivery.

The figures also show that induced births, where women are given drugs to bring on labour, fell from 21.5% in 2002 to 20.5% in 2003.

Births using instruments such as forceps also fell slightly, from 10.7% to 10.5%.

'Momentum'

Mary Newburn, of the National Childbirth Trust, told BBC News Online: "These figures are terrific news.

"We have had a concerted campaign to raise awareness of the public health consequences of Caesareans.

"But there was such a strong trend, pushing C-sections up each year, it was very difficult to stop that momentum."

She added: "The first thing was to stop the rise. Now we hope that will lead to a fall.

"The Caesarean rate in this country is very much higher than the 10% recommended by the World Health Organization.

But she said the NHS had to ensure women were able to choose a natural delivery.

"We need to make sure women are cared for in a way that makes it easier for them to choose a natural birth."

Midwives response

The Royal College of Midwives expressed disappointment that the Caesarean rate had not actually fallen.

Dame Karlene Davis, the general secretary, said: "We believe that Caesarean delivery is appropriate and beneficial in only 10% to 15% of all births, as specified by the World Health Organisation.

"As it stands, one in four babies being delivered by Caesarean is simply too many."

The RCM is concerned that Caesarean sections may be performed on women as a matter of course rather than medical necessity, and that mothers-to-be are not always made aware of the risks involved.

Dame Karlene added: "A Caesarean section is major abdominal surgery, posing a significant risk to women, including wound infection and serious complications such as bleeding, blood clotting and bladder injuries."




SEE ALSO:
Caesarean crack-down urged
18 Jun 03  |  Health


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