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Last Updated: Thursday, 31 March, 2005, 14:58 GMT 15:58 UK
Caesarean rate 'still too high'
Image of caesarean birth
One in four babies are delivered by caesarean, the figures show
The number of women having caesarean sections to deliver their babies is still too high, say experts.

Latest figures show that 22.7% of deliveries in England in 2003/04 were by caesarean section, up slightly from 20% in the previous year.

Midwives questioned whether caesareans were being done "as a matter of course rather than medical necessity".

Half of them were emergency caesareans. The Department of Health said it was working to lower the caesarean rate.

One in four babies being delivered by caesarean is simply too many
Dame Karlene Davis of the Royal College of Midwives

Dame Karlene Davis, of the Royal College of Midwives, said: "We are disappointed and troubled by the rise of the caesarean rate.

"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."

She was concerned that mothers-to-be were not always made aware of the risks involved.

Major surgery

"A caesarean section is major abdominal surgery, posing a significant risk to women.

"Mothers-to-be must be given unbiased information on the benefits and risk of normal birth versus caesarean section, so they can make informed choices concerning the delivery of their child," she said.

Belinda Phipps, chief executive of the National Childbirth Trust, said: "We are disappointed that these new statistics show an increase.

"Maternity units are generally aware and concerned to bring their caesarean rates down and we hoped that the trend would have been downward following last year's statistics showing no increase."

She said ensuring women had one to one care with a midwife would help lower the rate.

The latest statistics
Nearly half of deliveries were 'normal' - without surgical intervention, use of instruments, induction, epidural or general anaesthetic
Over a fifth of deliveries were induced
About a third of women had an epidural, general or spinal anaesthetic

"Similarly, making simple changes to the room in which women give birth makes it easier for a woman to have a normal birth.

"Moving the bed to one side to give space for walking, providing lighting that can be dimmed and furniture or mats so a woman can choose upright comfortable positions are all inexpensive measures that can make a significant difference," she said.

Miranda Dodwell from BirthChoiceUK said she was disappointed that the latest figures had been compiled with only 72% of maternity records.

"We find it disappointing that some hospitals have not submitted any usable records.

"We believe that Trusts have a duty to produce details of the maternity care they provide in order to be accountable to both those that fund the service and those that use the service."

A Department of Health spokesperson said:"We commissioned the National Institute for Clinical Excellence (NICE) to produce evidence-based guidelines for caesarean sections, these were published on 29 April 2004.

"We have also developed a National Service Framework (NSF), which includes standards of care during labour and delivery and invested in more midwives to provide one to one support during labour.

"Our latest figures show that there are over 1,500 or 7% more midwives working on the wards than there were in 1997, and since 1996/97 the number of midwives entering training each year has increased by 35%.

"We are committed to caesarean sections only being performed where there is a clinical need, this is in line with the NICE guidelines on caesarean sections which was issued after the data collection for this Bulletin, and is reiterated in the NSF."

Caesarean 'low birth risk link'
15 Dec 04 |  Health
Risks of second caesarean studied
19 Oct 04 |  Bristol/Somerset

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