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BBC News Online: Health


Saturday, 25 August, 2001, 23:04 GMT 00:04 UK

Older mothers are 'overprotected'


Pregnant woman
Doctors have been told to think again over how they view older mums
Researchers say older mothers are more likely to have Caesareans, scans and help with delivery than younger women, even if they do not need them.

They have concluded that the higher levels of medical intervention are not necessarily linked to increased complications.

This could simply be due to the fact that doctors see older mothers as more high risk and so are more inclined to intervene in their births, even if it is not necessary.

There have been calls for doctors to reassess how they see older mothers.



Where there are no tangible medical complications of pregnancy, the risks of childbirth in older women are no greater than in younger women
John Grant
British Journal of Obstetrics and Gynaecology


The researchers from Aberdeen Maternity Hospital studied 28,484 deliveries over a nine-year period.

They found that as the mother's age increased she was more likely to have higher levels of amniocentesis, Caesarean section, assisted delivery and induction.

Previous studies at the same hospital showed first-time mothers over the age of 40 are 14 times more likely to have an elective Caesarean than those under 30.

The latest study showed that the older mother was also more likely to have more than two scans, a stay of more than five days in hospital and have their baby admitted to a neonatal unit.

The authors said that there was evidence to suggest that uterine function could deteriorate with age.

But said it more likely that medical staff simply saw the age of the mother and then decided to intervene.



The association may also reflect a preference for intervention among older women or their obstetricians, and these results would support that speculation
Study finding

The study said: "It has been proposed that the higher levels of intervention among older women may be partly a consequence of the 'high risk' label that is often assigned to them and that threshold for intervention are lower for older women than for their younger counterparts.

"The association may also reflect a preference for intervention among older women or their obstetricians, and these results would support that speculation."

Call for rethink

John Grant, editor-in-chief of the British Journal of Obstetrics and Gynaecology, where the study was published, said it was time for doctors to re-think their opinions of the older mum.

"How often have you seen 'Elderly primigravida' (first-time mother) written in the special features column of the maternity record?

"This will convey a subliminal message to the obstetrician and midwife caring for the woman in labour, which will colour their judgements, and lead inevitably to a Caesarean section.

"Where there are no tangible medical complications of pregnancy, the risks of childbirth in older women are no greater than in younger women."

Intervention 'unjustified'

Mr Peter Bowen-Simpkins, consultant obstetrician and spokesman for the Royal College of Obstetricians and Gynaecologists, agreed that women above 35 were more likely to be given medical intervention simply because of their age.

But he said older women were also more likely to ask the doctor for a Caesarean than the young mother.

"We probably do intervene more among older women and it probably is unjustified. It is probably the worry of the obstetrician than the fact the woman has problems."



One should always start from the premise that pregnancy is an entirely normal physiology
National Childbirth Trust

Gillian Fletcher, president of the National Childbirth Trust (NCT) agreed and said doctors should not make assumptions that all older women would need medical intervention.

"It could become a self-fulfilling prophecy."

She said older women often worried that they were at higher risk and said that it was important to strike a balance between informing patients and worrying them unnecessarily.

"One should always start from the premise that pregnancy is an entirely normal physiology."


Related to this story:
Caesarean rate riddle (13 Apr 01 | Health) Number of twins on increase (05 Jul 01 | Health) Sleepless nights lay new mums low (13 Mar 01 | Health) Caesarean urged for breech babies (20 Oct 00 | Health) Crackdown on Caesarean boom (02 May 00 | Health)


Internet links: Royal College of Obstetricians and Gynaecologists | Royal College of Midwives | British Journal of Obstetrics and Gynaecology | NCT |
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