Maternity unit caesarean-section, induced-labour rates vary up to 75%

There are wide variations in maternity services across Ireland, according to Cuidiú, the Irish Childbirth Trust.

Some units have caesarean or induction of labour rates that are 75% higher than other units, according to its latest guide, which was published today.

It is concerned about the “very high” number of caesareans and rate of induced labour for first-time mothers. These interventions have risen since their last guide was published, in 2011.

Cuidiú gathered information for the guide from all of the 19 maternity units in the State and the two midwifery-led units. All of the maternity units responded.

The rate at which mothers attempt a vaginal birth after a previous caesarean ranged from 29% to 57%.

“These figures are an indicator of the degree to which women are being provided with information and encouragement by the maternity unit,” it states.

Ireland has a high level of caesarean births, which is associated with poorer outcomes for both mothers and babies.

Promoting a vaginal birth, after a previous caesarean, reduces the overall caesarean rate, as repeat caesareans account for a significant proportion of the overall rate.

Typically, 60-75% of women attempting a vaginal birth after a previous caesarean succeed.

Policies for routine induction of labour, when mothers are past their estimated due date, vary across the units, from 40 weeks plus ten days, to 40 weeks plus 14 days.

“Cuidiú believes that women should be proactively informed, by the maternity unit, of the option to defer induction, when both mother and baby are healthy,” it states.

Another concern is that with the exception of the midwifery-led units and two maternity hospitals, very few women have access to private toilet and shower or bath facilities during labour. Most have to use communal facilities. “Cuidiú believes that women in the care of a maternity unit deserve access to private facilities, and the lack of these facilities is not consistent with the protection of their rights and dignity.”

The guide is available online here. Its author, Cuidiú antenatal teacher, Niamh Healy, says changes in policy, practice, and performance are needed to realise the objectives of the National Maternity Strategy, and to fully meet the needs of women and their families.

Cuidiú is a parent-to-parent, voluntary support organisation that supports families throughout parenthood.

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