Health fears as C-sections jump by 81%

THE number of women having Caesarean sections in Ireland has increased by a staggering 81% since 1991, leading midwives to claim that many mothers are enduring risky surgery when it is not medically necessary.

According to the National Perinatal Statistics report compiled by the Economic and Social Research Institute, of 58,261 births in 2001 22% were by Caesarean an 80.8% jump since 1992, when just 12% of women gave birth by this method.

Consultant obstetricians say the fear of litigation and the fact that women no longer have "the tolerance" for a natural birth are the main reasons behind the massive hike.

However, the National Birth Alliance, which represents mothers and midwives, insists "medical management" of the birth process has interfered with natural delivery.

"The rise in C-sections is clearly a huge concern if more than one-in-five are giving birth by major abdominal surgery," said Philomena Canning, spokeswoman for the National Birth Alliance. "The increase in C-sections is directly to do with the medical management of woman and childbirth.

Women nowadays are healthier than ever, so why is it that at our most healthy we can't give birth naturally? Women are frightened of birth because of the way we are managing it by increasing the intensity of contractions to get the baby out quicker for example," Ms Canning said.

Consultant obstetrician at Cork's Bon Secours hospital, Mr David Corr, said the fear of litigation is a significant factor behind the surge in Caesarean rates.

"Doctors are under huge pressure as obstetrics is now an uninsurable speciality no matter what you do, you're sued," he said. "We're trying to do the best for a mum, but fear of litigation does influence our judgment."

He also said many Irish women request a C-section delivery. "In modern Irish society the tolerance of women for labour has dropped substantially. They don't want pain, they don't want to take the time a normal labour can take, and they don't want any risks," he said. "The two-day labour is a thing of the past."

The World Health Organisation recommends that no more than 15% of births should be by Caesarean section.

Research has shown that Caesarean sections are four times more dangerous as normal deliveries.

Professor Miriam Wiley, head of the health policy research centre at the ESRI, said while the "medical/legal aspect" may be a causal factor, greater advances in technology could also explain the growing number of Caesarean births.

"Nowadays there is a greater probability that high-risk pregnancies will continue to full term and are more likely to result in a C-section," she said.

The ESRI also found:

Home births are on the rise.

The number of births to single mothers increased by 82.7% from an estimated rate of 16.5% in 1992 to a third of all births in 2001.

Breast-feeding rates are improving, with 39.1% of women breast-feeding compared to 33.9% in 1992.