Caesarean birth rate in Ireland about three times the recommended figure

Greater support for mothers to achieve natural births is “urgently needed”, experts have advised.

Caesarean birth rate in Ireland about three times the recommended figure

The caesarean birth rate in this country is about three times the figure recommended by the World Health Organisation.

A maternity care conference held yesterday heard the rate in 2015 was 32.3% for women having their first baby and 30% for women having their second or subsequent baby.

The WHO states that when the C-section rate goes above 10% there is no evidence mortality rates improve.

Trinity College Dublin and NUI Galway took part in a European study called OptiBirth that aims to increase the rates of vaginal births after a C-section through better and more women-centred maternity care.

While most women would be able to have a natural birth after having a C-section, the reality in Ireland and many western countries is that rates of natural birth after a C-section remain small.

The study’s authors developed a programme to improve rates of natural birth after a C-section. It was tested in 15 hospitals across Ireland, Germany, and Italy, with mixed results.

The Italian hospitals that used the programme increased their rates of natural birth after a C-section from 8% to 22%.

The co-ordinator of OptiBirth, Trinity Professor Cecily Begley, said the study clearly shows that women who understood the risks and benefits of a C-section and a natural birth were “strongly motivated” to plan a vaginal birth.

“Change took time here in Ireland and clinicians now need to take this cost- effective and safe support and information programme on board and work with women to reduce unnecessary caesarean sections into the future,” said Prof Begley.

She said the rate of vaginal births after a C-section in Ireland fell further during the study because there was a lot of negative media reports about maternity care at the time.

“The C-section rate has shot up in the last two years, and that affected vaginal births after a C-section as well.”

Prof Begley said the study shows the programme worked when people were motivated and wanted to change, and the environment was conducive to reducing C-sections.

“Women need to educate themselves about childbirth because sadly in Ireland and in many other countries clinicians don’t always tell women the full facts.

“I think that some women have this idea that a C-section is easier, quicker, and safer. It’s not. It is a very safe operation but, to be absolutely blunt, C-section is more dangerous for women, in particular, and sometimes for babies as well, than having a vaginal birth and there are knock-on effects for years afterwards.”

The principal investigator of the OptiBIRTH study in Ireland, Declan Devane of NUI Galway, said a C-section could be life-saving but that, overall, this operation led to higher maternal death and post-natal problems.

“The risk of death for babies born naturally after a previous C-section is higher than for those born by repeat C-section, but it is the same low level of risk that all first-born babies face,” said Prof Devane.

As the women’s conference today, the Association for Improvements in Maternity Services Ireland will launch an easy-to-read handbook on the facts surrounding caesarean birth.

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