Caesarean births 'highest in East'

MORE babies are delivered by Caesarean section in the east of England than in any other part of the country, new figures reveal.

New figures released by the Department of Health show one in four babies in the region is delivered by Caesarean section.

The Royal College of Midwives says it is troubled by the growth in Caesarean rates nationally and is concerned the abdominal surgery might be performed on women routinely rather than out of medical necessity.

It says such a delivery is only appropriate and beneficial in 10 to 15% of all births, and one in four is simply too many.

The data shows St John's Hospital in Chelmsford had the highest rate of Caesareans in the east of England during 2003-04 at 33%, followed by the West Suffolk Hospital in Bury St Edmunds at 31% and Colchester General Hospital at 25%.

Ipswich Hospital saw 22% of its births delivered by Caesarean section while the James Paget Hospital in Gorleston had a rate of 20%.

Melanie Every, regional manager of The Royal College of Midwives, said hospitals with high rates should be looking into the reasons why.

“There may be valid reasons but they need to be broken down and looked at,” she said.

“Quite why the eastern region appears to be so high is unclear. You can often get blips between one hospital and another and sometimes that's due to issues in the local population.

“In the last couple of years, figures suggest there are more Caesarean sections than absolutely necessary. There has been some concern that it has not gone down.

“I would agree if it's the highest in England then obviously that would cause concern. It's a major surgical procedure and carries many risks than a spontaneous natural birth.

“Along with the fact there seems to be a belief Caesarean section is the easier alternative and it is not - it is a major operation.”

A spokeswoman for the Mid Essex Hospital Services NHS Trust, which runs St John's Hospital, said it was concerned about the figures but it was introducing several initiatives to help reduce them.

“We are currently monitoring our procedure against recently issued national guidance. Since we have done this, there has been a slight decrease month on month of Caesarean deliveries,” she said.

“We also commissioned an independent review of maternity services and will be taking this into consideration as well to help reduce this figure.

“We are trying to promote the use of the low risk birthing unit at Maldon and Braintree and we hope to be able to introduce a low risk birthing unit in Chelmsford in the near future.

“Audits tell us a lot of women are choosing Caesareans and we are issuing special leaflets.”

A spokeswoman for West Suffolk Hospital disputed its figures as recorded by the Department of Health, and said it had seen 30.4% last year.

“Basically our policy is we do not encourage requests for normal mothers going through normal pregnancies to come in and have a Caesarean,” she said.

“We only give Caesareans to people who are in medical need for clinical reasons. In the last year, we have been following NICE guidelines.”

The spokeswoman added that through following these guidelines, the hospital had reduced the rate to 25.8% between April 2004 and March.

A spokesman for Colchester General Hospital said it only undertook the operation in the event it is a clinical necessity.

Janie Pearman, head of midwifery at James Paget Healthcare NHS Trust said: “While we are pleased to have the lowest Caesarean section rate in East Anglia we would like to see this reducing even further.

“Our midwives work hard to give women a good childbirth experience and to increase the number of normal births.”

Christine Colbourne, head of midwifery at Ipswich Hospital, said its Caesarean figures had remained stable for the past couple of years and added she was pleased they had not escalated.

“If there is a clinical need that has to be discussed with the obstetrician and the mother. Caesareans are a major operation not without complications.”