Rising number of caesarean ops

THE East of England has a higher proportion of births delivered by caesarean section than any other region in the country, new statistics reveal.The latest figures, released from the Department of Health, show that 24.

THE East of England has a higher proportion of births delivered by caesarean section than any other region in the country, new statistics reveal.

The latest figures, released from the Department of Health, show that 24.2% of NHS hospital deliveries are through the potentially dangerous surgery, with 9.8% of women electing to give birth by caesarean rather than naturally.

The proportion of women having caesareans in the region is higher than the average for England, 22%, and also tops the rate in London. Meanwhile the percentage of emergency caesareans, 14.3%, is above the national average of 12.7%.

The East of England also has the joint lowest proportion of babies being born naturally during 2002 to 2003, with the total for spontaneous deliveries tying with the south east at 64.4%.

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Elayne Guest , midwifery officer for the East Anglian region, said there had been a steady rise in caesareans over the last 15 years.

"It's worrying as it's a major operation and you've got a natural life event becoming a surgical procedure with all the attendant risks of surgical procedures, such as haemorrhages, infections, epidurals and anaesthetic."

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However doctors are often put in a difficult position when mothers-to-be request a caesarean, sometimes with the mentality of being 'too posh to push'. If obstetricians refuse to operate and complications occur during labour necessitating an emergency caesarean, they could face expensive claims.

Ms Guest said: "The reason why caesarean sections are going up is that obstetricians go straight to caesarean section, particularly for breech babies.

"If you had a breech with your first pregnancy and have to have a caesarean then you are likely to have a caesarean for your other pregnancies. It's to avoid what they call the trial of birth."

There were 2,444 births at West Suffolk Hospital, in Bury St Edmunds, last year but only 63% of them were delivered naturally compared to the national average, which totalled 66.9%. There was also a higher rate of caesarean sections at 25.8%.

Patricia Davis, head of midwifery at the hospital, said the number of caesarean sections in the region was "fairly high".

She added: "We do have requests from women to have caesareans. If you have a woman who's really distressed and saying she cannot face labour you have to be sympathetic to it.

"It is about educating women. The more normal deliveries we can have then consultants and midwives can work on more complex cases."

Chris Colbourne, head of midwifery at Ipswich Hospital, said her staff delivered 3,511 babies last year either at home or in the wards, including at the Gilchrist Maternity Unit in Eye.

A total of 21.1% of deliveries were by caesarean and 69.2% were normal births - both showing better results than the national picture.

She said the figures were a reflection of the support given to women, who were "empowered and encouraged" to chose normal deliveries, and the confidence instilled in them from competent staff.

She added: "I do not have a huge recruitment and retention problem here so the midwives I have got are very experienced. There is a lot of support here for junior midwives when they qualify.

"We do not have a central delivery suite and instead we have three wards where all the care is given. This means that midwives stay very skilled in everything and do not specialise in delivery, post natal or antenatal care.

"The home birth rate is 5%. I think the key issue for us is to offer women choice and to care for women completely throughout the experience."

James Paget Hopital, in Gorleston, saw 2,096 births and 54 home births during 2003, with a caesarean rate of 18% - a reduction of 3% on the year before.

Ms Guest , who is also the spokeswoman for the hospital, estimated that the proportion of women having natural births was probably as high as 75%.

However the number of women who had their deliveries induced had risen slightly to 25%, which she said was preferable to increases in caesareans.

"Inductions are performed for a variety of reasons and mostly this is because women are going over their estimated date of delivery and with the ultra-scanning process doctors are less willing to let them go very overdue," she said.

"The other reason is that by the end of the pregnancy women are very anxious to have their babies. If they then chose to be induced we don't deny them that. Obviously the inductions are only done with the professionals' consent."

At Colchester General Hospital the proportion of caesareans performed topped the national average by reaching 23.6% last year.

Out of the 3,298 babies born there 66.9% were delivered naturally, which exactly matched the total for spontaneous births in England.

A spokesman said: "Caesarean sections are only done on the basis of need. They are not done at Colchester General Hospital just for the sake of it."

Spokesman Peter Richardson said staff at the maternity units in Chelmsford, mainly at St John's Hospital, delivered 3,700 babies with a 29% caesarean rate.

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