Number of caesareans continues to rise
The number of caesarean sections taking place in Irish maternity services has jumped significantly over the last 30 years, new research has found.
According to the findings, just 7% of deliveries were by caesarean section in 1984. By 1993, this had almost doubled to 13%. However by 2014, it had jumped to 30% - a fourfold increase.
The research noted that the average age of mothers has increased from 30 in 1999 to 32 in 2014, and the proportion of births to women over the age of 35 has increased from 20% in 1999 to 33% in 2014.
Older mothers can face more risks during delivery because they are more likely to already have other health conditions, such as high blood pressure. The researchers found that the proportion of mothers presenting with high blood pressure had risen from 3.7% in 2005 to 4.4% in 2014.
High blood pressure in pregnancy can be dangerous for both the mother and the baby as it can lead to certain complications, such as damage to the mother's kidneys, premature delivery and low birth weight.
Pre-eclampsia may also occur. This is a dangerous condition related to increased blood pressure and protein in the mother's urine. The only way to ‘cure' it is to deliver the baby.
The research also found that the proportion of mothers with gestational diabetes had jumped from 1.3% in 2005 to 5.5% in 2014. Again, gestational diabetes can lead to a number of complications, such as premature labour and bigger than average babies, which are more difficult to deliver.
Meanwhile, the research also found that the use of vaginal birth after a previous caesarean section had fallen significantly over time.
Speaking on The Anton Savage Show on Today FM, the Master of the National Maternity Hospital in Dublin, Dr Rhona Mahony, said that two of the main reasons why first babies are delivered by caesarean section is because the baby is in distress or because the labour is not progressing. She acknowledged that a second delivery after a previous section can be more complicated by virtue of the fact that the first delivery was a caesarean.
The research noted that the number of births in Irish maternity units increased from 54,000 in 1999 to more than 76,000 in 2009. By 2014, it had fallen to 68,000, but this is still significantly higher than 1999's figure.
The researchers said that the average level of risk associated with mothers giving birth in Ireland is increasing, and funding and staffing levels have not kept pace with the number of births or the risk profile.
This was backed up by Dr Mahony who said that continued under-investment in this area means that services are not prepared for the much more complex cases that are now being seen.
"Every birth matters and we have to, as a society, invest in our maternity services," she commented.
These findings are based on ongoing research being carried out by the Economic and Social Research Institute (ESRI), the Department of Sociology at Trinity College Dublin and the UCD Centre of Human Reproduction at the Coombe Women and Infants University Hospital.
They were discussed at a conference entitled 'National Trends and Hospital-level Variation Caesarean Section: Evidence from Ireland at the ESRI' on Tuesday.
[Posted: Tue 25/10/2016]