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Caesarian-birth alert for mums, babies.

Byline: By ALED BLAKE Western Mail

Caesarean births could lead to a greater risk of illness and death - for both mother and baby - according to research published today. The World Health Organisation found that high rates of Caesarian delivery are associated with higher rates of maternal illness. Caesarean rates are increasing across the world and Wales has the highest rates in the UK.

Almost a quarter of births in Wales are by Caesarean section. According to the latest Assembly Government statistics, 23.8% of births in Wales were Caesarean. Fifteen per cent of mothers under 20 had Caesarean deliveries. This compares with 38% of mothers over 40. During 2005, report author JosA Villar assessed the association between rates of Caesarean delivery and maternal and newborn outcomes in hospitals in Latin America.

The investigators analysed more than 97,000 deliveries.

They found that hospitals with high rates of Caesarean delivery had higher rates of severe maternal illness, death, and antibiotic treatment post pregnancy, even after they adjusted for risk factors such as the characteristics of the women, referrals, and the type of hospital.

They also found that rates of pre-term delivery and newborn deaths rose with the increasing rates of Caesarean delivery of between 10% and 20%.

Dr Villar writes, 'In conclusion, high rates of Caesarean delivery do not necessarily indicate good- quality care or services.'

He said institutions that deliver many babies by Caesarean should do a detailed and rigorous study of their obstetric care and how babies are born. At present their services might be causing harm to patients.

Lorna Tinsley, national officer for the Royal College of Midwives in Wales, voiced her concern at the rate of Caesarean births in Wales.

She said, 'We are have the highest rate of Caesarean sections in the UK here in Wales. From those figures you would think women can't have births vaginally any more - which is a nonsense.

'Why are women in a position where they are having more Caesarean sections, either through choice or finding themselves in that model of care? What long-term effects can that have?

'Many women in Wales, instead of being treated under a midwifery office of care where they are encouraged to remain active and eat and drink properly, they are treated under a medical model.

'That does not make sense to us. Firstly, under a cost basis, the cost of having somebody on a bed under an epidural is much higher.

'We are doing lots of work with the Welsh Assembly Government and various trusts to get the message across that we need more birth centres developed.'

Mrs Tinsley warned that a Caesarean is a major operation which may have lasting effects on the mother.

She added, 'There are women who must have a Caesarean section and we need to nurture them through that.

'When the baby is on its way out vaginally, its chest is compressed which means any air in its lungs is forced out and there is an automatic reflex to take a breath.

'Under a Caesarean that does not happen and it means whoever is doing the operation has to do it squeezing the baby artificially.

'According to the latest research that means the baby is going to be more susceptible to allergies.

'Putting aside the medical reasons, mum is not in control; if someone else is delivering that baby the mother is going to have an emotional reaction being distant from that baby.

'In a vaginal birth the baby comes out and immediately has skin-to-skin contact with the mother, and the first thing it wants to do is feed. That doesn't happen with Caesarean births. 'We cannot continue to say to women, 'You don't need a medical delivery but you can have one'. 'It's a nonsense and is not sustainable for health and cost reasons.'
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Publication:Western Mail (Cardiff, Wales)
Date:May 23, 2006
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