High rates of intervention?

[LorlieS]

The C-Section rate is 40-something percent in my local NHS Trust. This seems remarkably high when considering labour and birth are in essence natural processes? Why might it be? What are rates like nationally I wonder?

I've had 8 pregnancies and 3 births. First birth - hospital induction (in hindsight should have declined). Second birth - "normal" delivery in hospital. Third birth (decade after second!) - "normal" delivery at home with no intervention (no internal exams, natural delivery of placenta etc) with an Independent Midwife.

I think it's similar in my trust. It will include electives as well as EMCS.

Partly because in recent years the 'natural birth at any cost' attitude in some NHS trusts has resulted in dead babies (and the associated scandal/investigation)

Good for you?

Also when people have other children to consider they opt for a C-sec or induction so they can have a set date to plan childcare.

Any method of birth is fine provided it’s in the best interest of mum & baby. You don’t get extra points for doing it at home unaided. If anything I think it’s irresponsible as if baby needed to be rushed to a high level NICU you’re delaying that.

it’s a process that often requires medical intervention as an emergency.

I don't know, why don't you ask them?

are you in London or somewhere else with a higher than average maternal age?

Check out ‘when push comes to shove’ it’s very enlightening work they’re doing.

Who knows why it’s such a high intervention rate but the statistics show it’s harming more than doing good!

There has been an increase in section rates due to maternal requests

@Doubleespresso33 I'm not sure it can be argued that matters of convenience such as childcare relating to C-sections are acting in the best interests of mother and baby? Any intervention obviously carries risk.

@magicravioli No and no.

@Doubleespresso33 Home births of subsequent babies are equally as safe (some studies suggest safer) than hospital births. See Cascade of Intevention.

Curious, How do I find out what the % is in my trust?

@purplestripes23 Our Trust publish it monthly on FB as "Birth Stats". I had no idea assisted birth rates were so high.

@purplestripes23 Just as example, looked it up for September 2023 and the % of C-Sections was 47.5%.

Looking at the NHS data, the highest hospital is 32% and most are under 30% c-section https://www.theguardian.com/news/datablog/2009/oct/28/caesarean-birth-statistics-hospital-england

@snowitall September 2023 and the % of C-Sections for our local Trust was 47.5%.
I had a home birth for my last baby.

What percentages are emergency and elective respectively?

@Porridgeinblankies Unsure, but to me nearly 50% seems very high?

The reasons are complex but in summary they include older maternal age, higher bmi's in mothers, more mothers with underlying health conditions (partly due to age) and maternal choice

Women requesting c sections, obstetricians agreeing to them for fear of litigation ( more complaints with vaginal delivery), in some countries c sections are more financially lucrative. Many women just do not want to birth at home.

@anothernamechangeagainsndagain Older mothers and mothers with higher BMIs can deliver safely too though. I was 39 and slightly overweight when I had my last; would personally have declined a C-section unless absolutely necessary based on genuine reasons for. Not that it was ever mentioned.

This @LorlieS also in my area some Trusts have certain specialist consultants resulting in a higher percentage of high-risk mothers.
The figure on its own doesn't mean much.
Labour and birth are natural processes. Survival of the baby and mother are not however natural outcomes of this natural process. Also, some people might choose to have control with a C-section planned again not natural to have control but there you go.

@Riverstep You can birth vaginally in hospital as well as at home?

Maternal age
Maternal BMI
Maternal right to request c section

These 3 reasons have been well publicised for years

Also I'd imagine maybe your trust might be one that has a declining number of units that offer c sections without medical need - in my area fewer and fewer hospitals offer it and push women who request one to a smaller pool of hospitals so naturally then these particular hospitals will have a much higher rate of c sections as they are taking women from further afield. When I had my eldest I'd say 70% of the hospitals offered electives. When I came to have my next one it more like 40% and all electives were pushed to 2 main hospitals

I agree. My local hospital always sits at over 50 percent c section rate taking into account elective and emergencies which seems very high but you can’t seem to have a conversation about it as people instantly get defensive and start talking about dead babies. People used to comment on the infographic they post each month asking why it’s so high but they were always deleted and now you just can’t comment on those posts 🤷‍♀️.