Fun facts of the day from the [http://www.hscic.gov.uk/catalogue/PUB12744 HES 2012 - 2013 maternity figures] officially released by the government this week:
60.9% of all women had a spontaneous vertex birth. 0.4% had spontaneous other. 3.2% had low forceps. 3.6% had forceps other. 6.0% had ventouse. 0.4% were breech, 0.0% were breech extraction. 25.5% of all women had an CS (10.7% ELCS, 14.8% EMCS).
Compare this with two different age groups.
69% of women aged 20 - 24 had a spontaneous vertex birth. 0.5% had spontaneous other. 2.8% had low forceps. 3.5% had forceps other. 6.0% had ventouse. 0.3% were breech, 0.0% were breech extraction. 17.9% of women between 20 and 24 had an CS (5.4% ELCS, 12.5% EMCS).
53.4% of women aged 35 - 39 had a spontaneous vertex birth. 0.3% had spontaneous other. 3.0% had low forceps. 3.7% had forceps other. 6.0% had ventouse. 0.4% were breech, 0.0% were breech extraction. 35.6% of women between aged 35 and 39 had an CS (17.1% ELCS, 16.8% EMCS).
Bit of a difference depending on your age there.
...remembering that women who are older are more likely to have more children read on.
404,094 woman had spontaneous deliveries. (Note here that data was unavailable for 293,685 women). Discounting this missing data, 34.3% of all spontaneous deliveries were 1st time mothers, 32.5% had one child, 16.7% had two children, 8.3% had three children, 4.1% had four child and 4.1% had 5 child or more.
83,984 women had instrumental deliveries. (Note here that data was unavailable for 25,121 women). Discounting this missing data, 64.1% of all instrumental deliveries were 1st time mothers, 23.5% had one child, 7.4% had two children, 2.8% had three children, 1.1% had four child and 1.0% had 5 child or more.
167,283 had CS (Note here that data was unavailable for 49,325 women). Discounting this missing data, 40.4% of all CS were 1st time mothers, 30.4% had one child, 15.2% had two children, 7.1% had three children, 3.4% had four child and 3.4% had 5 child or more.
Breaking that down to ELCS and EMCS:
23.7% of ELCS were 1st time mothers, 36.7% had one child, 20.9% had two children, 9.9% had three children, 4.6% had four child and 4.2% had 5 child or more.
52.4% of EMCS were 1st time mothers, 26% had one child, 11.1% had two children, 5.2% had three children, 2.5% had four child and 2.9% had 5 child or more.
Of course those figures are distorted by the number of children women have (there are less women for each subsequent group), but there is some interesting things there.
If you are a 1st time mother over 35 you might be raising an eyebrow a little by now... (Conversely if you are a second time mother there might be some comfort in them too)
...then you see this...
0.5% of all births were still births.
For spontaneous VBs 0.7% were still births.
If you break this down further:
Normal deliveries (Spontaneous vertex) 0.6%, Spontaneous other delivery 0.5%, Other breech 12.7%.
For instrumental deliveries 0.2% were still births.
For CS (All) 0.3% were still births.
Breaking down CS figures, ELCS was 0.2% and EMCS was 0.3%. Other was 1.1%
Huh? What? Yep. Go read the HES figures... Whats going on with that? Again there is data missing like the previous batch of figures, so it does need to be approached with some caution, but its enough to make you wonder why this is the case. Let me just repeat that. In 2012-2013 in the UK, the rate of recorded still births for 'normal deliveries' was 0.6% compared with 0.2% for ELCS (and indeed instrumental deliveries which might actually soften fears about instrumental deliveries for some women).
You'd be very much forgiven if you are over a first time mother over 35 planning to have just one child, to make a completely rational decision to have an ELCS based on that information, without any need of clinical anxiety or questioning of your mental health. Yet this is not deemed acceptable by society.
Of course its not as simple as that and loads of other factors come into the mix, but those statistics do make you stop and reconsider the general information that you are being told.
There's loads more data in the HES figures, including a full page of delivery complications (which I note are purely psychical) and a full page of birth complications by method of delivery which are too lengthy to post here but worth reading if you are trying to assess what might be best for you and your own personal circumstances.
Warning though; you can sit reading those figures for hours and drive yourself crazy with them too though. My point is really whether its appropriate to be giving out such generalised information that we are currently getting that might be completely unreflective of your situation and wondering why healthcare providers being so dismissive of questioning them.
There is plenty in there to encourage women to go for a VB and plenty to encourage women to have the freedom to choose an ELCS without being vilified for doing so.
It is not as simple as "planning a VB = natural, more likely, safer, good" vs "planning a CS = unnatural, unnecessary, has more complication, bad."