Caesareans increase despite campaign for natural birth

Caesarean births increased last year despite a high-profile campaign to promote natural births for expectant mothers.

Caesarean births increased last year despite a high-profile campaign to promote natural births for expectant mothers.

The statistics from the Department of Health, which revealed that the Caesarean rate in England increased slightly from 22 per cent in 2002-03 to 22.7 per cent in 2003-04, were condemned by health campaigners. They want more women to be able to give birth naturally, rather than having elected or emergency surgical deliveries.

More than half of the Caesareans carried out in 2003-04 were emergencies but the figures showed that 11 per cent of women opted to have an elective Caesarean.

Dame Karlene Davis, of the Royal College of Midwives, said: "We are disappointed and troubled by the rise of the Caesarean rate. We believe that Caesarean delivery is appropriate and beneficial in only 10 to 15 per cent of all births, as specified by the World Health Organisation. As it stands, one in four babies being delivered by Caesarean is simply too many."

Last year the National Institute for Clinical Excellence (Nice) issued guidelines saying that pregnant women should be discouraged from having a Caesarean delivery if they did not need one. This was seen by many as a move to cut down on the number of women dubbed "too posh to push" and discourage elective Caesareans where there was no clinical need.

Belinda Phipps, chief executive of the National Childbirth Trust (NCT), said although it was a small increase following a year when the Caesarean rate plateaued, the charity was disappointed by the rise in 2003-04. "It is of concern that emergency Caesareans account for more than half of these figures," she said. "Maternity units are generally aware and concerned to bring their Caesarean rates down and we hoped that the trend would have been downward following last year's statistics showing no increase. However, these figures show that medical intervention is continuing to occur in a high proportion of cases."

Ms Phipps said simple measures would increase the normal birth rate, such as ensuring all women in labour had a midwife with them whom they knew and who could give them their full attention.

"There is good evidence that one-to-one support reduces both Caesarean and other intervention rates," Ms Phipps said.

"Similarly, making simple changes to the room in which women give birth make it easier for a woman to have a normal birth. Moving the bed to one side to give space for walking, providing lighting that can be dimmed and furniture or mats so a woman can choose upright comfortable positions are all inexpensive measures that can make a significant difference."

In total there were around 593,600 births in England in 2003-04 - up 5 per cent on the previous year. More than 20 per cent of deliveries were induced, the statistics showed. Around 46 per cent were "normal deliveries" - defined as those without surgical intervention, use of instruments, induction, epidural or general anaesthetic.

Women who had a spontaneous delivery spent on average one day in hospital after delivery, while those with instrumental deliveries spent around one to two days. But women who had their baby by Caesarean spent around three to four days in hospital.