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Caesareans now used in one in four UK births, major new report reveals

The Telegraph logo The Telegraph 12/10/2018 Henry Bodkin

Caesareans can be life-saving interventions for women and newborns when complications occur, such as bleeding, foetal distress, hypertensive disease, and babies in abnormal position. (Representative image) © Provided by Shutterstock Caesareans can be life-saving interventions for women and newborns when complications occur, such as bleeding, foetal distress, hypertensive disease, and babies in abnormal position. (Representative image) One in four UK babies is now delivered by caesarean section, new figures reveal as experts say women are increasingly scared of natural birth.

A major international study, published in the Lancet, shows rates of C-section delivery have increased from 19.7 per cent in 2000 to 26.2 per cent in 2015, putting Britain among the highest in Western Europe for use of the procedure.

The 33 per cent increase comes despite years of a natural birth campaign in many NHS hospitals, which still sees women occasionally denied the treatment at three-quarters of maternity units.

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As well as “fear” of natural birth, Britain’s rise in caesarean use is likely to be driven by increased obesity among women of childbearing age.

However, scientists warned on Wednesday that only 10 to 15 per cent of deliveries medically require a caesarean section, meaning at least 85,00 are performed purely on the basis of preference each year.

(Representative image) © Provided by Shutterstock (Representative image) Caesareans can be life-saving interventions for women and newborns when complications occur, such as bleeding, foetal distress, hypertensive disease, and babies in abnormal position.

They also have the advantage of being less painful, and avoiding after effects such as urinary incontinence and reduced sexual functioning.

But the procedure can lead to scarring of the womb, which heightens the risk of complications during future births, such as from bleeding, abnormal development of the placenta, ectopic pregnancy, stillbirth and preterm birth.

Guidelines from the National Institute for Health and Care Excellence (Nice) state women who ask for a caesarean should be offered one if, after support and discussion with a doctor, they feel it is best for them.

The Lancet study, compiled by several UK Universities, found common reasons why women request C-sections include past negative experiences of vaginal birth, fear of labour pains and of the risk of reduced quality of sex.

Professor Jane Sandall, of King's College London, said: "Given the increasing use of C-section, particularly cases that are not medically required, there is a crucial need to understand the health effects on women and children.

"C-section is a type of major surgery, which carries risks that require careful consideration.

"The growing use of C-sections for non-medical purposes could be introducing avoidable complications, and we advocate that C-section should only be used when it is medically required."

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The rise in caesarean use in Britain is in line with the international trend, which has seen C-section use almost double globally from 2000 to 2015.

Researchers found 60 per cent of countries were overusing the procedure and 25 per cent under-using it.

The figures also show that in at least 15 countries C-section use exceeds 40 per cent.

Dominican Republic had the highest proportion - 58.1 percent - followed by Brazil and Egypt - both 55.5 per cent - and Turkey - 53.1 per cent.

Researchers, who used World Health Organisation (WHO) and Unicef data from 169 countries, also found significant disparities within low and middle-income countries, where the wealthiest women were six times more likely to have a C-section compared with the poorest women.

C-section delivery have increased from 19.7 per cent in 2000 to 26.2 per cent in 2015, putting Britain among the highest in Western Europe for use of the procedure. (Representative image) © Provided by Shutterstock C-section delivery have increased from 19.7 per cent in 2000 to 26.2 per cent in 2015, putting Britain among the highest in Western Europe for use of the procedure. (Representative image) They said it is important to note there are small but serious risks with C-sections, and that each of these risks increases the more times a woman has the procedure.

Mandy Forrester, from the Royal College of Midwives, called for expecting mother to see the same midwife throughout the antenatal and labour process.

“When the woman knows and trusts her midwives she will be more likely to share her concerns about her pregnancy,” she said.

“Midwives will respect a woman’s choice and support her in her choice.”

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