Too posh to push mums hike up Caesarian rates

EXPECTANT mothers who are "too posh to push" have helped to almost double the rate of Caesarean births in Edinburgh.

Last year, more than one in four women who gave birth in the Capital had Caesarean sections to deliver their babies - higher than the UK and Scottish average, and up from 16 per cent in 1995.

There were 1647 Caesarean births at the Simpson maternity centre last year - 27 per cent of all births.

Midwives said one of the reasons for the rise was "a class of women" in the city who choose pre-planned Caesareans for non-medical reasons.

Other explanations include more professional women who give birth later in life, and the large number of high-risk births from all over south-east Scotland that are handled in Edinburgh.

And as the number of first Caesareans grows, so too does the repeat rate, as women who have had one surgical birth are more likely to have another.

Medical experts today said the rate was "undoubtedly too high" and questioned whether Caesareans were being done as a matter of course.

Gillian Smith, acting director for RCM Scotland, said: "There is no doubt that a 27 per cent Caesarean section rate is high. Some places get it below 20 per cent. It is a fallacy to purport that Caesareans are a safe option - there are risks associated with major abdominal operations."

Edinburgh-based Cynthia Clarkson, maternity services convener with the National Childbirth Trust, added:

"The World Health Organisation (WHO) said the rate should not exceed 15 per cent.

We need to look carefully at individual cases and decide if Caesareans are really beneficial."

The national average rate in 2005 was 24.9 per cent. At St John's Hospital in Livingston, there has been a steady year-on-year rise to 26 per cent in 2006.

In 2000, the former Simpson Memorial Maternity Pavilion in the city had a rate of 22.4 per cent, and just 16 per cent in 1995.

In the most recent figures, just over one third were elective - or unplanned - Caesareans, usually for medical reasons but sometimes by personal choice.

Dr Rhona Hughes, lead obstetrician with NHS Lothian, said: "A Caesarean section is only carried out when there is a clinical need. We always prefer to see a natural birth and we are proactively trying to encourage that.

"Senior midwives are also involved in a scheme to help and support mothers who have previously had a Caesarean section, to enable them to have natural births in subsequent pregnancies.

"Edinburgh's figures may be higher than the Scottish average for a number of reasons, including the fact our mothers are generally older than elsewhere in the country, we receive problematic pregnancies from all over the south-east of Scotland and we have an IVF service which tends to produce more twins and, therefore, increases the need for Caesarean section."
'I didn't want surgery but my baby was in distress'

NEW mother Louise Cumming was adamant she did not want a Caesarean birth.

But when the 33-year-old housewife was told that her unborn baby was in distress, she reluctantly agreed to go ahead with the emergency operation.

Mrs Cumming, from Mitchell Street in Leith, is still unsure if the decision was necessary.

She also fears she may be required to undergo an elective Caesarean in the future if she wants more children.

Daughter Emily is now nearly 21 months old, and in perfect health.

"I went to the ERI to be induced because I was showing symptoms of pre-eclampsia and my blood pressure was high," she said.

"On the Friday, I was told my baby was in distress so I had an emergency Caesarean. I was adamant I did not want a Caesarean birth, but I had had little sleep and was exhausted so I gave in.

"We live in a fourth floor flat, and for six weeks after the birth I was stuck inside recuperating.

"I hope it was the right decision to make, but you never know. Afterwards, my GP said my daughter may have come out on her own if left a bit longer, but there's no way of knowing."
NHS hails healthy rise in nursing staff

AN extra 390 nurses have been employed to work on Lothian hospital wards following a successful recruitment drive.

In the past two years, new figures show NHS Lothian has moved from having the highest to one of the lower vacancy levels in Scotland.

Currently the board employs 9268 full-time registered and unregistered nurses, up from 8876 at the same point in 2005.

Health chiefs have also dramatically cut the amount paid to nursing agencies from £11 million in 2003/04 to £4m in the most recent financial year, with the efficiency savings ploughed back into patient care.

Heather Tierney-Moore, NHS Lothian director of nursing, said: "The recruitment drive has been a great success. Nurses are increasingly attracted to Lothian because it is a flexible employer with family friendly policies, and is recognised as a centre of excellence."

The board has also developed a bank of experienced nurses, who are able to provide cover for holidays and sickness.

Source:news.scotsman.com