Women 'not too posh to push'

Most women have caesarean sections for medical reasons, not because they are 'too posh to push,' new research suggests.

Researchers from the Royal College of Obstetricians and Gynaecologists (RCOG) looked at caesarean section rates in 146 NHS trusts in England in 2008, when 620,000 births occurred.

Overall, nearly one in four women had a caesarean section, but rates varied between NHS trusts, even after differences in the local populations were taken into account.

Most women had a caesarean section for medical reasons. In nine out of 10 cases the baby was in breech position, 71 per cent had a previous c-section and 85 per cent had pregnancy complications.

Only 9.3 per cent of women chose to have a c-section over natural childbirth.

Although 14.5 per cent of caesarean sections were performed as an emergency procedure, the rates also varied between NHS Trusts.

The variation in c-section rates across the country was likely down to doctors deciding when to perform an emergency caesarean section, said study leader Dr Fiona Bragg, a registrar in public health from the London School of Hygiene and Tropical Medicine.

"We observed that variation in overall rates of caesarean section was associated with rates of emergency procedures," Dr Bragg wrote in the British Medical Journal.

"The results also suggest that another explanation—that high numbers of low risk women are requesting elective caesarean—is unlikely to be a major contributor because most women undergoing a caesarean section in 2008 had at least one clinical risk factor," she added.

This article was published on Thu 7 October 2010