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C-section rates are on the rise in Ireland - but age is a considerable risk factor, says study

The study investigated the factors driving the increasing use of CS using data on births recorded in the 19 Irish maternity units over the last 17 years.

Image: Shutterstock/UzFoto

A STUDY HAS found that the number of births delivered by caesarean section (c-section), has increased fourfold in the past 30 years.

The study conducted by the Economic and Social Research Institute (ESRI), UCD and Trinity College Dublin, found that births by c-section has increased from 7% in 1984 to 13% in 1993 and 30% by 2014 (the latest year available).

The increase in c-sections is a major reason why deaths among mothers and children in childbirth are a fraction of what they were in the past, as similar increases are evident across other OECD countries.

Concerns

But there are now concerns that the benefits of c-section may be outweighed by the increased clinical risks and economic costs that it carries.

The primary reason why use of c-section has increased over time is that medical advances have made the operation much safer for the mother.

But the research also shows that factors like the increasing average age of mothers, particularly first-time mothers and the clinical risks that this brings are crucial.

shutterstock_340887587 Source: Shutterstock/Aliaksei Smalenski

Other research findings from the joint research initiative include:

  • Ireland’s c-section rate is average-to-high within the OECD, where countries like the Netherlands have rates almost 50% lower than Ireland. Italy has the highest rates of c-section in Europe
  • The average age of mothers has increased from 30 in 1999 to 32 in 2014.
  • The proportion of births-to-women aged 35 plus has increased from 20% in 1999 to 33% in 2014, a 65% increase
  • The proportion of first births in the total decreased from 41% in 1999 to 39% in 2014
  • The proportion of mothers with high blood pressure (including pre-existing) increased from 3.7% in 2005 to 4.4% in 2014
  • The proportion of mothers with gestational diabetes increased from 1.3% in 2005 to 5.5% in 2014
  • Use of vaginal birth after c-section has fallen significantly over time.

Policy Implications

shutterstock_465843752 Source: Shutterstock/Africa Studio

The number of births in Irish maternity units increased from 54,000 in 1999 to over 76,000 in 2009 before falling to 68,000 in 2014 – a 26% increase.

The average level of risk associated with mothers giving birth in Irish hospitals is increasing.

However, funding and staffing levels in maternity services has not kept pace with either the number of births or the risk profile.

Prof Michael Turner  from the UCD Centre for Human Reproduction said that:

“Irish maternity units continue to deliver results which are among the best in the world.

If we wish to maintain this record, we will need to invest to take account of adverse trends whilst constantly striving to coordinate and improve practice in Irish maternity services.

The study’s findings were based on data on births recorded in the 19 Irish maternity units over the last 17 years.

A conference taking place at the ESRI today will bring together leading researchers and practitioners in the field of maternal health to discuss the increasing use of caesarean section in Ireland and the associated risks for mothers and infants.

The conference will discuss this recently published and ongoing research from a collaboration between researchers from the ESRI, the Department of Sociology, Trinity College Dublin and the UCD Centre of Human Reproduction at the Coombe Women and Infants University Hospital.

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