Belfast Telegraph

Thursday 17 April 2014

'More Caesareans' with private care

Private patients are twice as likely to have pre-planned Caesarean sections as women whose treatment is publicly funded, research found

Private patients are twice as likely to have pre-planned Caesarean sections as women whose treatment is publicly funded, according to new figures that lend support to the theory that some mothers are "too posh to push".

Twenty one percent of private patients have a scheduled C-section compared to just 8.9% of publicly funded ones, the study found.

Researchers examined 30,000 women who gave birth at a hospital in Ireland which caters for both private and public-funded patients between 2008 and 2011. A round one in five of the women paid for their treatment themselves .

The research, published in the journal BMJ Open, found that overall 34.4% of privately paying mothers had a C-section compared to 22.5% of public patients.

The "greatest disparity" noted between the mothers was the rates of scheduled C-sections, they found.

For first time mothers, 11.9% of private patients had pre-planned surgery compared to just 4.6% of those whose care was paid for by the public purse.

"We found that private patients are more likely than public patients to have an operative vaginal delivery or a C aesarean section.

"The greatest disparity is for scheduled C aesarean sections, and twofold differences persist even after adjustment for sociodemographic, medical and obstetric factors.

"We found that the differences observed in relation to operative deliveries were not explained by higher rates of medical or obstetrical complications among private patients, although like other studies some of the disparity could be attributed to differences in maternal age and socioeconomic status."

But the authors said that it was not possible to determine whether the decision to give birth via C-section was driven by the expectant mother or the doctors caring for them.

Like any surgery a Caesarean section carries a certain amount of risk - such as the wound becoming infected or the baby developing breathing difficulties. It also takes longer to recover than after a vaginal birth.

The Royal College of Midwives (RCM) said the study highlights the need to avoid "unnecessary" Caesarean sections.

Janine Stockdale, research fellow at the RCM, said: "This is interesting research that may throw a spotlight on the high rates of Caesarean sections that we are seeing in Western Europe including the UK, a number that we would like to see falling.

"The findings also underline the need to avoid unnecessary Caesarean sections as this is a major surgical operation, that has the potential for increased complications every time a woman has the procedure carried out.

"The RCM therefore supports National Institute for Health and Care Excellence guidelines which encourage women to have a thorough discussion with their obstetricians and midwives about the implications of having a Caesarean section, especially in circumstances where other options remain open to them."

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