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£3,500 C-section charge proposal

By Lisa Smyth

Women in Northern Ireland could be charged thousands of pounds for choosing to have a baby by Caesarean section for non-medical reasons, the Health Minister has said.

Edwin Poots said he does not believe the public purse should be used to cover the financial burden resulting from women who reject the option of a natural birth.

The cost of the 8,540 C-sections carried out in Northern Ireland in 2009/10 ran to £31m.

With the average cost of a C-section in Northern Ireland standing at £3,585, the introduction of a charge could result in women here shelling out thousands of pounds for the procedure.

Health professionals have argued natural births - when appropriate - are better for mother and baby, but Mr Poots said cutting the number of C-sections will also provide financial benefits for the cash-strapped health service.

Mr Poots said women who are considered at low risk of experiencing medical complications should be encouraged to have their baby in a midwife-led unit or at home, if appropriate. His comments come as he launched a public consultation of a review of maternity services in Northern Ireland.

Northern Ireland currently has the highest rate of C-sections in the UK and Ireland.

Almost 30% of babies here are delivered by C-section compared to 24% in England, 26% in Wales and Scotland and 25% in Ireland.

Mr Poots said: "It costs several thousand pounds more for a Caesarean section so there are savings to be made.

"This isn't about saving money per se. What we want to encourage is more people to give birth naturally because it has better outcomes for the mother and the baby.

"If you want to go down that route, if you want to pay for it, it is totally up to yourself, but I don't feel that we the public in Northern Ireland should be paying additional money for people to have the choice."

A spokeswoman from the Department of Health, Social Services and Public Safety stressed the possibility of being charged for an elective C-section is not in the current consultation document.

She said this is an option the minister may consider in future and any move to introduce a charge would be subject to normal consultation.

The spokeswoman also said that it is not known how much women may have to pay for an elective C-section if charges are introduced.

The draft strategy follows a review of maternity services in Northern Ireland and focuses on providing high quality maternity care tailored to meet the needs of the woman.

It also puts midwives back at the heart of maternity services to normalise birth.

Mr Poots said: "The provision of safe, sustainable, high quality maternity services is one of my priorities. Everyone will come in contact with maternity services at some time and the standard of care provided to families is very close to everyone's hearts.

"That is why this strategy is so important."

Under the proposed strategy, the health trusts will be expected to work to reduce the number of C-sections carried out.

Breedagh Hughes from the Royal College of Midwives said she welcomed any attempts to reduce the number of C-sections in Northern Ireland.

"We have a very high Caesarean section rate and it is not generally realised but it is actually major abdominal surgery," she said.

"You're asking a woman who has had major abdominal surgery to recover from the surgery and look after a brand new baby at the same time."

Ms Hughes said that more needs to be done to shift the perception among women that their bodies will not cope with a normal delivery.

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