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RCOG statement on emergency caesarean section rates

News 4 June 2013

Experts speaking at Euroanaesthesia, the annual congress of the European Society of Anaesthesiology (ESA) say today that there is an increasing need for safe emergency anaesthesia as cases of emergency caesarean section (CS) continue to rise.

Dr Geraldine O’Sullivan (Lead clinician for obstetric anaesthesia, Guy’s and St Thomas’ NHS Foundation Trust, London, UK) discusses how in the UK between 25-30% of deliveries are by CS, which is above the WHO recommended rate of 15% (England 25%, Scotland/Wales 26%, Northern Ireland 30%, UK overall 25%). The 25% overall rate in the UK is made up of approximately 15% emergency CS, and 10% elective CS.

She says that maternal demand is increasing and this has a knock-on effect on future pregnancies as women following one CS are more likely to have another. She adds that this increased CS rate is putting anaesthesia, obstetric, and midwife teams under greater strain.

Dr Tony Falconer, President of the RCOG, says:

“We know that the likelihood of a caesarean section is strongly associated with maternal characteristics and clinical risk factors. Women are more likely to have a c-section if they had a previous c-section, if the baby is in a breech presentation or if the woman has placenta praevia or placental abruption.

“In addition we are seeing a more complicated case load with the rising levels of obesity, multiple births and older mothers. These complex deliveries require the presence of senior medical staff and support the case for more consultants on labour wards. This may impact on lowering the c-section rate and will improve safety for mother and baby.

“Women who have already had a caesarean section need to consider how they would like to deliver in their subsequent pregnancy. Choosing a vaginal birth or a caesarean section carries different risks and benefits but overall in the majority of cases the outcome will be good for mother and baby. It is important that women discuss all the options for their individual case with their midwife and obstetrician.”