The NHS Maternity Statistics, England: 2006–2007 show a caesarean section rate of 24.3%, a 0.2% increase on the previous year. Although this increase is small, it shows that maternity services must continue to work together to ensure quality and appropriate services for each and every woman. The RCOG will continue to work towards improving care with the aim to help women achieve normal birth.
An important measure to reduce the caesarean rate is to increase the number of consultant obstetricians on the labour ward to supervise junior doctors. With the introduction of the European Working Time Directive in 2009, this need will become even more apparent when junior doctors weekly working hours are reduced.
The statistics show that 14.7% of deliveries were emergency caesareans and 9.5% were elective caesarean sections. The vast majority of elective caesareans are performed for medical reasons because the health of mother and/or baby would be endangered during labour and attempted vaginal birth. These reasons include: the baby being in a breech position at term; multiple pregnancy; preterm birth; and placenta praevia. For some women and their babies, caesarean section remains the safest form of birth.
A very small proportion of women do request caesarean sections for non-medical reasons, often because of psychological reasons such as a fear of childbirth (tokophobia), fear of pain or due to a previous traumatic birth experience. It is therefore important for obstetricians and midwives to explore the reasons why a patient may request this procedure and ensure that all the relevant information is provided about the risks and benefits of caesarean section, as stated in the NICE guideline on caesarean section.