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Electing for Caesarean

The number of women in the UK giving birth by Caesarean has doubled in the past 20 years. Pat Thomas looks at recent research which highlights the risks of surgical intervention

Posh didn’t push. Neither did All Saints’ Melanie Blatt. Neither did the mother of all popstars, Madonna. But according to a new study involving three London hospitals, celebrity mums who choose convenience Caesareans rather than normal birth, risk life-threatening complications, by opting for major surgery when they don’t really need it.

More than 20% of women in the UK now give birth by Caesarean – 20 years ago the figure was 9% – and while doctors have long maintained that the operation is safe, a recent overview of the procedure, published in The Lancet, showed otherwise. It revealed that women who have Caesareans are three times (some studies put the figure as high as six times) more likely to die during the procedure than during a normal delivery.

However, so few women die in childbirth these days that researchers believe maternal death figures don’t give the full picture. At King’s College, Guy’s and St Thomas’s hospitals in London, doctors have been looking at what they call ‘near misses’ – the number of women who experienced life-threatening complications during labour. Their study, published in The British Medical Journal (May 2001), involved 49,000 women, and found that for every woman who died there were 118 near misses. Caesareans, whether ‘emergencies’ or planned, accounted for a fourfold increase in the risk of serious complications, including haemorrhage, infection and rupture of the uterus.

Caesareans are a life-saving option and a necessity if:

• The mother has severe pre-eclampsia
• The mother has placenta praevia (when the placenta covers the cervix)
• The baby is in transverse position in the womb
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