Caesarean births have not become 'trendy', say experts

MATERNITY experts have dismissed the notion that women are opting to give birth by Caesarean section because the method is 'trendy'.

Last week the health minister, Susan Deacon, indicated that she wants to curb the number of Caesareans performed in Scotland as fears emerged that it is becoming the birth method of choice for fashionable mothers who regard themselves as "too posh to push".

"When this was last studied, in 1995, there were a total of 60,000 births in Scotland, and just 32 of them were to women who chose Caesarean section for no other reason than that they wanted them," said Professor Edith Hillan of the University of Glasgow. "The numbers are really infinitesimally small, and there is no reason to believe they have risen much since."

Pop stars Victoria "Posh Spice" Beckham and Madonna both delivered their children by Caesarean , as did Liam Gallagher's wife, actress Patsy Kensit. Cherie Blair, the Prime Minister's wife, is also understood to be planning a Caesarean delivery for her fourth child, due in April, and there is concern that these celebrity mothers may be setting a trend.

However, maternity specialists say that is unlikely. "In the past, doctors used to record only clinical reasons for performing sections," said Hillan. "Now they are tending to note down that it is maternal choice as well, partly because they have been accused of forcing women into it. The notion that an increasing number of women are demanding these operations is, in my opinion, a bit of a red herring."

There is no doubt that Caesarean section rates in Scotland have risen from 5% to 18.5% since 1970, and the experts want to know why. "I don't believe that fashion accounts for many Caesareans, but I do believe the increasing numbers have to be examined to establish why this is happening," said Nadine Edwards, a spokeswoman for the Association for Improvement in Maternity Services. "It could be that many obstetricians are recommending it for breech births, which have been thought to be more dangerous to deliver vaginally. However the evidence for that is not entirely clear."

Yvonne Williams, who runs a Caesarean section telephone advice line from her home in the Isle of Man, receives several calls a day from women seeking advice on surgical births and post-natal support. A minority are from first-time mothers exploring the prospect of surgical birth. "Some people seem to think it's the easy option, but it's not," she said. "They are not aware that a normal delivery is still four times safer. Any major operation puts life at risk."

She wants better, more honest, information to be made available. "Leaflets could set out clearly the pros and cons of Caesareans," she said. "Midwives and doctors are dubious about frightening mothers-to- be, and I sympathise with that. But people ought to have the opportunity to think about it before they are in the labour suite."

Liz Goudie, spokeswoman for the National Childbirth Trust in Scotland, agrees. "Women often aren't aware of the length of time it will take to recover, or the possibility of wound infections, and they may be caught unawares by the psychological after-effects," she said. If they are really making informed choices, they have to be told about that."

Linda Watson-Brown, a lecturer in reproductive health at the University of Edinburgh, warns against stigmatising women who deliver surgically.

"They need more accurate information, and if discussion is couched in terms of 'curbs', they may feel ashamed and reluctant to talk about it openly," she said. "If anyone thinks a Caesarean goes with the Fendi handbag and the kitten heels, we have to examine the messages we are sending out. There may be a feeling that opting for an operation is opting out of pain, but that is not the case."

Watson-Brown, herself the mother of two children born by Caesarean, says better information would also help those mothers who have no choice but to undergo surgery cope with the consequences.

"It can be a positive experience," she said. "But that requires women to be properly informed."

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