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Thursday 18 September 2014

Caesarean rates soar among mums in private healthcare

Published 15/04/2014 | 02:30

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Pregnant women with private healthcare are twice as likely to have an elective caesarean delivery than those in the public system, a study has found
Pregnant women with private healthcare are twice as likely to have an elective caesarean delivery than those in the public system, a study has found

PREGNANT women with private healthcare cover are twice as likely to have an elective caesarean delivery than women on public health cover.

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A study of 403,642 births in various maternity hospitals between 2005 and 2010 found significant differences between private and public patients.

According to the study by BMC Pregnancy and the National Perinatal Epidemiology Centre (NPEC) based at University College Cork (UCC), roughly one-in-three births involved mothers who had booked privately into maternity hospitals.

However, the number of mothers who booked privately dropped significantly over the six-year study period from 33.3pc down to 24.2pc.

The key findings were:

* Women with private health coverage were almost twice as likely to have an elective caesarean delivery than those on only public cover – 17.8pc compared with 9.4pc.

* They were also more likely to have an emergency caesarean delivery – 14.3pc compared with 13.3pc.

* Private patients were 25pc more likely to have a delivery assisted with forceps or vacuum than mothers on public wards.

* Mothers who booked privately for a natural delivery were 40pc more likely to have an episiotomy or a planned, surgical incision on the posterior vaginal wall during second stage of labour.

The study also found significant age differentials in terms of maternity healthcare cover.

Eight out of 10 pregnant women with private healthcare coverage were in the 30-39 year age group. In contrast, less than half the women on public health cover fell within the 30-39 year age bracket.

But the UCC research team warned that further research was required to fully understand the major issues involved.

"To provide the best quality maternity care, we need to understand differences in obstetric practice and avoid unnecessary risks," NPEC study author Jennifer Lutomski said.

"Irrespective of obstetric risk factors, women who opted for private maternity care were significantly more likely to have an obstetric intervention."

Given the need for further data analysis, it is too early for conclusions to be drawn from the research findings, she said.

The study found that the choice in various maternity procedures could be influenced by a variety of factors, including stature, health issues, age and difficulties with previous pregnancies – and the size of the expected baby.

Roughly 75,000 women give birth in Ireland each year at 20 maternity units, 19 public and one private. Private maternity care can be received at any of Ireland's public hospitals.

The Institute of Obstetricians and Gynaecologists (IOG) welcomed the new research.

"Overall the rate of caesarean birth in Ireland is average across all European countries," an official said.

"The current study finds that caesarean section rates are higher in mothers who opt for private care compared to those who have public care. This difference has also been found in other European countries."

"But the reasons for this are unclear.

"However, women who opt to become private patients in Ireland tend to be older, are more likely to have had a caesarean section before and are more likely to have multiple pregnancies.

"Other factors may also be different, for example if a woman perceives herself to be high risk she may be more likely to opt for private care," the IOG said.

Irish Independent

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