Wednesday 22 October 2014

Big variance in C-sections by maternity hospitals here

Dearbhail McDonald Legal Editor

Published 06/01/2014 | 02:30

Newborn is crying
Newborn baby

MORE than one-in-three babies is delivered by caesarean section at many of the country's leading maternity units -- double the recommended World Health Organisation (WHO) rate.

And the rate of deliveries by caesarean at every public hospital in the country exceeds the standard WHO rate of 10pc to 15pc.

At St Luke's Hospital in Kilkenny, almost 40pc of babies are born by caesarean section.

The facility has emerged as the public hospital in Ireland where expectant mums are most likely to give birth by C-section, according to new figures released under the Freedom of Information Acts.

Even the country's lowest rate for C-sections -- 19.1pc at Sligo General -- is far above the WHO recommendations.

LEGAL

In 2011, the year for which latest figures are available, St Luke's had a 38pc C-section rate, followed by 30pc at Cavan General and Our Lady of Lourdes Hospital in Drogheda.

The high rate at St Luke's was raised as part of legal proceedings brought by a pregnant academic.

Although the national C-section rate is published in the ESRI's annual Perinatal Statistics Report, this is the first time that such data has been published by the HSE on an individual hospital basis.

Data from the National Casemix programme shows that around one-in-three babies is born by C-section at some of the country's leading maternity hospitals including the Rotunda, Portiuncula, UCH Galway, Portlaoise and Cork University Maternity Hospital.

The figures were released by the Health Services Executive to the Association for the Improvements to Maternity Services in Ireland (AIMS Ireland).

AIMS, whose mission is to "highlight normal birth practices", said it welcomed the publication of C-section and episiotomy data on a hospital-by-hospital basis.

"Until now, women availing of maternity services in Ireland have been in the dark about the level of interventions performed at their local maternity units and this data will help inform them about where best to have their babies," said Krysia Lynch, co-chair of AIMS Ireland.

"While we are delighted that these figures are finally available to the public, we are concerned that these regional variations in obstetric interventions across Ireland essentially present women with a 'geographic lottery' in terms of their maternity care."

The National Casemix also reveals national rates of instrumental deliveries and episiotomies.

Instrumental deliveries are births that require the use of one or a combination of vacuum extraction and forceps to extract a baby's head during a breech (feet first) birth.

Episiotomies are surgical incisions made during childbirth to widen the vaginal opening.

The highest rate of episiotomies is carried out at the National Maternity Hospital in Dublin, where almost one-in-three will have such surgical incisions. This compares with 14.6pc in the Coombe and 10.3pc in Wexford.

The highest rate of instrumental deliveries is carried out at Waterford Regional (Ardkeen) where more than one-in-five vaginal births requires the use of instruments.

This rate is closely followed by the Rotunda (19.23pc), Castlebar County Hospital (18.46pc) and Our Lady of Lourdes Hospital in Drogheda (17.98pc).

Irish Independent

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