More women are having babies by planned C-section
The number of pregnant women who are having planned caesarean sections before the onset of labour in the Rotunda Hospital is continuing to rise.
Some 386 had their babies at term delivered by this method last year - up from 277 in 2012.
They accounted for 13pc of all caesarean sections in the maternity hospital in 2016, according to the Rotunda's annual report.
The report said it is unclear if these women are having a caesarean solely "for personal reasons" or whether there are significant changes happening in the medical risk profile of the patients booking caesarean sections.
Overall, more than a third of babies born in the Rotunda Hospital, Dublin, last year were delivered by caesarean section. The rate rose to 34.6pc - up from 28.7pc - in the previous five years.
A small increase has been seen in these deliveries due to a possible "declining enthusiasm" on the part of patients or doctors for a trial of labour having already had a caesarean birth.
Among the main drivers is a rise in the number of mothers whose baby is in a breech position with feet rather than head first. They include first-time mothers and women who have had a previous caesarean section.
The report also noted that the rise is influenced by the use of oxytocin, a drug given to speed up labour. Changes in protocols mean staff can move to order a caesarean section earlier if they have concerns about the fetal heart rate where a woman had been administered this drug.
Other factors pushing up the rate are the increase in obesity and the numbers of women who are having repeat caesareans.
Rotunda master Professor Fergal Malone said it cared for 10,024 mothers last year.
There were 8,589 babies born to 8,405 women.
"Mothers pregnant with a healthy foetus who obtain their care in the Rotunda can be reassured of a superb standard of care, better than the vast majority of maternity hospitals worldwide," he said.
However, he said the challenge remains in maintaining standards due to the outdated facilities at the hospital, which is to move to a new building at Connolly Hospital, Dublin.