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Monday 26 February 2018

One in five mothers going private has a planned c-section

Ella Pickover and Eilish O'Regan

IRISH women who have private health insurance are twice as likely to have a pre-planned caesarean section delivery compared to public patients, according to a new study published today.

It shows that 21pc of private patients had a scheduled caesarean section, compared to 8.9pc among pregnant women who relied on public care.

The research, carried out by the Royal College of Midwives in Britain, looked at 30,000 women who gave birth at hospitals in Ireland between 2008 and 2011.

It led the authors to speculate that women with private health insurance in this country are 'too posh to push'. Around one in five of the women paid for their treatment themselves.

The findings back up a trend found in previous research published in May of this year, showing a clear public and private divide when it comes to planned caesarean sections.

The earlier study, by researchers at the Department of Public Health and Primary Care in Trinity College, found women who have private health insurance are 22pc more likely to give birth by caesarean section than those who go public.

The gap was as high as 70pc between women who choose to be looked after exclusively by a private obstetrician during pregnancy, compared to those who have a system of shared care involving their GP and another doctor or midwife.

DELIVERY

The research, which is published in the journal 'BMJ Open' today, found that overall 34.4pc of privately paying mothers had a caesarean, both scheduled and emergency, compared to 22.5pc of public patients.

But the biggest gap between the mothers was the rates of scheduled sections, they found.

For first-time mothers, 11.9p of private patients had pre-planned surgery, compared to just 4.6pc of those whose care was paid for by the public purse.

"We found private patients are more likely to have an operative vaginal delivery or a caesarean section.

"The greatest disparity is for scheduled caesarean sections, and twofold differences persist even after adjustment for sociodemographic, medical and obstetric factors.

"We found that the differences observed in relation to operative deliveries were not explained by higher rates of medical or obstetrical complications among private patients, although, like other studies, some of the disparity could be attributed to differences in maternal age and socioeconomic status."

But the authors said it was not possible to determine whether the decision to give birth via caesarean was driven by the expectant mother or the doctors caring for them.

Like any surgery, a caesarean carries a certain amount of risk, such as the wound becoming infected or the baby developing breathing difficulties. It also takes longer to recover than after a vaginal birth.

Janine Stockdale, research fellow at the RCM, said: "This is interesting research that may throw a spotlight on the high rates of caesarean sections we are seeing in western Europe including Britain, a number we would like to see falling."

Irish Independent

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