Monday 18 December 2017

Older mothers and rise in C-sections: Holles St reflects on changes over 100 years

Master Dr Rhona Mahony
Master Dr Rhona Mahony

Jane O'Faherty

The proportion of women over the age of 35 giving birth in the National Maternity Hospital has surged in the space of 10 years.

Speaking at a symposium to mark the hospital's Charter Day, Master Dr Rhona Mahony noted that 40pc of women attending Holles St were now over 35, up from around 20pc in 2003.

But she added that the increase brought a "huge amount of complication" in births.

"We are more likely to have difficulties such as gestational diabetes. We are more likely to have obesity. We are more likely to have everything," she said. "It's a massive problem."

Dr Mahony also said that the hospital had seen cases where women aged 48, 51 and 52 were giving birth, and explained that dealing with these older age groups had "not been a straightforward transition".

"Certainly, when you look at women over 44, there is an enormous challenge associated with childbirth.

"That has really changed our practice here in the hospital and has been quite difficult a trend for us to deal with," she added.

Meanwhile, 35pc of mothers seen by Holles St are overweight, which Dr Mahony says can pose difficulties with subsequent operations, anaesthesia, diabetes and miscarriages.

Dr Mahony was addressing guests as part of a lecture on how the hospital had changed since the days of the 1916 Rising, and referred to the hospital's 1916 and 1917 annual report.

She highlighted the rise of Caesarean sections at the hospital and predicted inductions of labour would continue to be more common, adding that it was "hard to imagine" the current figure falling.

"In spite of the rise of caesarean section rates, the premise of cerebral palsy at two per thousand hasn't changed at all," she added.

"We have, thankfully, seen a massive decline in our perinatal mortality rates," she added, stating that mortality rates had fallen from 70 per thousand to just four per thousand today.

The lecture also focused on the role of women in the Rising, and revealed the hospital's own role in the events of Easter week.

"We treated 40 cases of gunshot wounds - men, women and children - in our hospital here," she said.

She also noted that Elizabeth O'Farrell, the nurse who flew the White Flag when the rebels surrendered, later trained as a midwife at the hospital, calling her "an extraordinary woman".

Irish Independent

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