Caesarean rate continues to creep up: report

4.00pm

The latest report on maternity information shows the number of women having caesarean section births in New Zealand continues to increase.

The Report on Maternity: Maternal and Newborn Information 2002 is the third report analysing such information.

It shows that in 2002, 22.7 per cent of hospital births were by caesarean section, compared to 22.1 per cent in 2001. Just under 68 per cent of hospital births were normal vaginal deliveries in 2002, down from 70 per cent in 2001.

The report also highlights wide regional differences in caesarean section rates in New Zealand.

A statement by the Ministry of Health said factors driving this included differences in regional populations, different expectations among women, and differences in clinical practice.

Ministry chief advisor for child and youth health Dr Pat Tuohy said the ministry was working to reduce the last factor.

New guidelines on breech birth and vaginal birth following a previous caesarean section were being developed by the ministry-funded NZ Guidelines Group.

Guidelines for the best care in labour would be developed next.

These guidelines would be progressively implemented in consultation with district health boards (DHBs), together with monitoring and evaluation strategies .

Other ministry initiatives to reduce the caesarean rate included:

* Distributing pamphlets based on the first guidelines, to help expectant mothers become fully aware of their birth options.

* Clarifying for DHBs that caesarean sections must not be performed using public funding unless they are medically indicated.

* Canvassing women's views on caesarean section to help develop strategies to reverse the trend (to be done in the next maternity services consumer survey, in 2005).

* Establishing a national maternity policy advisory group .

The report also shows the proportion of women giving birth in the 30-34 year age group and the 35-plus age group continues to grow as a proportion of all women giving birth.

Dr Tuohy said this had implications for services -- for example, fertility, interventions during labour and birth, and low birth weight.

The proportion of under-19 year old women giving birth has declined, as a result of an increasing abortion rate, rather than a declining fertility rate. New Zealand's teen pregnancy rate remains high by international standards.

Dr Tuohy said guidance to assist DHBs reduce rates of teen pregnancy and teen abortion had been shared with boards and would soon be published by the Ministry of Health in the Child Health Toolkit.

Other points in the report include:

In 2002, 53,037 women gave birth in a hospital to a total of 53,589 babies. Deliveries involving operative vaginal procedures such as forceps were 9.6 per cent in 2002, compared to 10.3 per cent the year before. In 2002, 72.6 per cent of all pregnant women had a midwife as lead carer and 8.6 per cent had a GP.

- NZPA