Rise in elective c-sections causes practice review
Planned caesareans are putting Auckland City Hospital under pressure as more and more mums opt for the birthing procedure.
Over the past few years, there has been a rise in planned caesareans especially at Auckland City Hospital, which falls under Auckland District Health Board’s (ADHB). ADHB is now embarking on a review to find out why the rate is increasing.
Last year 36 per cent of babies born in Auckland hospital were delivered via caesarean section.
Caesarean sections fall into two categories - emergency and elective. Emergency caesareans are unplanned. Elective caesareans are planned and can be done at the request of a mother even if there are no complications.
A 2016 National Women’s annual clinical report found the emergency caesarean rate was stable at 16 to 18 per cent but the percentage of elective caesareans was increasing.
First time mothers who opted for elective caesareans at maternal request was 19 per cent
‘‘There are no other areas in healthcare in New Zealand where this is acceptable.’’ Alison Eddy
which was an ‘‘area of concern,’’ the report said.
Auckland Hospital obstetrician Michelle Wise said if numbers continued to increase, the hospital would not have enough resources to provide for the number of caesareans.
ADHB’S elective caesarean pathway will be reviewed to find out why women were choosing to have planned caesareans, especially when there was no reason to do so, Wise said.
‘‘It’s not about looking at the number of caesareans that we’re doing, it’s about looking at every single one and reassuring ourselves that each one is medically necessary and has some medical benefit to the woman.’’
New Zealand College of Midwives spokeswoman Alison Eddy said caesareans were an over-utilised intervention in many countries, including New Zealand. Women who had no complications could be opting for elective caesarean sections due to fear, Eddy said.
‘‘Maternity services are fully funded for New Zealand women, so it appears that the public purse is funding unnecessary surgery which is likely to be causing harm to women and babies,’’ Eddy said. ‘‘There are no other areas in healthcare in New Zealand where this is acceptable.’’
The pathway for elective caesareans at Auckland City Hospital will soon be under review.