Sunday Express

Caesareans ‘are causing thousands to lose babies’

- By Lucy Johnston

CAESAREAN sections are causing thousands of women to lose babies in subsequent pregnancie­s, according to a leading obstetrici­an.

In what experts describe as a “tragedy” and “hidden disaster”, some women lose multiple babies before doctors realise that a c-section for their first child may be to blame.

Doctors who perform the procedure late can inadverten­tly make an incision low in the womb which weakens the woman’s cervix, according to Professor Andrew Shennan, one of the country’s leading experts on premature birth.

This makes it more difficult for women to hold an unborn baby in subsequent pregnancie­s.

Often, women don’t even need a c-section, according to the professor, from King’s College London, who is due to publish his findings in a medical journal later this year. Caesareans in the second stage of labour have become increasing­ly common. But Prof Shennan believes that the trend is having a “devastatin­g” effect on women, who are then six times more likely to suffer a subsequent miscarriag­e or premature birth.

A series of studies carried out by Prof Shennan – who is also the director of the Prematurit­y Research Centre at charity Tommy’s – show that 14 per cent of women who have a late stage c-sections go on to have a subsequent premature birth.

In contrast, only two per cent of women who did not have a late stage c-section have a premature baby.

His research also showed that previous caesareans cause up to 1,000 premature births every year.

Of these children, 500 will die while many others will suffer problems such as brain damage, blindness or deafness because of early delivery.

Most premature births occur before the baby is 32 weeks, and many happen before 24 weeks, when the baby is old enough to survive.

Prof Shennan claims that many doctors are opting to carry out late c-sections instead of using forceps or other instrument­s because mistaken belief it is safer.

He also said “just a handful of consultant­s” were currently aware of the issue and called for “new guidelines”.

The professor added: “Many people are unaware of the tragedy of the fact women are recurrentl­y losing babies because they are not being appropriat­ely referred or seeking appropriat­e help during a delivery.

“Doctors really need to be aware of this problem.

“Many senior doctors – even consultant­s who qualified in recent years – avoid using forceps and other instrument­s to assist in delivery because of the mistaken belief this is less safe but this is not the case.

“Once doctors stop doing assisted deliveries or do fewer, they rapidly de-skill, making it harder for them to judge when it is appropriat­e to do or how to properly carry them out.”

Prof Shennan said he saw women affected by the issue in his clinic “every week”.

He said: “They often go through multiple pregnancie­s before they find out what the problem is. This will be by luck, very often.

“What is dreadful is that there will be women out there who give up after numerous attempts, unaware of the cause, and that help could have led them to carry a child to term again.

Last night, NHS England revealed that it is working closely with Prof Shennan to make improvemen­ts to its services.

Matthew Jolly, national clinical director for maternity and women’s health, said: “These research findings will help obstetrici­ans provide best practice care when a caesarean section at full dilatation is required.

“As part of the long-term plan for the NHS, we want to build on the excellent work across the country to make maternity services in England among the safest in the world.” of the

‘Women often go through multiple pregnancie­s before they find out what the problem is’

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