Women ‘being pressured into having caesareans’
WOMEN are being pushed into unnecessary C-sections because they are not given time to give birth, the World Health Organisation has warned. The agency has issued new childbirth guidance removing the emphasis on a timescale over which a ‘normal’ labour should take place.
They warned ‘increasing medicalisation’ of childbirth has meant unnecessary interventions have become ‘rampant’ in many nations, usually because doctors think women are taking too long to give birth. Guidelines dating back to the 1950s suggest a normal birth should be expected to progress at a set pace – roughly 1cm of dilation every hour – but mounting evidence suggests this is inaccurate and often childbirth takes far longer.
The WHO yesterday said women are being forced into having unnecessary procedures because midwives and doctors thought labour was taking too long, adding that slow progress alone should not be a trigger for intervention.
Its new advice says the threshold of 1cm per hour of dilation is ‘unrealistic’ and leads to too many women having needless caesareans. Dr Olufemi Oladapo, a medical officer at WHO, said childbirth can take longer without endangering the health of a woman or child. ‘It’s not a one size-fits-all kind of thing,’ he said.
The WHO said a better threshold for a new mother would be 5cm of dilation during the first 12 hours, and 10 hours in subsequent labours. Dr Oladapo added: ‘What has been happening over the last two decades is that we are having more and more interventions being applied unnecessarily to women. Things like caesarean sections, using a drug called oxytocin to speed up labour is becoming very rampant in several areas of the world.’
Rates of caesarean section have soared in Britain from about 10% of births three decades ago to 26% today. That is significantly above the global average of 18%.
The WHO says some caesarean sections will always be necessary, but should not rise above 15% in any country. Some medical experts suggest intervention should be considered if cervical dilation is less than 2cm in four hours – roughly half the ‘normal’ rate.