Wide variations foundin rates of Caesareans

The number of women undergoing the birth procedure ranged between regions from 13.6 per cent to 31.9 per cent, research published in the British Medical Journal found.

Experts said the study of 146 NHS trusts, which examined more than 620,000 births, showed the need for “informed surveillance” of why there were such differences.

The results did not support suggestions that increasing numbers of women were opting for Caesareans for non-medical reasons.

Researchers based at the Royal College of Obstetricians and Gynaecologists analysed births among women aged between 15 and 44 years during 2008.

Of the 620,604 births, almost one in four (24 per cent) were delivered by Caesarean section.

A high proportion of women underwent the procedure because they had previously had a Caesarean (71 per cent), a breech baby (90 per cent), or serious medical complications (85 per cent). The likelihood of having a Caesarean was also higher in older women.

But even taking into account medical reasons for the procedure, the report authors said there remained a considerable difference in the birth methods used based on medical judgments.

The report found the variation “probably reflects” the lack of a precise definition for foetal distress or dystocia – an abnormal or difficult birth – and differences in practices among professionals.

The authors called on NHS trusts to examine the reasons for the regional variation and to consider how the consistency of care for pregnant women could be improved.