Rise in Caesareans prompts review

The Otago District Health Board will review national and Australasian Caesarean section rates in light of the board's climbing rate of Caesarean births.

Last month, 39.5% of the board's 147 births were Caesarean; its target is 28%.

In February 2008, 28.6% of 154 births were Caesarean; in February 2009, 31.5% of 149 births were.

Board member Louise Rosson told this week's hospital advisory committee meeting, Caesareans had been climbing for "too long", and the reason needed to be examined.

"How much are the factors societal, as against clinical?"Chief medical officer Richard Bunton said a "risk averse" culture in birthing meant situations that previously would not have warranted a Caesarean now did.

"Also ... specialists are not skilled at complex vaginal deliveries as they do not do them anymore."

Chief operating officer Vivian Blake said the high number of Caesareans placed pressure on available beds, as the board also had to increase elective surgeries to meet national targets.

However, it was possible the target was "out of sync" with other centres, as it was set a long time ago.

Staff would look at whether the board's target was in line with national and Australasian rates.

The review would not examine why so many procedures were being carried out.

New Zealand College of Midwives Otago regional chairwoman Kerry Adams said when contacted a broader review was needed into Caesarean rates.

Using New Zealand rates to review the target would not address the issue of why rates were growing.

Caesareans were complex abdominal surgery, carrying possible complications, and should be limited to particular circumstances.

"We should not be doing them particularly lightly; it should be a last-resort scenario."

- eileen.goodwin@odt.co.nz


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