No "dedicated project" existed to reduce the Caesarean-section rate at Dunedin Hospital, despite its continuing to show an increase, an Otago District Health Board committee was told this week.
The Caesarean rate was 35% last month, compared with 28.5% the previous October. The target rate is 28%.
Hospital advisory committee member Louise Rosson raised concern about the increasingrate and said when the figures were continually running about 7% above the target, it gave the impression tackling the rising rate was "in the too-hard basket".
Chief medical officer Richard Bunton said the increased rate was a reflection of changing clinical practice as obstetricians took a more risk-averse approach to pregnancy than they did 20 or 30 years ago.
"You could ask yourself why choose this particular percentage as a target."
For example, obstetricians were much less comfortable with delivering breech babies than they were 30 years ago and those clinical skills became lost.
His child had been breech and was "pulled out by the legs", but not many clinicians would do that these days, he said.
Regional chief nursing and midwifery officer Leanne Samuel said clinicians were aware of the rising rate of Caesareans, but it was a "real challenge for them on the ground" to deny a woman a Caesarean when there was a "robust" case for her to have one.
More twin pregnancies and more older mothers were also a factor in the increasing rates, she said.