More older mothers, obese mothers

A soon-to-be-released inquiry into obstetric care in the UK will show that
hospitals are battling to cope with rising numbers of older mothers, obese women
and IVF patients requiring extra medical attention. Not enough staff are
available to care for ordinary deliveries. Experts say that caesarean rates have
doubled over the past 15 years to one in four births. In some hospitals 35% of
births come via caesareans, despite advice from the World Health Organisation
that the figure should not rise above 15%. The report, by the medical thinktank,
The King’s Fund, cites "wide professional unease" over the increasing use of
surgery in childbirth.

More older mothers, who require special care, have increased the pressure on
maternity wards. The latest annual figures show that more than 90,000 children
were born to mothers in their late 30s, compared with 54,000 10 years ago. The
number of births among women over 40 has gone from 8,000 to 16,000. More obese
women are also a problem. Half of all maternal deaths in childbirth involve
women who are overweight or obese.

Experts warn that the increased "medicalisation" of birth causes staff to
concentrate on "high risk" cases. Belinda Phipps, of the National Childbirth
Trust, told the London Telegraph: "This medicalisation of childbirth is
bad for the women who fall victim to it, but it also means there are fewer
midwives on the wards, leaving them running from one mother to the rest."

Katherine Murphy, of the Patients’ Association, says too many women are
"being treated like they are on a conveyer belt". She said: "At a time when
mothers are frightened and vulnerable, the midwives are so stretched that there
is no time for them to offer reassurance and advice, and instead women get
pushed into caesareans. We think that is appalling."

Professor Sabaratnam Arulkumaran, of the Royal College of Obstetricians and
Gynaecologists, says much of the rise in caesareans can be explained by greater
health risks among older and obese women, although consultants can be too quick
to act because they fear litigation. But he also feels that some pregnant women
value their lifestyles over their health. "For some it comes down to
convenience; their husband is flying off next week, and they want to fit the
birth in first." ~ Daily Telegraph (London), Feb
27

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Michael Cook

Michael Cook edits BioEdge, a bioethics newsletter, and MercatorNet, an on-line magazine whose focus is human dignity. He writes from Sydney, Australia.

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