Normal birth after caesarean putting women and babies at risk

The rising rate of caesarean deliveries is putting more women and babies at risk when they have a second child, research suggests.

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Scientists found that women are 50 times more likely to suffer a ruptured womb during childbirth if they previously had a caesarean delivery. If the uterus tears, it is life-threatening for both mother and baby and about one in 20 babies die as a result.

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The study of more than 300,000 Swedish women, carried out by BJOG: An International Journal of Obstetrics and Gynaecology, called for extra care to be given to women with a history of caesarean births and said doctors should ensure that they were aware of their childbirth options.

The study found that almost a quarter of women attempting a normal birth after a caesarean required a second caesarean. Mothers over 34 were nearly three times as likely to suffer a ruptured womb than were those under 25. Those with a body mass index (BMI) of 30 or over (clinically obese) were more than twice as likely to experience uterine rupture than those with a BMI under 25 (normal). The risks are even greater among women over 35, or if the second birth is induced, the study found.

There are about 120,000 caesareans performed in NHS hospitals in England and Wales every year. There are no figures for how many women go on to try for a normal vaginal birth the next time, but it has become more common in recent years.

Virginia Beckett, a consultant obstetrician and gynaecologist at Bradford Teaching Hospitals Foundation Trust, said the figures found in the Swedish study reinforced advice already given in Britain. She said: “One important thing is that we should ensure that the Caesarean rate doesn’t rise any higher. In some units it is now as high as 30% of births.”

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Belinda Phipps, chief executive of the National Childbirth Trust, said: “The absolute risk of rupture is very small. We have to try very hard to get the first labour right. Then the problem doesn’t arise.”

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