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Increasing rates of caesarean sections among first-time Irish mothers have been found to be strongly related to increasing maternal age, according to a new study.
The findings of the new study conducted at Coombe University Hospital for Women and Infants are important in light of the evidence that Irish women are choosing to postpone the delivery of their first baby until later in life.
The HSE’s recently released Perinatal Statistics Report found that the number of new mothers in Ireland over the age of 35 has nearly doubled in recent years.
One in four or 25% of the first births were to women aged 35 and over in 2017 compared to 14% in 2008.
The Healthcare Pricing Office report found that in 2017, just over three in ten or 31% of single live births were delivered by cesarean section, while 54% of women gave birth spontaneously.
It also found that obese women were more likely to have their babies delivered by cesarean section in 2014 than in 2009.
Professor of Obstetrics and Gynecology at UCD’s Center for Human Reproduction in Coombe, Michael Turner, said that there are several factors for the increased rates of caesarean sections in older mothers.
He said: “There is no single explanation for the increase in caesarean section rates in older women, especially those over 35 years old.
“One is that older women are more likely to have a history of pregnancy loss or have received treatment for infertility.
Professor Turner, who is one of the authors of the study along with Dr. Aoife Brick, added that older women do not work as efficiently because the uterine muscles are not as powerful.
“This is not surprising because all our muscle power decreases with age,” he explained.
The obstetrician did not believe that the increase in caesarean sections was due to an increase in women requesting the procedure.
“In my experience, the number of women requesting a cesarean is relatively low in Ireland,” he said.
He added: “In general, obese women are twice as likely to have a C-section as non-obese women.” The study found that rising C-section rates in new mothers is strongly associated with the tendency for women to wait until later in life to start a family.
“(This) is important because of the evidence that Irish women are choosing to put off having their first baby until later in life,” the study said.
Professor Turner said that new mothers are more likely to have an emergency C-section, while women with two or more pregnancies are more likely to have an elective C-section, which is usually a repeat C-section.
He said: “There are no national guidelines for caesarean section and this is also true for other countries.
“The caesarean section rate per se is not a concern and it is increasing in all developed countries.
“The biggest concern of the WHO is that women do not have a caesarean section due to the lack of human resources in developing countries.
The New Study: Does Maternal Obesity Explain Trends in C-section Rates? – just been published in the Irish Journal of Medical Science.
The study found that although the prevalence of being overweight or obese changed little over the period, the odds of having a C-section if a woman is obese have increased for women with two or more pregnancies.
The researchers said in their study that nearly one in five women who gave birth in 2017 at Coombe University Hospital for Women and Children was obese at their first prenatal visit.
The number of obese women, including morbidly obese women, has been shown to increase over time.
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