Letters

Caesarean section rate in England and Wales

BMJ 2002; 324 doi: http://dx.doi.org/10.1136/bmj.324.7335.486 (Published 23 February 2002) Cite this as: BMJ 2002;324:486

Maybe midwives were too busy

  1. Woody Caan ([email protected]), public health specialist,
  2. Peter Messent, public health specialist
  1. University College London, London WC1
  2. Queen Mary, University of London, London E1
  3. Department of Community Medicine, University of Hong Kong Medical Centre, 7 Sassoon Road, Pokfulam, Hong Kong Special Administrative Region, China

    EDITOR—Dobson reports that deliveries by caesarean section in England rose from 4% in 1970 to 19% in 1999.1 Potentially, this created substantially increased demand on postnatal care within maternity services, at just the time when many hospitals, especially in Greater London, found difficulties even in maintaining numbers of midwives at their former levels.

    For 477 women in two former London health trusts, 86 aspects of maternity care were surveyed in 1999.2 In general, the survey showed problems with postnatal hospital care. We re-examined the data to contrast the postnatal experiences of women after a caesarean (88, 18.4%) with those who had a “normal” vaginal delivery (340, 71.3%). We focused on 69 caesarean deliveries without any general anaesthetic (in case anaesthesia affected mothers' recall), 34 in the first trust and 35 in the second trust. We used non-parametric statistics (χ2, Spearman's rank correlation, Mann-Whitney U test), and our threshold for significance was P<0.05.

    Caesarean deliveries were associated with some …

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