May 19, 2011

Cesarean Delivery Linked to Social Status

(Ivanhoe Newswire) -- The fact is indisputable: The number of babies being delivered by Cesarean section is rising sharply.  But beyond that fact are vast uncertainties, including the cause of the increase and even whether it's a good or bad thing.  Some blame a generation of new mothers unwilling to endure the pain and inconvenience of having a baby the old-fashioned way.  In fact, a recent study shows advantaged mothers are more likely to have their babies by Caesarean section than mothers living in more difficult circumstances.

Birth by Caesarean section can be a lifesaver for both the mother as well as their child; conversely, there are multifold risks involved in such a major abdominal surgery, in addition to increased costs due to extended hospital stays for both mother and child.  Researchers looked at the mother's social class, as well as the level of deprivation of the area each mother lived in.  This data was held in comparison to patient records describing hospital births and patient records covering details about the pregnancy and delivery.  Social class was obtained from the parent's occupation listed on the child's birth certificates and level of deprivation was calculated for each mother's postcode from the relevant census.

"Thirty years ago mothers having Caesarean sections were more likely to come from deprived areas and/or from a lower social background," which Ruth Dundas from the MRC/CSO SPHSU, was quoted as saying.  "This was true for both elective and emergency sections.  Ten years later the rates had changed so that, although women from a lower social background were more likely to have emergency sections, there was no difference between them and women from a higher social background in elective surgery rates.  By 1999-2000 the rates had equalized for emergency section, but babies born by elective surgery were more likely to belong to mothers from the higher of the social classes measured."

"The disappearance of social trends for emergency Caesarean section reflects increased equality in health care," Dundas adds.  "However this does not explain the differences seen for elective section nor the differences seen between health boards.  It is important to ensure that the clinical decision making process is the same for all women, regardless of their background, so that they all have equal chance of the best medical care."

SOURCE: BMC Public Health, May 17, 2011