The Best Start - caesarean section rates: review report

This report provides information about the rising caesarean section rate in Scotland and explores the factors contributing to this by exploring the published data and evidence within Scotland, across the UK and wider where applicable.


References

1. "Caesarean Section Caesarean Section Clinical Guideline." 2011. https://www.nice.org.uk/guidance/cg132/resources/caesarean-section-pdf-35109507009733.

2. The Scottish Government. 2017. "The Best Start: Five-Year Plan for Maternity and Neonatal Care." Gov.scot. The Scottish Government. January 20, 2017. https://www.gov.scot/publications/best-start-five-year-forward-plan-maternity-neonatal-care-scotland/

3. "Caesarean Section Caesarean Section Clinical Guideline." 2011. https://www.nice.org.uk/guidance/cg132/resources/caesarean-section-pdf-35109507009733.

4. "Births in Scottish Hospitals 24 November 2020 - Data & Intelligence from PHS." n.d. Beta.isdscotland.org. https://beta.isdscotland.org/find-publications-and-data/population-health/births-and-maternity/births-in-scottish-hospitals/.

5. Ibid.

6. Betrán, Ana Pilar, Jianfeng Ye, Anne-Beth Moller, Jun Zhang, A. Metin Gülmezoglu, and Maria Regina Torloni. 2016. "The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014." Edited by Hajo Zeeb. PLOS ONE 11 (2): e0148343.

7. "Births in Scottish Hospitals 24 November 2020 - Data & Intelligence from PHS." n.d. Beta.isdscotland.org. https://beta.isdscotland.org/find-publications-and-data/population-health/births-and-maternity/births-in-scottish-hospitals/.

8. "NHS Maternity Statistics, England 2019-20." n.d. NHS Digital. https://digital.nhs.uk/data-and-information/publications/statistical/nhs-maternity-statistics/2019-20.

9. "Births in Scottish Hospitals 24 November 2020 - Data & Intelligence from PHS." n.d. Beta.isdscotland.org. https://beta.isdscotland.org/find-publications-and-data/population-health/births-and-maternity/births-in-scottish-hospitals/.

10. "Births in Scottish Hospitals - Scottish Health and Social Care Open Data." n.d. Www.opendata.nhs.scot. Accessed June 21, 2021. https://www.opendata.nhs.scot/dataset/births-in-scottish-hospitals.

11. Ibid.

12. Expert Advisory Group on Caesarean Section in Scotland. Report and Recommendations to the Chief Medical Officer of the Scottish Executive Health Department. Scottish Executive: Edinburgh, 2001.

13. "Births in Scottish Hospitals 24 November 2020 - Data & Intelligence from PHS." n.d. Beta.isdscotland.org. https://beta.isdscotland.org/find-publications-and-data/population-health/births-and-maternity/births-in-scottish-hospitals/.

14. Ibid.

15. Ibid.

16. Ibid.

17. Ibid.

18. Ibid.

19. NMPA Project Team. National Maternity and Perinatal Audit: Clinical Report 2019. Based on births in NHS maternity services between 1 April 2016 and 31 March 2017. London: RCOG; 2019.

20. TC. 2013. "Induction of Labour at Term in Older Mothers." https://www.rcog.org.uk/globalassets/documents/guidelines/scientific-impact-papers/sip_34.pdf.

21. Walker, Kate F., George J. Bugg, Marion Macpherson, and James Thornton. 2012. "Induction of Labour at Term for Women over 35 Years Old: A Survey of the Views of Women and Obstetricians." European Journal of Obstetrics & Gynecology and Reproductive Biology 162 (2): 144–48.

22. Wang, Yun, Tom Tanbo, Thomas Åbyholm, and Tore Henriksen. 2010. "The Impact of Advanced Maternal Age and Parity on Obstetric and Perinatal Outcomes in Singleton Gestations." Archives of Gynecology and Obstetrics 284 (1): 31–37.

23. Euro-Peristat Project. European Perinatal Health Report. Core indicators of the health and care of pregnant women and babies in Europe in 2015. November 2018. Available www.europeristat.com

24. "Births in Scottish Hospitals 24 November 2020 - Data & Intelligence from PHS." n.d. Beta.isdscotland.org. https://beta.isdscotland.org/find-publications-and-data/population-health/births-and-maternity/births-in-scottish-hospitals/.

25. kate.fitzsimons. 2010. "CMACE/RCOG Joint Guideline Management of Women with Obesity in Pregnancy Centre for Maternal and Child Enquiries Improving the Health of Mothers, Babies and Children." https://www.rcog.org.uk/globalassets/documents/guidelines/cmacercogjointguidelinemanagementwomenobesitypregnancya.pdf.

26. Weiss, Joshua L, Fergal D Malone, Danielle Emig, Robert H Ball, David A Nyberg, Christine H Comstock, George Saade, et al. 2004. "Obesity, Obstetric Complications and Cesarean Delivery Rate–a Population-Based Screening Study." American Journal of Obstetrics and Gynecology 190 (4): 1091–97.

27. "Births in Scottish Hospitals 24 November 2020 - Data & Intelligence from PHS." n.d. Beta.isdscotland.org. https://beta.isdscotland.org/find-publications-and-data/population-health/births-and-maternity/births-in-scottish-hospitals/.

28. National Records of Scotland Web. 2013. "National Records of Scotland." National Records of Scotland. May 31, 2013. https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/vital-events/general-publications/vital-events-reference-tables/2019.

29. Betran, Ana Pilar, Maria Regina Torloni, Jun Zhang, Jiangfeng Ye, Rafael Mikolajczyk, Catherine Deneux-Tharaux, Olufemi Taiwo Oladapo, et al. 2015. "What Is the Optimal Rate of Caesarean Section at Population Level? A Systematic Review of Ecologic Studies." Reproductive Health 12 (1).

30. Knight M, Bunch K, Tuffnell D, Shakespeare J, Kotnis R, Kenyon S, Kurinczuk JJ (Eds.) on behalf of MBRRACE-UK. Saving Lives, Improving Mothers' Care - Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2016-18. Oxford: National Perinatal Epidemiology Unit, University of Oxford 2020.

31. Ibid.

32. "WHO Statement on Caesarean Section Rates." 2015. Reproductive Health Matters 23 (45): 149–50.

33. "WHO Recommendations Non-Clinical Interventions to Reduce Unnecessary Caesarean Sections." n.d. https://apps.who.int/iris/bitstream/handle/10665/275377/9789241550338-eng.pdf?ua=1.

34. Merenstein, Daniel J., Margaret E. Gatti, and Darren M. Mays. 2011. "The Association of Mode of Delivery and Common Childhood Illnesses." Clinical Pediatrics 50 (11): 1024–30.

35. Silver, Robert M. 2010. "Delivery after Previous Cesarean: Long-Term Maternal Outcomes." Seminars in Perinatology 34 (4): 258–66.

36. Solheim, Karla N., Tania F. Esakoff, Sarah E. Little, Yvonne W. Cheng, Teresa N. Sparks, and Aaron B. Caughey. 2011. "The Effect of Cesarean Delivery Rates on the Future Incidence of Placenta Previa, Placenta Accreta, and Maternal Mortality." The Journal of Maternal-Fetal & Neonatal Medicine 24 (11): 1341–46.

37. Tully, Kristin P., and Helen L. Ball. 2013. "Misrecognition of Need: Women's Experiences of and Explanations for Undergoing Cesarean Delivery." Social Science & Medicine 85 (May): 103–11.

38. A Blotkamp, NMPA Project Team. National Maternity and Perinatal Audit: Organisational Report 2019. London: RCOG; 2019.

39. Ockenden, Donna. 2020. "OCKENDEN REPORT Emerging Findings and Recommendations from the Independent Review of MATERNITY SERVICES at the SHREWSBURY and TELFORD HOSPITAL NHS TRUST Our First Report Following 250 Clinical Reviews." https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/943011/Independent_review_of_maternity_services_at_Shrewsbury_and_Telford_Hospital_NHS_Trust.pdf.

40. "Caesarean Section Caesarean Section Clinical Guideline." 2011. https://www.nice.org.uk/guidance/cg132/resources/caesarean-section-pdf-35109507009733.

41. "Births in Scottish Hospitals - Scottish Health and Social Care Open Data." n.d. Www.opendata.nhs.scot. https://www.opendata.nhs.scot/dataset/births-in-scottish-hospitals.

42. Ibid.

43. Ibid.

44. Loke, Alice Yuen, Louise Davies, and Yim-wah Mak. 2019. "Is It the Decision of Women to Choose a Cesarean Section as the Mode of Birth? A Review of Literature on the Views of Stakeholders." BMC Pregnancy and Childbirth 19 (1).

45. Farrell, Scott A., Thomas F. Baskett, and Karen D. Farrell. 2005. "The Choice of Elective Cesarean Delivery in Obstetrics: A Voluntary Survey of Canadian Health Care Professionals." International Urogynecology Journal 16 (5): 378–83.

46. Loke, Alice Yuen, Louise Davies, and Yim-wah Mak. 2019. "Is It the Decision of Women to Choose a Cesarean Section as the Mode of Birth? A Review of Literature on the Views of Stakeholders." BMC Pregnancy and Childbirth 19 (1).

47. Mancuso, Alfredo, Salvatore Settineri, Giusi Fanara, Antonio De Vivo, Carmela Caruso, Alessandra Fattori, and Iorio Lo Monaco. 2006. "Confidential Survey on Cesarean Section on Request: Obstetricians' Personal Experience in Sicily." Acta Obstetricia et Gynecologica Scandinavica 85 (5): 623–24.

48. Wax, Joseph R., Angelina Cartin, Michael G. Pinette, and Jacquelyn Blackstone. 2005. "Patient Choice Cesarean-the Maine Experience." Birth 32 (3): 203–6.

49. Robson, Stephen J., Woo Syong Tan, Adebayo Adeyemi, and Keith B. G. Dear. 2009. "Estimating the Rate of Cesarean Section by Maternal Request: Anonymous Survey of Obstetricians in Australia." Birth 36 (3): 208–12

50. Lataifeh, Isam, Faheem Zayed, Oqba Al-Kuran, Lama Al-Mehaisen, Wadah Khriesat, and Yousef Khader. 2009. "Jordanian Obstetricians' Personal Preference Regarding Mode of Delivery." Acta Obstetricia et Gynecologica Scandinavica 88 (6): 733–36.

51. Kingdon, C, J Neilson, V Singleton, G Gyte, A Hart, M Gabbay, and T Lavender. 2009. "Choice and Birth Method: Mixed-Method Study of Caesarean Delivery for Maternal Request." BJOG: An International Journal of Obstetrics & Gynaecology 116 (7): 886–95.

52. Bryant, Joanne, Maree Porter, Sally K. Tracy, and Elizabeth A. Sullivan. 2007. "Caesarean Birth: Consumption, Safety, Order, and Good Mothering." Social Science & Medicine 65 (6): 1192–1201.

53. Mander, Rosemary, and Hanna-Leena Melender. 2009. "Choice in Maternity: Rhetoric, Reality and Resistance." Midwifery 25 (6): 637–48.

54. Kingdon, C, J Neilson, V Singleton, G Gyte, A Hart, M Gabbay, and T Lavender. 2009. "Choice and Birth Method: Mixed-Method Study of Caesarean Delivery for Maternal Request." BJOG: An International Journal of Obstetrics & Gynaecology 116 (7): 886–95.

55. Liu, Nancy H, Agustina Mazzoni, Nina Zamberlin, Mercedes Colomar, Olivia H Chang, Lila Arnaud, Fernando Althabe, and José M Belizán. 2013. "Preferences for Mode of Delivery in Nulliparous Argentinean Women: A Qualitative Study." Reproductive Health 10 (1).

56. Wittmann-Price, Ruth A., Rosemary Fliszar, and Anand Bhattacharya. 2011. "Elective Cesarean Births: Are Women Making Emancipated Decisions?" Applied Nursing Research 24 (3): 147–52.

57. Bryant, Joanne, Maree Porter, Sally K. Tracy, and Elizabeth A. Sullivan. 2007. "Caesarean Birth: Consumption, Safety, Order, and Good Mothering." Social Science & Medicine 65 (6): 1192–1201.

58. Wittmann-Price, Ruth A., Rosemary Fliszar, and Anand Bhattacharya. 2011. "Elective Cesarean Births: Are Women Making Emancipated Decisions?" Applied Nursing Research 24 (3): 147–52.

59. Bryant, Joanne, Maree Porter, Sally K. Tracy, and Elizabeth A. Sullivan. 2007. "Caesarean Birth: Consumption, Safety, Order, and Good Mothering." Social Science & Medicine 65 (6): 1192–1201.

60. Weaver, J.J., Statham, H. and Richards, M. (2007), Are There "Unnecessary" Cesarean Sections? Perceptions of Women and Obstetricians About Cesarean Sections for Nonclinical Indications. Birth, 34: 32-41.

61. Sharpe, A.N., G.J. Waring, J. Rees, K. McGarry, and K. Hinshaw. 2015. "Caesarean Section at Maternal Request – the Differing Views of Patients and Healthcare Professionals: A Questionnaire Based Study." European Journal of Obstetrics & Gynecology and Reproductive Biology 192 (September): 54–60.

62. MacDonald, Christine, Sheena B. Pinion, and Una M. MacLeod. 2002. "Scottish Female Obstetricians' Views on Elective Caesarean Section and Personal Choice for Delivery." Journal of Obstetrics and Gynaecology 22 (6): 586–89.

63. Hallgrimsdottir, Helga, Leah Shumka, Catherine Althaus, and Cecilia Benoit. 2017. "Fear, Risk, and the Responsible Choice: Risk Narratives and Lowering the Rate of Caesarean Sections in High-Income Countries." AIMS Public Health 4 (6): 615–32.

64. Bryant J, Porter M, Tracy SK, et al. Caesarean birth: Consumption, safety, order, and good mothering. Soc Sci Med. 2007;65:1192–1201.

65. Leslie MS. Counselling women about elective caesarean section. J Midwifery Women's Health. 2004;49:155–159.

66. Eide, Kristiane Tislevoll, Nils-Halvdan Morken, and Kristine Bærøe. 2019. "Maternal Reasons for Requesting Planned Cesarean Section in Norway: A Qualitative Study." BMC Pregnancy and Childbirth 19 (1).

67. Expert Advisory Group on Caesarean Section in Scotland. Report and Recommendations to the Chief Medical Officer of the Scottish Executive Health Department. Scottish Executive: Edinburgh, 2001.

68. Moffat, MA, JS Bell, MA Porter, S Lawton, V Hundley, P Danielian, and S Bhattacharya. 2006. "Decision Making about Mode of Delivery among Pregnant Women Who Have Previously Had a Caesarean Section: A Qualitative Study." BJOG: An International Journal of Obstetrics & Gynaecology 114 (1): 86–93.

69. Shorten, Allison, Brett Shorten, and Holly Powell Kennedy. 2014. "Complexities of Choice after Prior Cesarean: A Narrative Analysis." Birth 41 (2): 178–84.

70. Betrán, Ana Pilar, Jianfeng Ye, Anne-Beth Moller, Jun Zhang, A. Metin Gülmezoglu, and Maria Regina Torloni. 2016. "The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014." Edited by Hajo Zeeb. PLOS ONE 11 (2): e0148343.

71. "WHO Recommendations Non-Clinical Interventions to Reduce Unnecessary Caesarean Sections." https://apps.who.int/iris/bitstream/handle/10665/275377/9789241550338-eng.pdf?ua=1.

72. Ye, J., J. Zhang, R. Mikolajczyk, M.R. Torloni, A.M. G€ulmezoglu, and A.P. Betran. 2017. "Association between Rates of Caesarean Section and Maternal and Neonatal Mortality in the 21st Century." Obstetric Anesthesia Digest 37 (1): 17–18.

73. Torloni, Maria Regina, Ana Pilar Betran, Joao Paulo Souza, Mariana Widmer, Tomas Allen, Metin Gulmezoglu, and Mario Merialdi. 2011. "Classifications for Cesarean Section: A Systematic Review." Edited by Fernando Althabe. PLoS ONE 6 (1): e14566.

74. Betran, AP, MR Torloni, JJ Zhang, and AM Gülmezoglu. 2015. "WHO Statement on Caesarean Section Rates." BJOG: An International Journal of Obstetrics & Gynaecology 123 (5): 667–70.

75. Appleton, Bill, Christopher Target, Michael Rasmussen, Emma Readman, Fiona Sale, Michael Permezel, and the VBAC Study Group. 2000. "Knowledge and Attitudes about Vaginal Birth after Caesarean Section in Australian Hospitals." The Australian and New Zealand Journal of Obstetrics and Gynaecology 40 (2): 195–99.

76. Bailit JL, Schulkin J, Dawson NV. 2007. "Risk-adjusted cesarean rates: what risk factors for cesarean delivery are important to practicing obstetricians?" The Journal of Reproductive Medicine. Mar;52(3):194-198.

77. Usha Kiran, T.S., S. Hemmadi, J. Bethel, and J. Evans. 2005. "Outcome of Pregnancy in a Woman with an Increased Body Mass Index." BJOG: An International Journal of Obstetrics and Gynaecology 112 (6): 768–72.

78. Sebire, NJ, M Jolly, JP Harris, J Wadsworth, M Joffe, RW Beard, L Regan, and S Robinson. 2001. "Maternal Obesity and Pregnancy Outcome: A Study of 287 213 Pregnancies in London." International Journal of Obesity 25 (8): 1175–82.

79. kate.fitzsimons. 2010. "CMACE/RCOG Joint Guideline Management of Women with Obesity in Pregnancy Centre for Maternal and Child Enquiries Improving the Health of Mothers, Babies and Children." https://www.rcog.org.uk/globalassets/documents/guidelines/cmacercogjointguidelinemanagementwomenobesitypregnancya.pdf

80. TC. 2013. "Induction of Labour at Term in Older Mothers." https://www.rcog.org.uk/globalassets/documents/guidelines/scientific-impact-papers/sip_34.pdf.

81. Zhang, Jun, Helain J. Landy, D. Ware Branch, Ronald Burkman, Shoshana Haberman, Kimberly D. Gregory, Christos G. Hatjis, et al. 2010. "Contemporary Patterns of Spontaneous Labor with Normal Neonatal Outcomes."Obstetrics and Gynecology 116 (6): 1281–87.

82. Tully, Kristin P., and Helen L. Ball. 2013. "Misrecognition of Need: Women's Experiences of and Explanations for Undergoing Cesarean Delivery." Social Science & Medicine 85 (May): 103–11.

83. Hallgrimsdottir, Helga, Leah Shumka, Catherine Althaus, and Cecilia Benoit. 2017. "Fear, Risk, and the Responsible Choice: Risk Narratives and Lowering the Rate of Caesarean Sections in High-Income Countries." AIMS Public Health 4 (6): 615–32.

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87. Foureur, Maralyn, Sabera Turkmani, Danielle C. Clack, Deborah L. Davis, Lyndall Mollart, Bernadette Leiser, and Caroline S.E. Homer. 2017. "Caring for Women Wanting a Vaginal Birth after Previous Caesarean Section: A Qualitative Study of the Experiences of Midwives and Obstetricians." Women and Birth 30 (1): 3–8.

88. Bettes, Barbara A., Victoria H. Coleman, Stanley Zinberg, Catherine Y. Spong, Barry Portnoy, Emily DeVoto, and Jay Schulkin. 2007. "Cesarean Delivery on Maternal Request." Obstetrics & Gynecology 109 (1): 57–66.

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90. Bergholt, Thomas, Birgitte Østberg, Jesper Legarth, and Tom Weber. 2004. "Danish Obstetricians' Personal Preference and General Attitude to Elective Cesarean Section on Maternal Request: A Nation-Wide Postal Survey." Acta Obstetricia et Gynecologica Scandinavica 83 (3): 262–66.

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96. Kingdon, Carol, Soo Downe, and Ana Pilar Betran. 2018. "Women's and Communities' Views of Targeted Educational Interventions to Reduce Unnecessary Caesarean Section: A Qualitative Evidence Synthesis." Reproductive Health 15 (1).

97. Moffat, M., Bell, J., Porter, M., Lawton, S., Hundley, V., Danielian, P., & Bhattacharya, S. (2006). Decision making about mode of delivery among pregnant women who have previously had a caesarean section: a qualitative study. BJOG: An International Journal of Obstetrics & Gynaecology, 114(1), 86–93.

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Email: Justine.Menzies@gov.scot

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