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| Planned Caesarean births have doubled in 20 years in Scotland | Planned Caesarean births have doubled in 20 years in Scotland |
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| Last year in Scotland, 39% of all births were caesareans | Last year in Scotland, 39% of all births were caesareans |
| The number of planned Caesarean births in Scotland has more than doubled in the past 20 years, according to new figures obtained by BBC Scotland. | The number of planned Caesarean births in Scotland has more than doubled in the past 20 years, according to new figures obtained by BBC Scotland. |
| Public Health Scotland said there were 8,884 elective C-sections last year - where the surgery has been planned in advance - up from 4,285 in 2001. | Public Health Scotland said there were 8,884 elective C-sections last year - where the surgery has been planned in advance - up from 4,285 in 2001. |
| The number of emergency Caesareans also rose, from 7,526 to 9,359, despite the total number of births falling. | The number of emergency Caesareans also rose, from 7,526 to 9,359, despite the total number of births falling. |
| Experts have attributed the rise to higher obesity rates and older mothers. | Experts have attributed the rise to higher obesity rates and older mothers. |
| Consultant obstetrician Dr Rosie Townsend, a senior clinical research fellow at the University of Edinburgh, said an increasing number of women were having their first child by Caesarean. | Consultant obstetrician Dr Rosie Townsend, a senior clinical research fellow at the University of Edinburgh, said an increasing number of women were having their first child by Caesarean. |
| The latest headlines from Scotland | The latest headlines from Scotland |
| Births in Scotland fall to record low | Births in Scotland fall to record low |
| That leads to them being more likely to have later children by the same method. | That leads to them being more likely to have later children by the same method. |
| The largest group of women planning the procedure had either had a Caesarean or experienced a difficult delivery with their first pregnancy. | The largest group of women planning the procedure had either had a Caesarean or experienced a difficult delivery with their first pregnancy. |
| Dr Townsend said the number of C-sections was also rising due to women having babies older, slightly heavier and with more health complications. | Dr Townsend said the number of C-sections was also rising due to women having babies older, slightly heavier and with more health complications. |
| The World Health Organization advises that a maximum of 15% of births should be by caesarean section, but most countries exceed this limit. | The World Health Organization advises that a maximum of 15% of births should be by caesarean section, but most countries exceed this limit. |
| In 2019/20, they accounted for 31% of births in England, 28% in Wales and 34.5% in Scotland. | In 2019/20, they accounted for 31% of births in England, 28% in Wales and 34.5% in Scotland. |
| Dr Townsend said: "We know that Caesarean section rates are really rising in a lot of areas of the world and what we're seeing in Scotland is really consistent with rises in England, Wales and Northern Ireland. | Dr Townsend said: "We know that Caesarean section rates are really rising in a lot of areas of the world and what we're seeing in Scotland is really consistent with rises in England, Wales and Northern Ireland. |
| "This is a concern to obstetricians and to maternity workers around the world. | "This is a concern to obstetricians and to maternity workers around the world. |
| "Are we doing too many? Are we doing the right Caesarean sections? I think it's right we think about that and look into it a little bit more." | "Are we doing too many? Are we doing the right Caesarean sections? I think it's right we think about that and look into it a little bit more." |
| Dr Townsend said there is a year-on-year increase of women who elect for a Caesarean without a having medical reason but they are a small group, who do not take the decision lightly. | Dr Townsend said there is a year-on-year increase of women who elect for a Caesarean without a having medical reason but they are a small group, who do not take the decision lightly. |
| The National Institute for Health and Care Excellence (Nice) published guidelines in 2011, and updated in 2021, on a woman's right to choose how she gives birth. | The National Institute for Health and Care Excellence (Nice) published guidelines in 2011, and updated in 2021, on a woman's right to choose how she gives birth. |
| It states that if a mother still does not want a vaginal birth after discussing the benefits and risks, the medic should "offer a planned Caesarean birth for women requesting a Caesarean birth." | It states that if a mother still does not want a vaginal birth after discussing the benefits and risks, the medic should "offer a planned Caesarean birth for women requesting a Caesarean birth." |
| Kelly Borthwick gave birth to her son Struan by elective c-section last year | Kelly Borthwick gave birth to her son Struan by elective c-section last year |
| Kelly Borthwick, 40, who lives in Elgin, gave birth to her daughter, Skye, and son, Struan, through elective C-sections. They are now aged four and one. | Kelly Borthwick, 40, who lives in Elgin, gave birth to her daughter, Skye, and son, Struan, through elective C-sections. They are now aged four and one. |
| A planned caesarean was recommended for her first child after ultrasounds showed Skye was in a breech position but Kelly said she had initially been "really upset" at the prospect. | A planned caesarean was recommended for her first child after ultrasounds showed Skye was in a breech position but Kelly said she had initially been "really upset" at the prospect. |
| "I was pretty gutted and it took me a couple of weeks to accept the fact that I was going to be having a section," she said. | "I was pretty gutted and it took me a couple of weeks to accept the fact that I was going to be having a section," she said. |
| "When it came to Struan obviously I knew what to expect and never having a natural birth, the tables turned a little bit - I was a little bit fearful of having a natural birth." | "When it came to Struan obviously I knew what to expect and never having a natural birth, the tables turned a little bit - I was a little bit fearful of having a natural birth." |
| Kelly said her consultant had recommended a Caesarean, telling her that she was "pretty much too old to push". | Kelly said her consultant had recommended a Caesarean, telling her that she was "pretty much too old to push". |
| She had also wanted to avoid the uncertainty of a long journey to Aberdeen, which takes at least 80 minutes, while in labour. | She had also wanted to avoid the uncertainty of a long journey to Aberdeen, which takes at least 80 minutes, while in labour. |
| Danielle Jackson planned to have her second son by Caesarean after she had an emergency C-section with her first born | Danielle Jackson planned to have her second son by Caesarean after she had an emergency C-section with her first born |
| Danielle Jackson, 35, who lives in Dyce on the outskirts of Aberdeen, has two sons who were both born via C-section. Malik is 19 months and Zaire is one month old. | Danielle Jackson, 35, who lives in Dyce on the outskirts of Aberdeen, has two sons who were both born via C-section. Malik is 19 months and Zaire is one month old. |
| Her first pregnancy ended in an emergency operation after she had been in labour for 30 hours. | Her first pregnancy ended in an emergency operation after she had been in labour for 30 hours. |
| "This time around I thought I really want to take matters into my own hands, I don't want to feel pressured or cornered or let situations get away from me," she said. | "This time around I thought I really want to take matters into my own hands, I don't want to feel pressured or cornered or let situations get away from me," she said. |
| "I really felt as though an elective C-section would give me, for want of a better word, as much control of the situation as I could have, even though my recovery last time was really tough." | "I really felt as though an elective C-section would give me, for want of a better word, as much control of the situation as I could have, even though my recovery last time was really tough." |
| Despite having scheduled a date, her baby had other ideas and Ms Jackson went into labour two weeks early. | Despite having scheduled a date, her baby had other ideas and Ms Jackson went into labour two weeks early. |
| She was placed on the emergency list, but said it was still a very calm experience. | She was placed on the emergency list, but said it was still a very calm experience. |
| "There was Lewis Capaldi playing in the background," she said. "It was just super positive, which is exactly what I was going for." | "There was Lewis Capaldi playing in the background," she said. "It was just super positive, which is exactly what I was going for." |
| Medical reasons | Medical reasons |
| Consultant obstetrician Dr Alastair Campbell said there had been an increase in Caesarean births over the past decade throughout the UK due to a higher number of complex births. | Consultant obstetrician Dr Alastair Campbell said there had been an increase in Caesarean births over the past decade throughout the UK due to a higher number of complex births. |
| "Two contributing factors to this trend are the rising rates of obesity and an increase in maternal age of those giving birth," he said. | "Two contributing factors to this trend are the rising rates of obesity and an increase in maternal age of those giving birth," he said. |
| "These factors can lead to an increased chance of Caesarean birth as this may be safer for mother and baby." | "These factors can lead to an increased chance of Caesarean birth as this may be safer for mother and baby." |
| Dr Campbell, who is a spokesperson for the Royal College of Obstetricians and Gynaecologists, said the majority of planned Caesarean births were for medical reasons. | Dr Campbell, who is a spokesperson for the Royal College of Obstetricians and Gynaecologists, said the majority of planned Caesarean births were for medical reasons. |
| Figures provided to BBC Scotland by Public Health Scotland showed that the health boards with the highest percentage of planned C-sections in 2021 were NHS Grampian and NHS Greater Glasgow and Clyde, both with 22%. | Figures provided to BBC Scotland by Public Health Scotland showed that the health boards with the highest percentage of planned C-sections in 2021 were NHS Grampian and NHS Greater Glasgow and Clyde, both with 22%. |
| A report published by the Scottish government last year said the country had the highest overall rate of Caesarean sections in Great Britain. | A report published by the Scottish government last year said the country had the highest overall rate of Caesarean sections in Great Britain. |
| A spokesman for the Scottish government said rates of C-section had steadily increased throughout the world over the past three decades. | A spokesman for the Scottish government said rates of C-section had steadily increased throughout the world over the past three decades. |
| He said: "Maternal age has continued to steadily rise and older women are more likely to have a Caesarean section: 59% of women were 30 years or older at the time of giving birth, which is the highest proportion since reporting began." | He said: "Maternal age has continued to steadily rise and older women are more likely to have a Caesarean section: 59% of women were 30 years or older at the time of giving birth, which is the highest proportion since reporting began." |
| The spokesman said a range of other factors may be contributing to the rise and data suggests there is considerable variation across Scotland. He said work was being carried out to improve understanding. | The spokesman said a range of other factors may be contributing to the rise and data suggests there is considerable variation across Scotland. He said work was being carried out to improve understanding. |
| "Caesarean section is a safe mode of delivery for both mother and baby and there are a number of good clinical reasons why this may be recommended," he added. | "Caesarean section is a safe mode of delivery for both mother and baby and there are a number of good clinical reasons why this may be recommended," he added. |
| "Decisions about mode of delivery should be made in partnership with women, taking account of their individual circumstances, preferences and clinical needs." | "Decisions about mode of delivery should be made in partnership with women, taking account of their individual circumstances, preferences and clinical needs." |
| University of Edinburgh researchers have recently begun a new birth cohort study - Born in Scotland - which is now open to pregnant people in the Edinburgh area. | University of Edinburgh researchers have recently begun a new birth cohort study - Born in Scotland - which is now open to pregnant people in the Edinburgh area. |
| Researchers hope the study will highlight the factors associated with healthy pregnancy and different types of birth in modern Scotland. | Researchers hope the study will highlight the factors associated with healthy pregnancy and different types of birth in modern Scotland. |
| Related Topics | Related Topics |
| Scotland | |
| Motherhood | Motherhood |
| Childbirth | Childbirth |
| Pregnancy | Pregnancy |