Complex births on the rise and could be down to obesity and rising age of mothers

PUBLISHED: 07:00 11 April 2019 | UPDATED: 09:49 11 April 2019

Complex births mean more help needed by mothers at Royal Devon and Exeter NHS Foundation Trust. Picture: Radar

Complex births mean more help needed by mothers at Royal Devon and Exeter NHS Foundation Trust. Picture: Radar

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More women are needing caesarean sections or other medical assistance when giving birth at Royal Devon and Exeter NHS Foundation Trust.

The Royal College of Midwives has warned increasing levels of obesity and the rising age of mothers are leading to more complex births in England.

Women who attended their first scan at Royal Devon and Exeter NHS Foundation Trust in December were aged 30 years old on average, in line with the national average.

Of those who had their Body Mass Index recorded, 29 per cent were overweight and 20 per cent were obese. Across England, more than half of pregnant women were overweight or obese.

In December last year, 307 births were recorded at Royal Devon and Exeter NHS Foundation Trust, NHS figures show.

Around 108 of them - or 35 per cent - required some form of intervention from doctors or midwives, compared to 28 per cent three years ago.

Instrumental deliveries, when forceps or a vacuum extractor are used to pull the baby out, accounted for 30 births.

Women who have an instrumental delivery have a higher chance of more serious vaginal tears, incontinence and blood clots, according to the NHS.

Doctors also carried out pre-planned caesarian sections 41 times, and emergency caesarians on 37 occasions.

This means C-sections accounted for about 25 per cent of births at the trust, below the national standard which aims to be less than 28.8 per cent.

C-sections can pose a number of risks, and are usually only carried out if the safety of the mother or baby is at risk.

The World Health Organisation says it would only expect the method in up to 15 per cent of births, if it is performed when medically necessary.

Across England, the proportion of unassisted births has fallen from 63 per cent in 2007-08, to 58 per cent in 2017-18.

In December, C-sections were used in 30 per cent of births

A Trust spokesperson said: “The RD&E has seen an increase in the number of women who require obstetric intervention when giving birth, however this is in line with a national increase. This is largely due to an increase in women with complex conditions, as highlighted by RCM, and the maternity safety agenda that is being implemented both nationally and locally.

“We continue to monitor these rates on a monthly basis and ensure to review any areas in which we are outliers.”

Mandy Forrester, from RCM, said the trend could be down to women with complex health problems becoming pregnant.

“We’re seeing more women with obesity, diabetes and hypertension, which makes pregnancy and delivery more complex.

“It’s definitely a demand on resources. It’s a different way of working with women, and there’s more machinery to look after.

“Women with more complications may come into hospital more, too, which takes up more time.

“We need to be aware of the trend, and make sure women have all the information they need to make the right decision for them.”

Jacqueline Dunkley Bent, NHS England’s chief midwife, said: “The absolute priority for mums-to-be, and their midwives and doctors, is the safety of new parents and their baby.

“As more women with complex conditions can now give birth safely, it’s vital that everyone gets personalised care, and can make informed choices about birth, whatever their preference and medical needs.”

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