Kilkenny has highest level of C-sections while Sligo lowest

Wide variation in rates across State, figures show

There is a wide variation in Caesarean -section rates across the State with St Luke’s Hospital, Kilkenny showing the highest level in public hospitals at 38 per cent of all deliveries, according to 2011 data released today.

The lowest C-section rate was at Sligo General Hospital at 19 per cent of all births, followed by the National Maternity Holles Street, Dublin at 21.5 per cent.

All of the State’s maternity hospitals show a higher rate than the 10 to 15 per cent recommended by the World Health Organisation.

The detailed statistics on the State's 19 maternity unit was released by the Association of Improvements in Maternity Services, Ireland (AIMS Ireland) on foot of a Freedom of Information request by the voluntary organisation from the Health Service Executive.

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Krysia Lynch, Co-Chair of AIMS Ireland noted noted the "marked regional variations" in obstetrical interventions for hospital births described the C-section rates in St Luke's Hospital, Kilkenny as "worrying".

Welcoming the publication of the data, she said women had until now been “in the dark about the level of interventions” at maternity units and this would help to “inform them about where best to have their babies.”

However she said they showed a “geographic lottery” in maternity care. She called for an overhaul of maternity care model which was “obstetric led”.

Private Hospitals and home births are not included in the figures released by the HSE. An Irish study released last year found that Caesarean sections are far more common among pregnant women who attend private consultants than among mothers delivering in the public health system.

The figures show the lowest breast-feeding rates in 2011 were at Limerick Regional Hospital at 39 per cent followed by Letterkenny hospital at 40 per cent while the highest was at the National Maternity Hospital, Holles Street at 67 per cent ,followed by the Rotunda Hospital, Dublin at 62 per cent.

The highest rates of episiotomy (surgical incision in perineum and the posterior vaginal wall during labour) performed during delivery was at the National Maternity Hospital Holles Street (27 per cent) while the lowest was at Wexford General Hospital (10 per cent).

Research published last year by the Health Research Board found that of over 11,000 women surveyed, 26.7 per cent had C-sections, C-sections rates have been rising in Ireland for some years and is higher than the UK rate (23 per cent) and the European average of 19 per cent.

In a statement this evening, the HSE said St Luke’s Hospital provided “excellent quality of care” to women during labour and birth.

The hospital’s perinatal morbidity rates are among the lowest in Ireland which is a “reliable indicator of a high standard maternity service.” it said.

A variation in c- section rates between hospitals is expected because it is based on clinical need, it said.

It said reviews take place weekly at St Luke’s which monitors the rate.

There is a team at the hospital to implement the HSE clinical programme on obstetrics.

Genevieve Carbery

Genevieve Carbery

Genevieve Carbery is Deputy Head of Audience at The Irish Times