Private patients twice as likely to have Caesarean, study finds

Private patients are twice as likely to have pre-planned Caesarean sections as women whose treatment is publicly funded, according to new figures that lend support to the theory that some mothers are “too posh to push”.

Twenty-one per cent of private patients have a scheduled C-section compared to just 8.9 per cent of publicly funded ones, the study found.

Researchers examined 30,000 women who gave birth at a hospital in Ireland which caters for both private and public-funded patients between 2008 and 2011. Around one in five of the women paid for their treatment themselves.

The research, published in the journal BMJ Open, found that, overall, 34.4 per cent of privately paying mothers had a C-section compared to 22.5 per cent of public patients.

‘Greatest disparity’

The “greatest disparity” noted between the mothers was the rates of scheduled C-sections, the study found.

For first-time mothers, 11.9 per cent of private patients had pre-planned surgery compared to just 4.6 per cent of those whose care was paid for by the public purse.

“We found that private patients are more likely than public patients to have an operative vaginal delivery or a Caesarean section.

“The greatest disparity is for scheduled Caesarean sections, and two-fold differences persist even after adjustment for socio-demographic, medical and obstetric factors.

“We found that the differences observed in relation to operative deliveries were not explained by higher rates of medical or obstetrical complications among private patients, although like other studies some of the disparity could be attributed to differences in maternal age and socio-economic status.”

The authors said it was not possible to determine whether the decision to give birth via C-section was driven by the expectant mother or the doctors caring for them.

Like any surgery, a Caesarean section carries a certain amount of risk - such as the wound becoming infected or the baby developing breathing difficulties. It also takes longer to recover from than a vaginal birth.

The UK’s Royal College of Midwives (RCM) said the study highlights the need to avoid “unnecessary” Caesarean sections.

Janine Stockdale, research fellow at the RCM, said: "This is interesting research that may throw a spotlight on the high rates of Caesarean sections that we are seeing in western Europe including the UK, a number that we would like to see falling.

“The findings also underline the need to avoid unnecessary Caesarean sections, as this is a major surgical operation that has the potential for increased complications every time a woman has the procedure carried out.

“The RCM therefore supports National Institute for Health and Care Excellence guidelines which encourage women to have a thorough discussion with their obstetricians and midwives about the implications of having a Caesarean section, especially in circumstances where other options remain open to them.”

Press Association