Caesarean sections at Rotunda Hospital reach highest level ever

The rate of Caesarean sections at Dublin’s Rotunda Hospital has reached its highest level ever, the procedure being used in 39 per cent of deliveries last year, according to a new report.

The hospital’s annual report for 2022 notes that the rate of Caesarean sections had risen by four percentage points over 2016′s figures, to 3,179 deliveries. A decrease in mothers who, having previously had the procedure, opt to attempt a vaginal birth is cited by the report as a key driver in the upward trend.

It also noted that while a small number of women opted for Caesarean sections for non-medical reasons, this number “has not changed significantly in the last few years”.

Prof Fergal Malone, who was master of the hospital from 2016 to 2022 and authored the report, also noted that there was a “direct correlation” between increasing rates of obesity in the general population and a higher demand for Caesarean sections.

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“Patients who are obese are more likely to have other medical complications – for example, gestational diabetes,” Prof Malone said. “Babies of mothers who have gestational diabetes are often too big to fit out through the pelvis – so they’re more likely to need a C-section.”

For patients who are very obese, Prof Malone said, monitoring a baby effectively during labour can be difficult – thus leading to the need for a Caesarean section.

[ Caesarean sections: ‘Too posh to push’ or ‘too poor to choose’ ]

[ ‘We have patients aged 40, 45 or 50 having babies all the time now,’ says outgoing master of Rotunda Hospital ]

Prof Malone described as “stark” the increase in obesity among mothers presenting at the Rotunda – 22 per cent of women seen at the hospital last year were deemed obese, compared with 11 per cent in 2011.

According to the report, a rise in the rate of “non-medically indicated” Caesarean sections in coming years “will not be surprising”, because of a general trend in women having their first child at an older age, and “an expectation for small family sizes”.

Last year, there were 8,151 deliveries at the hospital, resulting in the birth of 8,292 babies.

Women aged between 30 and 34 years old made up the bulk of patients presenting at the hospital, at 33 per cent.

The baby mortality rate at the hospital remained very low, with 1.2 deaths per 1,000 births.

The Rotunda, located on Parnell Square in the north inner city, is the busiest maternity hospital in the State, and one of the busiest in Europe. It received €86 million in HSE funding in 2022 – the hospital had an overall budget of €101.4 million – with 1,215 staff members employed, representing a 33 per cent increase over the last seven years.