Kilkenny hospital Caesarean rate of 60% ‘outrageous’

A Caesarean section rate in a Kilkenny hospital of almost 60 per cent for first-time mothers is “outrageous”, maternity lobby group Aims has said.

St Luke’s Hospital in Kilkenny recorded a Caesarean rate of 59.52 per cent for new mothers last November. In October almost half of mothers (48.65 per cent) had a Caesarean, according to the monthly maternity patient-safety statement.

The hospital said the unusual spike in Caesarean sections among first-time mothers is being reviewed by its maternity governance group.

It monitors and reviews this data monthly, and investigates where there are are unusual variances or trends.

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A total of 128 babies were born at St Luke’s in November. The number born to first-time mothers is not available.

However, as about 40 per cent of all babies in Ireland are born to first-time mothers, this would suggest there were about 50 first-time mothers at the hospital in November, with 30 Caesareans among them.

The hospital said that before the spike in October and November, the Caesarean rate among first-time mothers was consistently at about 30 per cent for 2016.

The World Health Organisation (WHO)recommends Caesarean rates be no higher than 15 per cent.

Krysia Lynch, chair of the Association of Improvements in Maternity Services (Aims), said St Luke’s Hospital has historically had one of the highest rates of Caesarean sections in the State. Ms Lynch is to appear at the Oireachtas health committee on Thursday to discuss maternity services in Ireland.

She said Declan Keane, a former master of Holles Street, drew attention to the high Caesarean rates in St Luke's three years ago. At the Home Birth conference in 2014, he said the Holles Street Caesarean rate at 20 per cent was too high, yet it was one of the lowest in the State. The level in St Luke's was 38 per cent in 2014.

Instrumental delivery

“We need to know why Kilkenny has a rate that is almost twice that of the rest of the country,” he said then.

In addition, a further 14 per cent of first-time mothers in November had an instrumental delivery at the Kilkenny hospital, leaving just a quarter giving birth naturally.

“How can it be right that three-quarters of first-time mothers cannot have a normal birth?” Ms Lynch said. “It is known within the county that if you want to have a normal birth, go up to Dublin.”

She added she was alarmed that the figures did not seem to have prompted an investigation by the HSE before the spike in October and November. “This in itself is an incident. Where in the HSE did a bell go off? What are we going to do about it?”

Ms Lynch said Caesarean sections were a burden on the health service as they were complicated operations and increased the chances of a mother having a Caesarean for future births.

A statement from the Ireland East Hospital Group said there was a review of obstetrics across all hospitals in the group providing maternity services as part of the clinical services design programme.