Alison Macfarlane said earlier (11 April) that the usefulness of the debate
has - that started with concern about the growth of Caesarians - was
severely limited because others with knowledge of the subject have not had
time to contribute to the debate .
But it appears that very little is known by experts or others on the
relationship between Caesarians and age of mother.
With Alison's guidance the only table I have been able to find relates to
1995, and the breakdown with age of mother is limited to three bands - less
than 25, 25-34, and 34 plus. These statistics show that Caesarians do rise
with age. For primoparous women (I think this means first births) the
elective Caesarian rates are given as 4%, 5% and 11% for those three age
bands. For emergency Caesarians for the rates are given as 9%, 14%, and 21%
respectively.
These dated statistics and limited age breakdown do not support much in the
way of knowledge of the part currently played by age of mother in
Caesarians. But it seems obvious to me the steadily increasing age of
first births must have been a major influence on the rise in the overall
Caesarian rate.
Have I missed something?
Ray Thomas
35 Passmore, Tinkers Bridge, Milton Keynes MK6 3DY
Email: [log in to unmask]
Tel/Fax 01908 679081
******************************
----- Original Message -----
From: Macfarlane, Alison
To: [log in to unmask]
Sent: Tuesday, April 05, 2005 9:53 AM
Subject: Re: Maternity statistics for England published to day
Age specific rates have been increasing, as can be seen each time they are
published, unfortunately not often enough. There was a major court case in
the late 1970s which is thought to have enhaced the fear of litigation.
Alison
-----Original Message-----
From: Ray Thomas [mailto:[log in to unmask]]
Sent: 04 April 2005 23:46
To: [log in to unmask]
Subject: Re: Maternity statistics for England published to day
Fear of litigation can hardly have been the major influence on in the
period up to about 1977 when instrumental deliveries were increasing faster
than caesarians. Surely the increasing age of mothers must have been the
major influence on operative rates in this period?
If age was an important influence in the 60s and 70s is it not reasonable
to expect that it would still be an important influence. And if age is an
important influence why are statistics not published with an age breakdown?
It surely cannot be that ethnicity of mothers is recorded but not age?
Ray Thomas
*********************************
With regard to the effect that fear of litigation may influence the rise in
Caesarean deliveries, I noted a comment by Christine Hogg in Health Matters
39 Winter 1999/2000.
"Experience in the US shows that litigation affects clinical practice. It
leads to defensive medicine (that is, over treatment). In this country, the
continuing rise in Caesareans - in spite of evidence of the dangers and
national policy - is attributed to defensive medicine, although it may be
used as an excuse by a profession that prefers intervention to waiting."
The article was about the less desirable consequences of introducing
'choice' into medical care.
Janet Shapiro
****************************************************** Please note that if
you press the 'Reply' button your message will go only to the sender of this
message. If you want to reply to the whole list, use your mailer's
'Reply-to-All' button to send your message automatically to
[log in to unmask]
*******************************************************
****************************************************** Please note that if
you press the 'Reply' button your message will go only to the sender of this
message. If you want to reply to the whole list, use your mailer's
'Reply-to-All' button to send your message automatically to
[log in to unmask]
*******************************************************
******************************************************
Please note that if you press the 'Reply' button your
message will go only to the sender of this message.
If you want to reply to the whole list, use your mailer's
'Reply-to-All' button to send your message automatically
to [log in to unmask]
*******************************************************
|