At 08:06 19/05/05 +0100, Stephen McKay wrote:
>Not sure if this simply swaps one set of confusions/issues for another,
>but a quick analysis of the Millennium Cohort Study certainly shows a
>strong link between mother's age at birth and rate of Caesareans for
>2001-2003-ish ....
Thanks; this is certainly helpful. Do I take it that you are working from
the raw data from this study and, if so, is it available publically (i.e to
me!)? It would be very helpful to see the Caesarian Section rate broken
down according the same (broad) age groups as with other published data -
i.e. <25, 25-34 and 35+ In the meantime, superficial eyeballing suggests
the age-specific rates you have presented for '2001-3' may not be very
different from those published for 1994/5.
>However, first babies (primiparous or whatever the demographers say) -
>more c-sections but a lower rate of planned Caesareans, much higher
>rate of emergency ones.
That's exactly what one would expect clinically. The risk of things going
wrong during labour is higher, but less predicatable, in relation to the
first birth, particularly in relation of poor progression of labour and/or
consequential foetal distress - so one would indeed expect lower rates of
elective CS but higher rates of emergency CS with first births, at any
age. The person who wrote "Statistical Bulletin 1997/28" (December 1997),
the last Bulletin to give some sort of age-breakdown of CS rates, clearly
did not understand these clinical considerations, because they expressed
'intrigue' at the figures relating to this issue.
One of the frustrations in trying to get to grips with these statistics is
that even those figures one can get hold of are often summarised in
differing ways, causing problems with comparisons, hence my interest in
getting hold of raw data.
>Smaller families -> higher % of births are first births? Perhaps another
>factor.
Indeed. As I keep saying, there are undoubtedly very many factors,
probably only a pretty small proportion of which are the ones which critics
and campaigners focus upon (and assume/imply are major factors).
Kind Regards,
John
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