During the last thirty years there has been an increase in the number of babies born by Caesarean section. New research published in BioMed Central's open access journal BMC Public Health shows that there has also been a change in the social and economic status of the mothers involved and that advantaged mothers are more likely to have their babies by Caesarean section than mothers living in more difficult circumstances.
Birth by Caesarean section can be a lifesaver for both mum and baby, however there are risks involved in such a major abdominal surgery and increased costs due to extended hospital stays for both mother and child. Researchers from the Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit (MRC/CSO SPHSU) looked at the mother's social class, and the level of deprivation of the area each mother lived in. This data was compared to patient records describing hospital births and patient records covering details about the pregnancy and delivery. Social class was obtained from the parent's occupation listed on the child's birth certificates and level of deprivation was calculated for each mother's postcode from the relevant census.
Ruth Dundas from the MRC/CSO SPHSU, said, "Thirty years ago mothers having Caesarean sections were more likely to come from deprived areas and/or from a lower social background. This was true for both elective and emergency sections. Ten years later the rates had changed so that, although women from a lower social background were more likely to have emergency sections, there was no difference between them and women from a higher social background in elective surgery rates. By 1999-2000 the rates had equalized for emergency section, but babies born by elective surgery were more likely to belong to mothers from the higher of the social classes measured."
She continued, "The disappearance of social trends for emergency Caesarean section reflects increased equality in health care. However this does not explain the differences seen for elective section nor the differences seen between health boards. It is important to ensure that the clinical decision making process is the same for all women, regardless of their background, so that they all have equal chance of the best medical care."
Notes to Editors
1. The influence of both individual and area based socioeconomic status on temporal trends in Caesarean sections in Scotland 1980-2000
Lesley Fairley, Ruth Dundas and Alastair H Leyland
BMC Public Health (in press)
Please name the journal in any story you write. If you are writing for the web, please link to the article. All articles are available free of charge, according to BioMed Central's open access policy.
Article citation and URL available on request at press@biomedcentral.com on the day of publication.
2. BMC Public Health is an open access journal publishing original peer-reviewed research articles in the epidemiology of disease and the understanding of all aspects of public health. The journal has a special focus on the social determinants of health, the environmental, behavioral, and occupational correlates of health and disease, and the impact of health policies, practices and interventions on the community.
3. BioMed Central (http://www.biomedcentral.com/) is an STM (Science, Technology and Medicine) publisher which has pioneered the open access publishing model. All peer-reviewed research articles published by BioMed Central are made immediately and freely accessible online, and are licensed to allow redistribution and reuse. BioMed Central is part of Springer Science+Business Media, a leading global publisher in the STM sector.
4. For almost 100 years the Medical Research Council has improved the health of people in the UK and around the world by supporting the highest quality science. The MRC invests in world-class scientists. It has produced 29 Nobel Prize winners and sustains a flourishing environment for internationally recognised research. The MRC focuses on making an impact and provides the financial muscle and scientific expertise behind medical breakthroughs, including one of the first antibiotics penicillin, the structure of DNA and the lethal link between smoking and cancer. Today MRC funded scientists tackle research into the major health challenges of the 21st century. www.mrc.ac.uk
Journal
BMC Public Health