Perinatal study: Births by Caesarean section have increased by 72 per cent in the decade from 1993 to 2002, a report to be published today will show.
It also shows there has been a significant rise in births to single women and an increase in those opting to breastfeed.
Overall, the birth rate in the Republic has increased by 23 per cent over the 10-year period, according to the Report on Perinatal Statistics for 2002, published by the Economic and Social Research Institute (ESRI).
It shows Caesarean section now accounts for 22.4 per cent of all births - a 2 per cent increase on the previous year and continuing an upward trend since 1991.
Some 60,865 births were notified to the national perinatal reporting system in 2002. This represents a birth rate of 15.5 per 1,000 population, a rise in the birth rate of 3 per cent since 2001. The Republic has the highest birth rate among the 25 EU States.
The perinatal mortality rate for 2002, defined as the number of stillbirths and deaths of infants in the first week of life divided by the total number of live births and stillbirths, was 8.4 per 1,000. A decrease of 2.3 per cent on the previous year, this indicator is influenced by factors such as birth weight and the mother's age and parity. The number of low birth weight babies as a proportion of all live births rose by 18 per cent between 1993 and 2002.
The report, written by Prof Miriam Wiley and Ms Sheelagh Bonham of the ESRI, also shows a 41 per cent rise in the number of women breastfeeding. There was a 17.5 per cent increase in the number of home births between 2001 and 2002, from 245 to 288 actual home births.
Single mothers accounted for almost one in three women giving birth in 2002. While this represents no change between 2001 and 2002, it is an increase of 65 per cent compared with 1993. The average age of single mothers in 2002 was 26 years compared with 23 in 1993.
And for the first time this decade there has been an increase in the percentage of early neonatal deaths undergoing post mortem examination. At 42 per cent, this rate increased by a quarter between 2001 and 2002.
Asked to comment on the continuing rise of Caesarean section deliveries as a percentage of total births, Dr Sean Daly, a former Master and consultant obstetrician at the Coombe hospital, said that contrary to popular opinion, "maternal requests are not influencing the rate of first Caesarean sections". He said changes in obstetric management were a factor - all breech presentations were now delivered by section and women who had a Caesarean on their first baby were now more likely to be delivered by section on subsequent pregnancies. He also said Caesarean section had become a safer operation.
Prof Wiley, who is also chairwoman of the National Committee on Breastfeeding, said: "I would like to see an acceleration in the breastfeeding rate. While the figure of 41 per cent is certainly positive, I would like to see breastfeeding become more the norm."
Welcoming the rise in neonatal post mortems, Prof Conor O'Keane, consultant pathologist at the Mater Hospital and spokesman for the Faculty of Pathology of the Royal College of Physicians in Ireland, said: "These are figures for 2002. If they do indeed indicate a reversal of the downward trend then this is a most welcome development. Taken with the recent Madden report, it indicates a restoration of confidence in post mortems as an appropriate medical procedure."