Doctors 'fail to discuss options to caesareans'

Consultants are routinely arranging caesarean sections for women without adequately discussing the alternatives, according to research which suggests there are at least 4,000 unnecessary caesarean sections a year in England and Wales.

Women are less likely to opt for a caesarean section if they use a simple computer program to help them decide rather than relying solely on the advice of their obstetrician and midwife, the study found.

The researchers suggest that consultants are too willing to arrange elective caesarean sections without discussing the options. Caesarean sections in the UK have risen from 9% of births in 1980 to 21% in 2001. Previous research identified a small but significant risk to the lives of babies born this way.

The study, led by Deirdre Murphy of the department of obstetrics at Trinity College, Dublin, was testing a computer tool which helps women analyse their decisions over delivery. They recruited 742 women who had a caesarean section and were pregnant again and deliberating on how they wanted to give birth.

A third were given standard care by a consultant and midwife, a third got extra information and a third the computer tool which asked what was important to them in the delivery. Some 37% of the computer users gave birth vaginally against 30% who received the standard care. The women who received extra information had a vaginal delivery rate of 29% but, like those who used the computer, felt less anxiety.

Prof Murphy said: "It seems too easy to get a caesarean now and actually the women wanted much more debate with their consultants."