A lack of skilled obstetricians has left more women with the option of a caesarean section (C-section) in the second stage of labor, often in situations where a natural birth could have been possible according to several senior doctors.
Obstetric trainees are often likely to opt for a C-section following a vaginal assessment, than consultant obstetricians due to inexperience.
AdvertisementSome of the common risks associated with second stage C-sections for the mother include major haemorrhage, longer hospital stay and greater risk of bladder trauma. Besides this women who have had a C-section also have lesser chances of having vaginal births in subsequent pregnancies becase they tend to request repeat elective caesarean delivery.
According to two consultant obstetricians and a professor in obstetrics and gynaecology who wrote in this week's British Medical Journal, argue that without increases in junior doctors' experience and recruitment into the specialty, "the problems with second stage caesareans will rise".
C-section is often found to be a common choice when a mother is in labour and reaches full cervical dilation with an unexpected breech position.
The doctors write, "In the absence of an experienced and skilful obstetrician to perform assisted vaginal breech delivery, women are advised to undergo an emergency second stage caesarean."
In addition a lack of experience has also leding many women to choose for C-sections to give birth to twins than is necessary. It has been estimated that about ten per cent of second twins are delivered by C-section after the first had been delivered vaginally while ten years ago this rate was five per cent.
Still the doctors allege that as many as two-thirds of these second twin C-sections are "preventable and due to operator inexperience".
In spite of UK "great strides" in terms of training and assessment, the doctors conclude that "it is essential to recognise the need for obstetricians to maintain and develop their skills if women are to be offered safe alternatives to caesarean section when complications arise in labour".