Natural birth or C-section?

There are wide differences in opinion about Caesareans across Europe, showing a lack of consensus on the best way to deliver babies, research shows.

Around one in four births in the UK is by caesarean section, while in Cyprus the figure is 52% and in Sweden it is 17%.

A study conducted in 26 European countries and published in the journal BJOG shows that more research is needed to understand why such opposing views exist.

According to the opinion of the Royal College of Midwives, the differences are due to the specifics of the health systems in these countries.

“We need benchmarking of national policies and further research to ensure that clinical practice is evidence-based,” says Professor Alison McFarlane.

The study, led by scientists at the University of London, shows that the preference for Caesareans in EU countries over natural birth is on the “steady rise”, although in some of them this type operative delivery is not widely practiced.

“There are several possible explanations for this – including fear of litigation and financial incentives. But many women want a C-section at birth because they think it’s a safe procedure,” McFarlane said.

The study also shows there are consequences to the rise, such as higher risks for mothers and babies. A clear example of this is stillbirth. Caesarean section is usually used when mothers are giving birth for the first time or have more than one child but have already had a Caesarean section.

However, there is ongoing debate about the use of CS in babies who come out feet-first and in women who have already used this type of delivery. The study showed that the highest rate of planned Cesareans was observed in Cyprus 38.8% and in Italy 25%.

The lowest values ​​were reported in Finland (6.6%), the Netherlands (7.7%) and Norway (6.6%). In the UK, the rates of planned caesarean sections are: 9% in England, 11% in Wales and Scotland and 14.6% in Northern Ireland.

The percentage of emergency C-sections was highest in Romania (33%) and lowest in Sweden (8.6%). In the UK, emergencies are around 15% of all births.

“Given that people should practice this type of birth under certain compelling circumstances, it is surprising that there are such large differences between countries,” says Alison McFarlane, professor of perinatal health at the University of London.

“We need an analysis of the policies of these countries to determine the reason for the large differences,” McFarlane said. “But the health of mothers and their children should always come first,” she added.

“Differences may be due to patterns of health services and the overall health of different population groups,” said Gail Johnson, professional research adviser at the Royal College of Midwives.

She said the rate of women having Caesareans in Britain was still too high. Caesarean section is an urgent procedure that is not required in a healthy mother and there is no pathology in the position and condition of the fetus.

Every woman has the right to choose, but still caesarean section carries more risks than natural birth. Due to this fact, it is advisable to consult a specialist before making this important decision.