Wide variations in the rate of caesarean sections carried out in Europe have raised concerns about whether women are benefiting from best practice.
A new study published by the journal BJOG has found that about a quarter of births in the UK are by C-section, compared with a low of 14.8 per cent in Iceland and a high of about 52 per cent in Cyprus.
Authors of the study, led by academics at City University London, said it highlights a clear "lack of consensus about best practice" between countries in Europe and the UK.
It urged further investigation, suggesting professionals' attitudes to care at delivery, adherence to guidelines and differences in healthcare systems and how they are financed could be to blame for the stark variations.
"We would hope that this data would be consistent but it clearly isn't," said Alison Macfarlane, professor of perinatal health at City University London and lead author of the study. "There is a concern that the caesarean rate is going up and that there are some women who undergo the surgery unnecessarily, which this reports suggests [is the case] because of the wide variation.
"The UK figures are neither high nor low, but there is a concern that the caesarean rates are still going up, with huge variations. When a caesarean is really necessary it can mean the difference between life and death but when it isn't, it can have big effects on the mother and the baby.
"We need to look at what the pressures are that lead to more caesareans and why there such wide variation in clinical practice."
She highlighted the need for a comparative review of national policies and guidelines to prioritise the health of mothers and children
The study, the first of its kind, found the average rate of C-sections in Europe is about 25.2 per cent. However, the figure for mothers giving birth to more than one baby is 63.1 per cent – 98.6 per cent in Malta, 31.1 per cent in Iceland and 62.6 per cent in England. Data for all the UK was not available.
C-sections are more likely to be performed when babies are born to first-time mothers, women who have previously undergone a caesarean, or who are carrying twins, or when babies are in a breech position.
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