Issue link: https://maltatoday.uberflip.com/i/937440
maltatoday WEDNESDAY 7 FEBRUARY 2018 News 7 TIA RELJIC 32% of all babies born in Mal- ta last year were delivered through Caesarean Section, one of the highest rates in the EU. According to the World Health Organisation (WHO) recommendations, a coun- try's rate of C-section births should remain between 10 to 15%. Out of 3,590 total births, 1,158 children were born through Caesarean Section between January and Octo- ber of last year, Health Min- ister Chris Fearne confirmed in response to a parliamen- tary question put forth by PN MP Maria Deguara yester- day. The rate of C-sections in Malta has consistently been among the highest in the EU for the past few years. In 2017, 85.4% of C-section operations involved spinal anaesthesia and 13.2% made use of general anaesthesia. 1.4% of the cases made use of both spinal and general an- aesthesia together. The remaining 2,432 births comprised 2,272 vertex vagi- nal births, 4 forceps deliver- ies, 155 ventouse deliveries, and one case of breech deliv- ery. A total of 6,772 Caesarean Section births were per- formed between 2012 and 2016. . The WHO had previously criticised Malta for its high rate of C-sections, citing risks of complications. On the other hand, obstetricians say that WHO recommenda- tions do not take newborn morbidity into account, and that Maltese women have the highest rates of obesity on Europe. In 2015, the Head of the University's Department of Obstetrics, Professor Charles Savona-Ventura told this newspaper that "a C-section is a poor price to pay to safe- guard the newborn from complications," including "significant life-changing morbid conditions." The high rate of obesity and the fact that Maltese women are on average shorter than their European counterparts should also be taken into consideration. "These fac- tors promote foetal growth, resulting in big babies, pro- longed labour, and a higher risk of the foetus being de- prived of oxygen." "These women have an op- tion – to persist in achieving a vaginal delivery and risk a severely damaged child or to intervene with a Caesarean Section." Malta maintains constant C-section birth rate Caesarean Section A C-section is the delivery of a baby through a surgical incision in the mother's abdomen and uterus. The surgery is normally opted for when the mother is at risk of com- plications, or in some case, due to a life-threatening emergency. Sched- uled C-sections often take place if the baby is in a feet-first, bottom- first, or sideways position in the womb, if the baby has birth defects, or if the mother has specific medi- cal conditions or has previously had surgery on her uterus. Emer- gency C-sections occur when labor is delayed or halted, the baby is too big, the placenta separates from the uterine wall early, the umbili- cal cord becomes pinched, or if the baby is in distress. Forceps Forceps delivery is a type of as- sisted delivery in which forceps – a type of instrument shaped like large tongs – are used in order to help guide the baby through the birth canal. Forceps are used dur- ing the second stage of labor, often when labor isn't progressing or if the baby needs to be delivered im- mediately due to problems related to the baby's heartbeat, or certain medical conditions of the mother. Forceps might also be used if the baby is facing up rather than down. However, the use of forceps does pose a degree of risk, which is why forceps delivery is not recommend- ed if the baby has certain condi- tions, if the position of the head is not known, or if the baby's head has not yet moved past the midpoint of the birth canal. Ventouse Ventouse births are assisted by the use of an instrument which looks like a soft plastic suction cup. The suction instrument is attached to the baby's head, and a handle on the cup is used to move the baby down the birth canal. The process most often takes place when the baby is close to birth, but has be- come distressed for some reason or another. This form of delivery is therefore used to speed up the pro- cess. Other reasons for using a ven- touse is in cases where the mother has been pushing for several hours, is exhausted from pushing, or has some other medical condition. It might also be used when the baby's head is not in the ideal position. Breech A breech birth is a more com- plex form of natural birth since the baby would be in a ' breech ' position – that is, positioned in the womb bottom-down. When a baby is born in this position, the rest of the baby's body is born be- fore the largest part – the head. For this reason, there is always a heightened chance that the rest of the body will not readily fol- low. Breech births need to be monitored very closely, and often lead to Caesarean Section deliv- eries. Assisted delivery methods 1,158 children out of 3,590 were delivered through a C-section operation in Malta last year Type of birth Number Normal vertex of births Vaginal 2,272 Forceps 4 Ventouse 155 Breech 1 Cesarean Section 1,158 Year Number of Average Caesarean maternal Sections age of mothers 2012 1409 30.2 2013 1270 30.4 2014 1368 30.8 2015 1359 30.9 2016 1366 31.2