P.E.I. C-section rate remains high despite investigation

The rate of caesarian section births on P.E.I. remains around 30 per cent, double the high range recommended by the World Health Organization.

Studies by WHO have found when the rate of C-sections goes above 10 per cent there is no evidence of an improvement in mortality rates for mothers or babies. In 2010, the province expressed concern about the high rate on the Island.

But the rate, as measured by the Canadian Institute for Health Information, had not changed significantly in the most recent numbers, which are for 2016-17.

Health PEI says the Department of Obstetrics and Gynecology at the Queen Elizabeth Hospital in Charlottetown did review C-section cases, and found they were medically necessary within appropriate guidelines.

Required C-section rates can vary within different populations, says Health PEI, and it is satisfied that C-sections are being performed appropriately.

Rate rising nationally

While the rate on the Island is largely unchanged since 2009-2010, it is rising nationally.

From 2008-09 to 2016-17 the rate has fluctuated slightly, but remained within a three point range, with a low of 28.9 per cent in 2011-12 and a high of 31.8 per cent in 2010-2011.

Around 2010 the national rate was running just under 27 per cent. In 2016-17 it was 28.2 per cent. As the national rate rises, P.E.I. is drawing closer to the Canadian average.

BORN, which advocates for midwifery on P.E.I., believes more could be done to encourage more natural childbirth on the Island.

"At the time the caesarian was performed I'm sure it was medically necessary," said Jenny Stewart, a doula and registered practical nurse who is one of the leaders of BORN.

"What we're concerned about is the events that lead up to that. Oftentimes there are several interventions that happen long before a caesarian ever becomes required."

For example, Stewart said, women whose labour is progressing slowly may be given Pitocin to speed things along, and that can lead to stronger contractions that may lead to a request for an epidural. All these interventions can make a C-section more likely.

"We'd really like them to look at how the interventions before a C-section correlate into the odds of having one, and then educating health professionals as well as women going into the hospital to birth, on some of the things they can do themselves that don't require actual physical intervention," said Stewart.

While CIHI publishes rates for C-section births it does not publish absolute numbers. The rates are measured against total births in hospitals.

More P.E.I. news