'Rise in Caesareans is harming midwifery'

The trend towards Caesarean births in place of natural delivery has led to a "deskilling" of the profession of midwifery, with non-interventionist methods of care becoming less and less common, midwives warned yesterday.

Carol Bates, of the Royal College of Midwives, said the choice of many women to seek a relatively pain-free labour, particularly with Ceasareans and epidurals, and the decline of home deliveries had led to childbirth becoming increasingly interventionist.

One area of concern is the lack of midwives experienced in dealing with breech births, a condition now routinely dealt with by Caesarean, particularly with first-time mothers.

A Department of Health study into Caesarean sections in 2000 found that the surgical procedure was used in one in five births, compared with a rate of one in 11 in 1980.

Ms Bates, who is the college's education development co-ordinator, said: "Most women can give birth naturally ... intervention is not good for women with healthy pregnancies." Women were continuing to opt for so-called pain-free births even when intervention was not necessary, she said. "This loss of midwifery skills is very difficult, especially if the women are pro-technology. I would like to know what women want," she said.

Her claims were backed by Andrea Robertson, a childbirth academic. Writing in the journal The Practising Midwife, she said many staff were becoming deskilled because of changes in attitudes. She added that the 90 per cent of women who could give birth naturally should be encouraged to do so.