In a wide-ranging interview with Sean O'Rourke on RTÉ Radio 1, Professor Malone spoke about the huge rise in Caesarean sections in Irish maternity hospitals.
It’s been just over a year since Professor Fergal Malone took on the role of Master at the Rotunda Maternity Hospital in Dublin.
It’s a role that comes with huge responsibilities, not just in terms of overseeing patient care, but managing staff in the face of impending industrial action, as well as planning the future co-location with Connolly hospital in Blanchardstown.
In a wide-ranging interview with Sean O’Rourke on the Today programme, Professor Malone spoke about many of these challenges, but the discussion opened with a subject that has been the focus of much debate and discussion in recent years: the huge rise in Caesarean sections in Irish maternity hospitals.
“It’s very hard to know what is the right number of Caesarean sections. About 33 – 35%, is the current Caesarean rate across much of the developed world. We are no different here.
"There are many reasons for that. Patient profiles are changing. Patients are older now, much more obesity, and therefore more medical complications.”
That figure, C-sections accounting for one-third of Irish deliveries, is more than double the figure recommended by the World Health Organisation, but Professor Malone was very keen to put context on those numbers.
The increase in multiple gestations, twins, and triplets, because of increased use of IVF, can lead to additional Caesarean sections, as well as an increasing expectation of perfection amongst patients.
"Patients want healthy babies, healthy outcomes, they are less likely to accept risk.
"If a patient has had one prior Caesarean section, about 60 to 80% of them will tell you next time, I want another Caesarean section, I don’t want to risk a vaginal delivery.”
The interview opened with a report originally featured on the show last month, in which a group of transition year students were invited by the Royal College of Surgeons to watch Professor Malone carrying out a C-Section.
The squeamishness evident in their gasps is clearly audible, and entertaining, in some ways. But for Professor Malone, it is routine at this stage.
“The most likely reason for the increasing Caesarean section rate is, patients are changing. About one-third of the women who deliver babies in the Rotunda now are over 35. 20 years ago, it was only 15% over 35.
"As one gets older, there is a higher chance that you might have higher blood pressure, you might get diabetes. These are complications that make it a more risky pregnancy.”
Fergal Malone also had something to say about the rising costs of the new Children’s Hospital. With recent reports indicating that costs could pass €1 billion, he pointed out that comparable hospitals in Finland and in the US, come in at just half that cost.
To listen to the full interview, click here.
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