National Women's Annual Clinical Report 2010

%
70
60
50
40
30
20
10
0
SVB Operative vaginal CS elective CS emergency
Independent midwife Pvt Obstetrician NW
Figure 56: Mode of birth at term by LMC at birth among standard primipara
The outstanding feature of the figure above is the outcome for standard primipara under
private specialist obstetrician care. It is possible that some of the elective Caesarean
sections are done for convenience (on the part of both women and obstetricians). However,
it is also possible that the women who attend private obstetricians are more likely to have
clinical or demographic factors associated with elective caesarean, or that women who wish
elective caesarean for no medical indication choose to see a private obstetrician who can
provide this service.
6.4 Spontaneous vaginal birth
Table 43: Spontaneous vaginal birth rates (2004-2010)
2004 2005 2006 2007 2008 2009 2010
n n n n n n n
Total births (mothers) 7491 7194 7212 7695 7589 7735 7709
Spontaneous vaginal birth 4127 3899 3866 4282 4280 4374 4217
Incidence % 55.1 54.2 53.6 55.6 56.4 56.4 55.5
Total nullipara 3597 3522 3499 3752 3623 3811 3650
Spontaneous vaginal birth 1604 1535 1509 1755 1749 1839 1675
Incidence % 44.6 43.6 43.1 46.8 48.3 48.3 45.9
Total multipara 3894 3672 3713 3943 3966 3924 4059
Spontaneous vaginal birth 2523 2364 2357 2527 2531 2495 2601
Incidence % 64.8 64.4 63.5 64.1 63.8 63.6 64.1
The spontaneous vaginal birth rate has remained relatively stable overall over the past 7
years. There has been a small decrease in spontaneous vaginal birth rate among nullipara
since last year.
6.4.1 Waterbirth
Twenty nine babies were recorded in the database as having been born in water in 2010.
Nine of these were under the care of NW LMC service, eighteen under the care of an
independent midwife, one cared for by a general practitioner and one by a private
obstetrician. There may be some under counting of waterbirths.
All were livebirths. One baby had an Apgar score of