It’s not often you can claim to have contributed in some small way to medical history, but I can. Or, at least, my mum can. Just before the pitter-patter of my tiny feet was first heard, my mother was told she needed a caesarean section, a procedure then done under general anaesthetic. Due to a separate emergency, the birth was delayed and mum and the anaesthetist got chatting.

After a while the anaesthetist, presumably having noticed her calm good nature, asked mum if she would like an epidural instead of a general. “Why not?” she replied. She had seen her son being born and would like to see this baby arrive in the world too. The consultant arrived at mum’s bedside next day to check up on us. “How did you find the procedure?” he asked. “Oh, great,” said mum, “although I wish they had let me wear my glasses.”

“Well, I was terrified,” he revealed. “I’ve never done an epidural caesarean before. Actually, no-one in Ireland has.”

Thirty-one years later and the Economic and Social Research Institute reveals that 26% of babies born in Ireland in 2005 were delivered by caesarean section. Apart from extreme emergencies, none of those would have arrived under general anaesthetic. In 1977, the caesarean rate was in low single digits, grew to more than one in 10 in 1991, and one in five in 1999.

Why the rapid increase, when the World Health Organisation (WHO) says the maximum justifiable rate of caesareans is just 15%? If the expression “too posh to push” is on the tip of your tongue, then go wash your mouth out with soap. If there has ever been a more facile, patronising and insulting assessment of a woman’s health issue, I haven’t heard it. Yet the belief is widespread that the increase in C-sections is due to vain women requesting elective surgery for cosmetic reasons.

This is codswallop. A myth. Who in their right mind would breezily request major abdominal surgery when there is an alternative? Sure, giving birth hurts like hell, but so does recovering from having your belly sliced open. Most pregnant women are well aware of the risks of both vaginal and caesarean delivery. A C-section may ultimately be medically necessary, but no expectant mother would choose to have one, as the risks include a higher rate of maternal death; haemorrhage; damage to the womb, bladder or bowel; thrombosis; infection; and an increased rate of problems in future pregnancies. Babies born this way are also more likely to suffer ill-health.

To top it all, a study published last week in The Journal of Child Psychology and Psychiatry found that women who give birth by C-section may find it harder to bond with their babies, as they don’t experience a natural rush of the “love hormone” oxytocin during labour. The increase in C-sections is partly explained by improvements in medical technology and the increased number of older women having babies. Caesareans are sometimes medically necessary anyway — I, for example, was a breech baby. Foetal or maternal distress, foetal illness or abnormality and a slew of other possible complications can all lead to C-sections.

It’s common for a woman to be given a C-section if she has already had the procedure with an earlier child, although there is now increasing medical support for vaginal births after caesareans. Another reason obstetricians reach for the scalpel is dystocia — failure of the labour to progress. There are no agreed standards for dystocia, and consequently, many women in labour feel pressurised into agreeing to interventions such as having their waters broken, inductions, oxytocin injections (to bring on labour) and — in extreme cases — caesarean sections. The Irish pregnancy discussion boards are full of horror stories of exhausted, vulnerable women in labour being coerced into “hurrying things along”.

So being “too posh to push” has nothing to do with it. The real issue is a strained maternity system with medical professionals who are under pressure to shoo women through the labour wards as quickly as possible, a situation that is compounded by the growing fear among midwives and consultants, of litigation.

Rates of C-sections, inductions and other interventions vary wildly in Irish hospitals, apparently depending largely on available manpower and the prevailing culture of labour management in each individual hospital. It’s a lottery for women and their babies, and an extremely unfair one at that. Studies consistently show that the fewer interventions there are during labour, the less likely it is to end in a C-section.

With the budget looming, our cash-strapped government might note that aiming to cut the rate of caesareans to WHO-mandated levels or below would make sound financial sense, as well as being better for mums and babies. Vaginal birth is cheaper, requires fewer medical staff, fewer drugs and less aftercare.

I must admit that I have something of a vested interest in all of this. I was the last baby born in our immediate family, but a little niece or nephew is due shortly. Here’s hoping for a safe arrival — however it happens.

kathy.foley@sunday-times.ie

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