Doctors have revealed that fear of legal action is a major factor behind the rising number of caesarean sections performed during childbirth, according to an unpublished survey which looks at why rates of natural deliveries are declining.
The high rates of caesarean sections in the UK , which are up to 28 per cent of all births in some trusts, may have less to do with women choosing an operation, and more to do with doctors' anxieties about being sued. Two-thirds of obstetricians admitted that such anxieties influenced their decision.
However, the perception that patients are becoming more litigious is a myth not born out by the statistics, according to experts. The number of legal claims against NHS trusts actually fell by 20 per cent last year.
Official recommendations were issued earlier this year stating that caesarean sections should not be openly offered to all women, but restricted to those at high risk of complications during birth. Since then, controversy has been raging over women's right to choose how to give birth. One in five births in the UK is now by caesarean, but only 7 per cent of those happen for non-medical reasons.
But the survey, conducted among 785 obstetricians in the UK and Ireland, suggests that apart from patient choice, the NHS may be moving towards more caesareans because of worries over legal action.
The study, carried out by Cambridge University researchers, questioned doctors about decisions over childbirth. Those questioned stressed they feared the 'devastating effect' of being taken to court because of the media coverage and the effect on their career. However, it emerged that very few of them had ever been in this situation.
When asked the main reason for the rising trend for caesareans, 77 per cent cited women's choice, and 67 per cent also said there was a fear of litigation.
When asked how many had experienced a direct request from a woman, most obstetricians reported that they had only had a few.
Helen Statham, of Cambridge University's centre for family research, said: 'Doctors point out that no one gets sued for doing a caesarean, but they may get sued for not doing one. The fear of litigation is out there, in the ether, whether or not it is grounded in reality.'
Defensive medicine - the name given to carrying out procedures that are not strictly necessary but protect staff against future legal claims - is not nearly as pronounced in Britain as it is in America, where some doctors have even suggested that they should no longer treat lawyers, such is the culture of suing if any accident happens.
British figures released earlier this year from the government's compensation recovery unit, which receives information from all insurers, showed that 60,000 fewer claims were registered in 2003-04 than the period before.
The cost of civil claims as a percentage of gross domestic product remained largely static at 0.6 per cent - one of the lowest in the West - between 1989 and 2000, compared with around 2 per cent in the United States.
