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04 Jul 2016

The number of mothers undergoing lifesaving hysterectomies after giving birth has climbed almost 40 per cent amid a surge in the rate of caesarean section deliveries.

In the first such national report of its kind, the Australian Institute of Health and Welfare has found that although peripartum hysterectomies (the surgical removal of a mother’s uterus following birth) are rare – fewer than 300 a year – their number increased by 37 per cent between 2003-04 and 2013-14.

Importantly though, despite the increase in number, their rate has so far remained relatively stable at around 0.79 for every 1000 mothers giving birth.

Nonetheless, health authorities are watching the area carefully because peripartum hysterectomies are strongly associated with caesarean sections, which are themselves becoming much more common.

Peripartum hysterectomy can be a life-saving procedure but, as the Institute notes, because it brings an end to fertility and is associated with considerable morbidity for both mothers and their infants, it is not one that is undertaken lightly, and is most commonly performed to treat otherwise uncontrollable haemorrhage.

And, like any procedure, it is not without risk. In the 10-year period examined by the Institute, 16 mothers undergoing peripartum hysterectomies died, as did 93 foetuses.

“There is concern that the rising rates of caesarean section in Australia, from 18 per cent in 1991 to 32 per cent in 2011, will lead to a marked increase in the rate of peripartum hysterectomies,” the AIHW said.

In addition to this, women are tending to give birth later in life, which increases the risk of peripartum hysterectomy, as does having previously given birth by caesarean section, having had multiple births (such as twins) and being overweight or obese.

The risk of hysterectomy doubles for mothers who have previously given birth by caesarean section attempting vaginal birth.

Adrian Rollins

Published: 04 Jul 2016