- The Observer, Sunday September 10 2000
Doctors are performing hundreds of hysterectomies on women without their consent while they are under anaesthetic for caesareans.
Pressure groups blame inexperienced doctors covering up their mistakes, and the increasing use of drugs and surgical procedures during births. They claim it is as if a man went in for a vasectomy and woke up to find he had been castrated. Doctors insist the procedures are necessary to save the patients' lives.
A study at one London hospital suggests the number of cases has increased sevenfold in the past 10 years. It shows women who have previously had a caesarean are far more likely to be at risk, with as many as one in 90 being given a hysterectomy at the same time as the birth. The women cannot give their consent because they are under anaesthetic.
Caesarean sections cause a scar inside the womb which can open up during the next birth. If the womb splits it can lead to a haemorrhage that can only be stopped by a total hysterectomy. Many of the mothers claim they are not clearly told of the risks beforehand, or that they are pressured into having a caesarean against their will.
Beverley Beech, chair of the Association for Improvements in the Maternity Services, says she has been contacted by an increasing number of mothers who suffered emergency hysterectomies. 'These women are devastated. Some say they would never have given consent and would have preferred to die. Their husbands are finding it difficult to cope with their wives' despair and are distraught,' she said.
Elaine Russell, from Manchester, said medical complacency led to her having a caesarean birth so late in her fourth pregnancy that her womb split. The doctor decided to do a hysterectomy. Despite asking to be put to sleep, Elaine was under local anaesthetic and awake during the entire three-and-a-half hour operation.
'I can't believe the way I was treated. I was a fertile person, and now I've got no womb. I would have liked more children. I feel so damaged by it all. I'm finding it very hard to come to terms with,' she told The Observer. 'I was horrified by the whole event, and it's deeply affected my life. It's like surgical rape.'
In some cases women can lose their womb after their first baby. Other cases uncovered by The Observer include:
• a Scottish mother who was given too much of the drug prostaglandin to induce her first baby and was overstimulated. Her womb ruptured, and she lost the baby and had an emergency hysterectomy;
• a woman who was pressured into having a caesarean, and woke up to be told she had also been given a hysterectomy. She says she was not given an adequate explanation;
• a woman who was told she was being taken back to the operating theatre to have her womb sewn up, to stop bleeding after her second baby was born. She woke up without a womb.
A study in the Journal of Obstetrics and Gynaecology found that the number of women having caesarean hysterectomies at St George's Hospital in London has risen sevenfold. In the early Nineties only one in 7,000 women who gave birth at the hospital had to have a hysterectomy. At the end of the decade it had risen to one in 1,000 mothers.
However, the risks rise sharply if the mother has previously already had a caesarean birth. The study suggested that one in 90 women who had already had a caesarean section ended up having a hysterectomy immediately after the birth.
The author, Dr Deborah Gould, said: 'Strikingly, women with a past history of caesarean section appeared to be up to 27 times more likely to require obstetric hysterectomy than women who have not had a previous caesarean section. We are now seeing hysterectomy being increasingly performed as a consequence of previous delivery by caesarean section.'
The proportion of mothers given caesareans has risen steadily in recent years. In 1989 only 11 per cent of births were by caesarean, but that had risen to 18 per cent by last year. In some hospitals, almost a third of babies are delivered by caesarean. Department of Health figures suggest there were 64 caesarean hysterectomies last year, although that might underestimate the scale of the problem.
Gina Lowdon, caesarean co-ordinator of the National Childbirth Trust, said: 'All the risks from caesareans are on the increase because the number of caesareans are rising dramatically. They are doing it so much they are becoming blasé, and not doing them as carefully as they used to.'
Beech claimed: 'Many of these caesareans are being given by junior doctors, who are making mistakes. They're then doing hysterectomies to save themselves - it's a rescue job. These things are predominantly caused by the meddling with child-birth, the medicalisation of childbirth.'
Gould warned that if caesarean births carried on being so popular the problem of emergency hysterectomies would increase. She wrote: 'It appears that hysterectomy may have an increasing role in future obstetric practice, particularly in view of the progressive increase in caesarean section rates. It is essential that obstetricians continue to be trained in major pelvic surgery.'
For advice, contact the Association for Improvements in Maternity Services on 01753 652 781; or the National Childbirth Trust helpline on 020 8992 8637.
