Calculations for Post Pregnancy Hysterectomy Statistics

Last updated June 2006

Why is it important the media cover post pregnancy hysterectomy?

Lies told to those given a post pregnancy hysterectomy and their families.
* There is no one to support you as you are the first person it has been done to for 20 years
* There is no support as it is SO rare
* It was the only way to save your life

Normal consequences for those given a post pregnancy hysterectomy
* People leave hospital with no information at all
* People lose their friends and are shunned as “others” can not cope with what has been done to them. (After one of the television appearances, one of a little wish rang me, she was in tears. Someone who had shunned her for several years due to her post pregnancy hysterectomy had spoken to her. She was amazed.
* Many times people wish that they had been in an accident or had a hysterectomy for cancer instead of post pregnancy as we are often not given compassion or support as accident victims or cancer sufferers are

What the media can help us accomplish
* We need to change peoples attitudes and reduce the suffering of those that have a post pregnancy hysterectomy, their partners and their families. People often leave hospital in pain, they often have to care for a new born baby on their own (partner at work, family too far away, shunned by friends as the friends cant cope) If the media as put though this you would understand how important it is to be able to speak to someone who HAS been there. Not to be talked down and to and TOLD what you SHOULD be thinking and TOLD what you SHOULD feeling.
* As there is unfortunately little in the public domain for post pregnancy hysterectomy (as it is such a specialise area that people have little experience or training in this situation.) It needs to be highlighted what is there and where for people to be able to utilise it.
* Even though we may have done several television appearances and a couple of news articles there are so many out there that still do not know we exists and they are suffering on their own.
* To educate others about post pregnancy hysterectomy and not to treat us as the guilty party.
* This is a really big problem, however until people know that support is available and research is being untaken, they can not contribute to it. The hospitals refuse to give out our information. They understandably can not give out other peoples information, so unless people are told about us via other means, we can not collect the information, which is exactly what the medical profession want.
* Allow expectant mothers to make informed decisions about their birth plans. (One lady went to her doctor and asked about the risks of a hysterectomy as he wanted her to have a c/s. Very aggressively he asked where she had the information from. He was not happy to discover that someone he had recently hysterecotmised was her friend. We are expected to go out into the world and NOT tell people it has been done to us.)

We just do not want anyone walking a mile in our moccasins, if they do not want to, do not need to.

What is the true problem of post pregnancy hysterectomy?

Our guess at the statistics were 400 – 600 people per year for the UK based on 2 – 3 women per hospital per year, however we have underestimated considerably.

Birth rate for England and Wales 2005 – 645,835
Caesarean rate – 22.7% ( 146,605 ) Vaginal birth rate – 77.3% ( 499,230 )

From those statistics the number of those given a post pregnancy hysterectomy that need to come forward (as there is no legal requirement for the doctors/hospitals to declare when it is done) is about 1,500 (one thousand five hundred) people and families A YEAR!

Consequently 1,500 should be coming forward a year … where are they?

Hysterectomy from Home birth site

The risk of a mother who has one past caesarean ending up with a hysterectomy after a subsequent caesarean was 1 in 90, according to a recent study from the UK [5]. However, for women having a vaginal birth who did not have a past caesarean, the rate was only 1 in 5,189. The rate for women having a VBAC is not given, but is likely to be between these two figures.

[5] Gould, D et al, 'emergency obstetric hysterectomy - an increasing incidence', Journ. Obset. Gynaecol. 1999 vol 19 p580-583

Compiled from the following information

- One emergency hysterectomy required after every 110 caesareans, compared to one after every 824 deliveries overall (vaginal or caesarean) [1, USA 1975-1981]

- Caesarean hysterectomy was performed in 0.17% (1 in 588) of caesarean sections and a hysterectomy was done in 0.02% (1 in 5,000) of cases following a vaginal delivery.[2, Singapore, 1998]

- hysterectomy rate during or after caesarean section was 0.44% (1 in 227) and after vaginal delivery was 0.02% (1 in 5,000) [3, Italy, 1991]

- From 1978 to 1982, 70 cases of emergency hysterectomy for obstetric haemorrhage were performed at Los Angeles County/University of Southern California Women's Hospital. Sixty hysterectomies followed caesarean section, and ten were performed for haemorrhage after vaginal delivery [4, 1984]

- The incidence of obstetric hysterectomy was 1 in 1420 deliveries. Overall, 0.32% (1 in 313) of caesarean sections and 0.02% (1 in 5,000) of vaginal deliveries were complicated by emergency obstetric hysterectomy. [5, Hong Kong, 1997]

- a recent study from St George's Hospital in London [7] found that women with a previous c/s are up to 27 times more likely to need obstetric hysterectomy in subsequent births, than those who have only had vaginal births.

REFS

[1]
TITLE: Cesarean hysterectomy at Louisiana State University, 1975 through 1981.
AUTHORS: Plauche WC; Wycheck JG; Iannessa MJ; Rousset KM; Mickal A
SOURCE: South Med J 1983 Oct;76(10):1261-3
CITATION IDS: PMID: 6623139 UI: 84017742

[2]
TITLE: Caesarean and postpartum hysterectomy.
AUTHORS: Chew S; Biswas A
AUTHOR AFFILIATION: Department of Obstetrics and Gynaecology, National University Hospital, Singapore.
SOURCE: Singapore Med J 1998 Jan;39(1):9-13
CITATION IDS: PMID: 9557096 UI: 98217844

[3]
TITLE: [Ablative cesarean section and post-partum hysterectomy: review of 11 years of obstetric practice]
VERNACULAR TITLE: Taglio cesareo demolitore ed isterectomia post-partum: rassegna di 11 anni di attivita ostetrica.
AUTHORS: Dindelli M; Ferrari S; Potenza MT; Ferrari D; Ferrari A
AUTHOR AFFILIATION: Clinica Ostetrico-Ginecologica L. Mangiagalli, Universita degli Studi di Milano.
SOURCE: Ann Ostet Ginecol Med Perinat 1991 May-Jun;112(3):179-87
CITATION IDS: PMID: 1812802 UI: 92255178

[4]
TITLE: Emergency hysterectomy for obstetric hemorrhage.
AUTHORS: Clark SL; Yeh SY; Phelan JP; Bruce S; Paul RH
SOURCE: Obstet Gynecol 1984 Sep;64(3):376-80
CITATION IDS: PMID: 6462567 UI: 84271569

[5]
TITLE: Ten years experience of caesarean and postpartum hysterectomy in a teaching hospital in Hong Kong.
AUTHORS: Lau WC; Fung HY; Rogers MS
AUTHOR AFFILIATION: Department of Obstetrics and Gynaecology, Chinese University of Hong Kong, Shatin NT, Hong Kong.
SOURCE: Eur J Obstet Gynecol Reprod Biol 1997 Aug;74(2):133-7
CITATION IDS: PMID: 9306105 UI: 97451129

[6]
TITLE: Obstetrical hysterectomy and placenta previa/accreta: three bladder injury case reports.
AUTHORS: Chung CL; Cheng PJ; Liang CC; Chang FH; Lee JD; Soong YK
AUTHOR AFFILIATION: Department of Obstetrics & Gynecology, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
SOURCE: Chang Keng I Hsueh 1997 Mar;20(1):44-51
CITATION IDS: PMID: 9178593 UI: 97321901

[7]
Gould, D et al, 'emergency obstetric hysterectomy - an increasing incidence',
Journ. Obset. Gynaecol. 1999 vol 19 p580-583

One comment I would like to share "Indeed, if one does not collect the statistics then they do not exist!"

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