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75 Maternity and Obstetrics Population changes of nulliparous women and multiparous women 1999 Number in group Number of C/S Contribution to total population % C/S Nullip 3465 562 3465/7533 (46.0%) 562/3465 (16.2%) Multip no scars 3559 185 3559/7533 (47.2%) 185/3559 (5.2%) Multip + 1 scar 450 169 450/7533 (6.0%) 169/450 (37.6%) Multip + 2 or more scars 59 58 59/7533 (0.8%) 58/59 (98.3%) Totals 7533 974 974/7533 (12.9%) 2019 2020 Number in group Number of C/S Contribution to total population % C/S Number in group Number of C/S Contribution to total population % C/S Nullip 3415 1104 3415/7871 (43.4%) 1104/3415 (32.3%) 3201 1025 3201/7263 (44.1%) 1025/3201 (32.0%) Multip no scars 3290 334 3290/7871 (41.8%) 334/3290 (10.1%) 2956 349 2956/7263 (40.7%) 349/2956 (11.8%) Multip + 1 scar 930 708 930/7871 (11.8%) 708/930 (76.1%) 882 683 882/7263 (12.1%) 683/882 (77.4%) Multip + 2 or more scars 236 236 236/7871 (3.0%) 236/236 (100%) 224 222 224/7263 (3.1%) 222/224 (99.1%) Totals 7871 2382 2384/7871 (30.3%) 7263 2279 2279/7263 (31.4%) Comment: Significant increase in the percentage of women that have a previous caesarean scar since 1999 and increasing every year . Onset Rates 1999 % 2012 % 2013 % 2014 % 2015 % Spontaneous 5062 67.2% 5494 61.2% 5214 59.6% 5347 58.7% 5164 56.2% Induced 2006 26.6% 2367 26.4% 2323 26.5% 2465 27.1% 2534 27.6% Pre-labour CS 466 6.2% 1117 12.4% 1218 13.9% 1294 14.2% 1488 16.2% Total Deliveries 7534 8978 8755 9106 9186 2016 % 2017 % 2019 % 2020 % Spontaneous 4850 54.8% 4461 52.9% 3841 48.8% 3240 44.6% Induced 2530 28.6% 2518 29.9% 2443 31.0% 2500 34.4% Pre-labour CS 1471 16.6% 1454 17.2% 1587 20.2% 1523 21.0% Total Deliveries 8851 8433 7871 7263 Comment: Significant increase in the number of women that are induced or in particular have a prelabour caesarean section. Overall Delivery Method 2016 % 2017 % 2019 % 2020 % Spontaneous Vaginal Delivery 5287 59.7% 5048 59.9% 4498 57.1% 4063 55.9% Vaginal Operative Delivery 1261 14.2% 1094 13.0% 989 12.6% 921 12.7% Caesarean Section 2303 26.0% 2291 27.1% 2384 30.3% 2279 31.4% Total 8851 8433 7871 7263 Comment: Overall the caesarean section rate continues to rise each year. NMH Annual Rep t | 2020