Abstract
SummarySummaryGrandmultipara are now uncommon in Western obstetric populations, and the approach to antenatal and intrapartum care in such cases is likely to be dictated by past teaching in which they would uniformly be classified as ‘high risk’. Such an approach is in danger of becoming self sustaining for obstetric and medicolegal reasons. This modern retrospective study of a large population (n = 1590) of grandmultipara receiving a high standard of antenatal care provides evidence to confound this view and support a low intervention approach. A 4–8 per cent rate of primary caesarean section was achieved, with a low overall rate of only 74 per cent. An antenatal diagnosis of hypertension or diabetes and a birthweight of > 4 kg were all strongly associated with an increased likelihood of abdominal delivery, and could serve as risk factors in clinical judgement.
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