Infections after caesarean birth higher than other operations

One in ten women who give birth by caesarean section develop an infection, a study has found- which is a much higher rate than for similar operations.Infections after caesarean birth higher than other operationsIt suggests that 15,000 women a year in England suffer an infection after their caesarean birth, the researchers said.

The study found that 9.6 per cent of women having caesarean section births developed an infection afterwards compared with just 6.6 per cent of women having a hysterectomy.

As one in four births are by caesarean, experts said the infections are a serious problem for both patients and add extra costs for the NHS.

Being overweight, aged under 20 and having the operation performed by a more junior doctor than a consultant increased the risk of infection even more.

The study investigated almost 400 infections in more than 4,000 caesarean births during 2009.

The findings Infection following a caesarean is more likely if you are obese, suggests new research were published in the British Journal of Obstetrics & Gynaecology surprised experts because the operation is considered relatively ‘clean’ unlikely surgery involving the large bowel which results in 13 per cent of patients suffering infections.

Of the 394 women who developed an infection, the majority had been given antibiotics as a precaution.

Most infections were not serious however seven per cent were more serious and would have required an additional stay in hospital and a further five per cent were deep infections which may have required further surgery.

Women who were overweight were 60 per cent more likely to develop an infection and those who were obese were almost 2.5 times more likely to have an infected wound.

Women aged under 20 were almost twice as likely to have an infection compared with those aged 25 to 30 and having an associate specialist or staff grade doctor perform the operation instead of a consultant increased the risk by 60 per cent.

Dr Elizabeth Sheridan, Head of Healthcare Associated Infections at the HPA, said: “Reducing rates of surgical site infections following a caesarean should be made a priority.

“Given that one in four women deliver their baby by caesarean section, these infections represent a substantial burden. They will impact not only directly on the mother and her family but also are a significant cost in terms of antibiotic use, GP time and midwife care and every effort should be made to avoid them.

“Women choosing to have caesarean section for non-medical reasons should be aware of the risk of infection, particularly if they are overweight.”

“As has been seen in both this study and several others, there is an established link between BMI and an increase in the risk of developing a surgical site infection. Monitoring infections in women having a caesarean section is important as a means to drive down infection rates.”

“As levels of obesity are rising, optimising surgical techniques and identifying the most appropriate dosing of antibiotics could provide a means for reducing wound infections in obese women.”

Lead author Dr Catherine Wloch, Department of Healthcare Associated Infection and Antimicrobial Resistance at the Health Protection Agency said: “This study has identified high rates of surgical infection following a caesarean with one in ten women developing an infection. Whilst our study didn’t measure this, these infections are likely to have an impact on a woman’s experience and quality of life.

“Although most caesarean section wound infections are not serious, they do represent a substantial burden to the health system, given the high number of women undergoing this type of surgery. Minor infections can still result in pain and discomfort for the woman and may spread to affect deeper tissues. The more serious infections will require extended hospital stays or readmission to hospital.

“Prevention of these infections should be a clinical and public health priority.”

John Thorp, BJOG Deputy-Editor-in-Chief said: “With the rise in numbers of women having a caesarean section and the rise in obesity rates, this issue is an important one.

“Post-surgical infection can seriously affect a woman’s quality of life at a critical time when she is recovering from an operation and has a new born baby to look after. More needs to be done to look into this and address ways of reducing infection.”

Patients swamp A&E as GPs cut surgery hours

Hospital Accident and Emergency departments are being swamped by patients who cannot visit GP surgeries or NHS walk-in centres, leading to longer waiting times.Patients swamp A&E as GPs cut surgery hoursThe reduction in opening hours is forcing some patients to wait up to three weeks for a GP’s appointment.

Information provided by almost two thirds of NHS primary care trusts indicated that almost 500 surgeries in England have stopped offering evening and weekend appointments.

Andy Burnham, the shadow health secretary, who commissioned the research, raised concerns that the NHS was being turned into an organisation that works for the convenience of doctors, rather than patients.

In April 2010, David Cameron promised that the Conservatives would ensure that GP surgeries remained open “until 8pm, seven days a week”.

The Coalition has abolished the official survey of GPs’ opening hours and is giving more power to doctors to commission and organise health services for patients in their areas.

However, figures from 91 primary care trusts, obtained by Labour under the Freedom of Information Act, showed a fall in the number of surgeries offering extended opening hours in half of NHS trusts.

Nationally, the survey suggested there had been a 5.7 per cent decline in surgeries offering weekend and evening appointments. This would be equivalent to 477 surgeries serving more than two million patients across England.

Labour said 26 emergency care units, including 12 NHS walk-in centres, had closed in the last year. At the same time, hospital emergency departments have been overwhelmed by one million more patients this year than in 2011, the Opposition claimed.

Mr Burnham said: “People are turning up at accident and emergency sicker and you get fewer staff to deal with them. David Cameron made a lot of promises on the NHS and one by one we are seeing them broken. The combination of the financial challenge with the biggest ever reorganisation of the NHS has served to severely destabilise the NHS.”

Mr Burnham said that more than 1,300 patients had contacted the party with concerns, many reporting that it takes two to three weeks to secure a doctor’s appointment. The worst affected area for cuts to opening hours was Hartlepool, where 31 per cent of surgeries were operating a reduced service. In Newcastle and Haringey, a quarter of practices were reducing opening hours.

The research also found that accident and emergency wards in 46 NHS trusts were not meeting the maximum waiting time of four hours.

A Conservative party spokesman said it was “more than a bit rich” for the Labour to complain about doctors’ opening hours “when it was their disastrous GP contract which meant that 90% of surgeries stopped offering this service altogether”.

“Our plans to put doctors back in charge of the NHS, which were opposed by Labour, will mean that local doctors will once again be responsible for caring for their patients out of hours and will offer patients a real choice of which GP surgery to go to,” he said.


Women can delay menopause indefinitely with ovary transplants

Women can remain fertile indefinitely after successful ovarian transplants lead to births and delay the menopause doctors have told a conference.Women can delay menopause indefinitely with ovary transplantsA technique to remove pieces of ovary, store it for decades and then replace it with delicate surgery could effectively put a woman’s menopause ‘on ice’, doctors said.

The only thing preventing them from having babies into their old age would be their physical ability to carry a pregnancy, they said.

The controversial notion would allow career women peace of mind with a fertility insurance policy so they can find a partner, settle down and become financially secure before starting a family.

By delaying the menopause they could also avoid the increased risk of osteoporosis and heart disease that come with the end of their fertile life but may raise the risk of breast and womb cancer.

A conference heard how 28 babies have been born worldwide to patients who either had their own ovarian tissue removed before treatment that would have left them infertile and replaced afterwards or twins where one donated tissue to the other.

Most of the children have been conceived naturally without the need for IVF for drugs.

Dr Sherman Silber, an American surgeon, has been involved in transplants for 11 women at St Luke’s Hospital in St Louis, Missouri, US, said: “A woman born today has a 50 per cent chance of living to 100. That means they are going to be spending half of their lives post-menopause.”

“But you could have grafts removed as a young woman and then have the first replaced as you approach menopausal age. You could then put a slice back every decade.  Some women might want to go through the menopause, but others might not.”

That would mean women would not have to “watch their body clocks”, he said, and would only be physically limited by their ability to carry a baby and give birth.

Transplants carried out eight years ago are still working showing the technique is ‘robust’ and it should no longer be considered experiemental, he said.

One transplant from one 38-year-old to her identical twin, has lasted seven years so far without failing.  In that time the recipient has had two healthy baby boys and a baby girl, all without IVF, conceiving the last aged 45.

Originally it was thought the transplants would only last months, or a few years at most, giving the women just a brief chance of conceiving. But Dr Silber said early hopes had been surpassed.

In Belgium, a woman has given birth after her ovarian tissue was frozen for decade, and in Italy a woman has just had a healthy baby girl after her tissue was frozen for seven years.

He and European colleagues have presented their findings this week at the European Society for Human Reproduction and Embryology (ESHRE) in Istanbul.

They wrote: “All modern women are concerned about what is commonly referred to as their ‘biological clock’ as they worry about the chances of conceiving by the time they have established their career and/or their marriage and their financial stability.

“Most of our cured cancer patients, who have young ovarian tissue frozen, feel almost grateful they had cancer, because otherwise they would share this same fear all modern, liberated women have about their ‘biological clock’.”

The first operation, conducted on Oudara Touirat in Belgium in 2003, led to a pregnancy and successful birth a year later.

Strips of her ovarian tissue were removed before chemotherapy for Hodgkin’s lymphoma and were replaced after she was given the all clear.

The majority of women who have undergone the procedure have had cancer but doctors said it is now time to extend it to others.

Warning over shortage of midwives

The Government must address the “serious shortage” of midwives, the Royal College of Midwives said, as an independent report found that numbers of staff are one of the main challenges facing maternity services.Warning over shortage of midwivesLong term vacancy rates for midwives have steadily increased in recent years, the Care Quality Commission (CQC) report found.

Although births in England increased by over 21% between 2001 and 2010, the number of midwives only increased by around 15%, from 18,048 to 20,790.

Louise Silverton, deputy general secretary of the Royal College of Midwives, said: “This supports and highlights all we have been saying for many years about the shortage of midwives and the need for serious investment in maternity services.

“A failure to have adequate numbers of midwives leads to mistakes and lower quality care.

“We recognise investment in midwifery training but this will be wasted if the newly qualified midwives cannot find jobs. Once qualified, they need support from experienced midwives whist they consolidate the skills learned during their training. Many of these midwives are those whose jobs are currently under threat.

“This Government must take this issue much more seriously and give it more attention than they are doing. If they do not mothers, babies and their families are the ones who will suffer the consequences of this Government’s failure to ensure that maternity services have the resources to meet the demands facing them.”

The union has launched an online petition Recruit 5000 more NHS midwives in England calling for more midwives in the NHS in England.

The CQC report, which is based on findings from unannounced inspections of 14,000 health and social care providers in England, found that across the board one in 10 institutions were failing to meet staffing standards.

“The non-availability of temporary staff and organisations leaving vacancies open for a number of months – particularly for qualified staff – can lead to compromises in the quality of care given to people, and staff training and supervision,” the CQC said.


Home births more cost effective Oxford research concludes

Planned births at home and in midwifery units are more cost-effective than giving birth in hospital, particularly for women who have given birth before University of Oxford research concludes.Home births more cost effective Oxford research concludesThe research, in the British Medical Journal, compared the costs of giving birth in different places and the health outcomes for mother and baby.

More than 60,000 low-risk women in England were studied over two years.

The Royal College of Midwives says all women should receive one-to-one care.

For women having their first baby, however, planned home birth was more risky for the baby but still the most cost effective option.

The study used data from the Birthplace in England national study to calculate the cost, and health effects, of women at low-risk of complications giving birth.

It looked at planned births in obstetric units, midwifery units located in the same hospital as an obstetric unit, free-standing midwifery units not in a hospital and at home.

The study takes into account all NHS costs associated with the birth itself – such as midwifery care during labour and immediately after the birth, the cost of pain relief in hospital, and the cost of any stay in hospital or neonatal unit immediately after the birth, either by the mother or the baby.

The costs for planned home and midwifery unit births take account of any hospital care a woman may receive if she is transferred into hospital during labour or after the birth.

But the costs do not include any longer term costs, for example the life-long cost of caring for babies who suffer serious birth injuries.

The study found that the average cost per low-risk woman planning birth at the start of labour was £1,631 for an obstetric unit, compared with £1,067 at home.

When the researchers analysed women who had already given birth or who had no complicating conditions, the cost differences between planned places of birth narrowed.

The authors of the study conclude that giving women the opportunity to give birth at home or in a midwifery unit saves the NHS money and is safe for baby and mother, resulting in fewer expensive interventions.


  • £1,066 – births planned at home
  • £1,435 – births in freestanding midwifery units
  • £1,461 – births in midwifery units alongside hospitals
  • £1,631 – births in hospital obstetric unitsSource: BMJ study

The study found that individual care at home is cheaper than a planned hospital birth because hospital overheads tend to be higher and women who plan birth in an obstetric unit tend to have more interventions, such as caesarean section, which are expensive.

Morning after pill not effective on most fertile days

The ‘morning after pill’ which was being offered over the phone in a controversial new scheme over the Christmas period is “not effective” when a woman is most fertile, a consultant gynaecologist has warned.Morning after pill not effective on most fertile daysDr Kate Guthrie said Levonelle One Step, the form of emergency contraception being offered by the British Pregnancy Advice Service (bpas), was “not effective” for up to five days around ovulation.

Dr Guthrie, a member of the Faculty of Sexual and Reproductive Health, was concerned that women could take the pill during these days and wrongly think they would avoid pregnancy.

She said: “There’s very clear evidence showing that it’s not effective in the couple of days running up to ovulation, and probably not very effective in the 36 hours afterwards.”

The aim of the bpas scheme is to cut the number of women seeking abortions over the festive season.

The idea is that women will be able to pop the pill on the morning after accidentally having unprotected sex, rather than having to get an appointment, which can be difficult over the Christmas break.

Part of the rationale is, as bpas puts it, “the sooner the morning after pill is taken after unprotected sex, the more effective it is.”

Dr Guthrie, who works in East Yorkshire, agreed with that, saying that Levonelle should always be taken within 72 hours of sex.

However, she was concerned that women would not be sufficiently informed of Levonelle’s limitations.

While she welcomed immediate access to emergency contraception, she said: “You have to know how effective or ineffective it is.”

Guidance from the faculty, published this August, states that Levonelle “has been shown to be no better than placebo at suppressing ovulation when given immediately prior to ovulation, and is not thought to be effective once the process of fertilisation has occurred”.

Dr Guthrie said that, if a woman has had unprotected sex at this time of the menstrual cycle, she should see a doctor about obtaining another form of emergency contraception.

Caesareans operations to be offered due to midwife shortages

Caesareans are to be offered to all pregnant women who ask for them, new guidelines state, amid concerns that some are too scared to give birth naturally on Britain’s overstretched labour wards.Caesareans operations to be offered due to midwife shortagesA lack of support is leading to “traumatic” natural births, say experts, resulting in women fearing a repeat experience.

Studies show that up to 10 per cent of women in Britain suffer from a serious fear of natural childbirth, called tokophobia.

Now the National Institute for Curbing Expenditure (NICE) is recommending that women should always have the right to a caesarean, even if they have no physical or mental health need.

The guidelines, state: “For women requesting a CS [caesarean section], if after discussion and offer of support (including perinatal mental health support for women with anxiety about childbirth), a vaginal birth is still not an acceptable option, offer a planned CS.”

Malcolm Griffiths, a consultant obstetrician and gynaecologist at Luton and Dunstable Hospital, who chaired the guidelines development group, said most women were not interested in having a caesarean.

“It is a major operation, about as major as a hysterectomy,” he said.

Nonetheless, 25 per cent of births in Britain are now by caesarean. Between a third and a half of them are pre-planned.

Figures show that rates in Nordic countries are much lower, at about 15 per cent.

Many obstetricians want the UK rate to come down, but believe that is impossible without better midwifery services.

Mr Griffiths said: “I think probably key to the difference is support during labour, with one-to-one midwifery care and support in Nordic countries.”

Better midwifery care was “key to reducing the caesarean rate”, he added.

Nina Khazaezadeh, a consultant midwife at St Thomas’ Hospital in London and a member of the guidelines panel, said some women opted for caesareans because they feared childbirth after a “traumatic” first experience in an understaffed ward – a condition known as “secondary tokophobia”.

She said: “We might see a rise in secondary tokophobia where women have already had a birth that they have found very traumatic, and the perceived lack of support will have had an impact on their decisions for the next pregnancy.”

Cathy Warwick, chief executive of the Royal College of Midwives, said: “There is very clear evidence that one-to-one support in labour reduces caesarean rates”.

However, she welcomed the new Nice guidelines, saying it was “absolutely acceptable” that a woman who feared childbirth should be offered a caesarean.

Coincidentally, the RCM publishes a new report today claiming that England faces “massive midwife shortages” and needs another 5,000 of them.

Even though numbers have increased since 2001, they have “failed to keep pace with the rocketing number and increasing complexity of births”, it warns.

The number of births has risen by 22 per cent in a decade, with midwives having to deal with 120,000 more in 2010 than in 2001.

Mothers also tend to be older and heavier than in the past, which both raise the chance of complications.

Belinda Phipps, chief executive of NCT, said: “Most women want a straightforward birth, some need a caesarean. When women are treated with respect, and are offered support and information tailored to their concerns, very few of them will choose a caesarean birth unless there are clear health reasons.

“However, our services fail women badly at the moment, with midwifery numbers well below the level required to guarantee safe and satisfying care.”

She went on: “If caesarean rates go up following the change to the guidelines, it will be evidence that women are not getting the quality of midwifery support they need.”

The guidelines do recommend that a woman requesting a caesarean should be made to talk about her fear of childbirth before an operation is granted.


Overweight mothers give birth to fat babies new research finds

Childhood obesity appears to begin in a mother’s womb, a new study has concluded using state of the art technology to monitor fat levels in unborn babies.Overweight mothers give birth to fat babies new research findsResearchers found some babies have similar build up of fat around their abdomen that adults aged in their 50s have.

The study of babies at Chelsea and Westminster Hospital, west London, used magnetic resonance imaging (MRI) scans to investigate links between childhood obesity and their mothers.

It reportedly found evidence that being overweight or obese in pregnancy could result in potentially harmful changes to a baby’s fat levels while still in the womb.

The study, led by Prof Neena Modi, one of Britain’s best experts on high-risk health problems in newborns found nearly a third of children had more fat than expected.

Of the 105 babies – 54 boys and 51 girls – a total of 31 babies had more adpose, or fat, tissue around their abdomen than normal.

Experts said the study was the first direct link that proved the weight of a mother-to-be was passed on to her child and showed that overweight mothers gave birth to fat babies.

“I was very surprised to be able to detect such a clear continuum of effect of maternal BMI (body mass index) on the baby,” said Prof Modi, head of neonatal medicine at Imperial College London.

“This is a very important finding indeed, opening the door to a new understanding of how a mother’s metabolism affects her baby.”

Newborn babies usually have about 700g of adipose tissue, but for each unit increase in maternal BMI, this increased by approximately 7g with a huge build-up in fat in the babies’ livers.

Meanwhile in adults, adipose tissue is found mainly under the skin, but also in deposits between the muscles, around the intestines and around the heart.

Prof Modi, who is also a consultant neonatologist at Chelsea and Westminster Hospital, told the Daily Mail that all women should be aware of the effects of being obese and what this means for their child.

“This shows how sensitive the baby is to the environment experienced within the womb and how lifelong effects may be initiated before birth,” she said.

Body mass index is calculated by dividing a person’s weight in kilograms by the square of their height in metres.

The World Health Organisation classes a BMI between 18.5 and 25 as normal weight, between 25 and 30 as overweight and over 30 as obese.

In adults, high amounts of fat around the stomach and in the liver impair their control of blood sugar, leading to diabetes. Problems associated with obesity are set to cost the NHS up to £6.3 billion a year by 2015.


NHS hospitals crippled by labour’s PFI scheme

Patient care is under threat at more than 60 NHS hospitals which are “on the brink of financial collapse” because of costly private finance initiative schemes the Health Secretary warns.NHS hospitals crippled by labour's PFI schemeAndrew Lansley says he has been contacted by 22 health service trusts which claim their “clinical and financial stability” is being undermined by the costs of the contracts, which the Labour government used extensively to fund public sector projects.

The trusts in jeopardy include Barts and the London, Oxford Radcliffe, North Bristol, St Helens and Knowsley, and Portsmouth.

Between them the trusts run more than 60 hospitals which care for 12 million patients.

There is already evidence that waiting lists for non–urgent operations have begun to rise as hospitals delay treatment to save money. Adding to this are growing fears over the impact of the financial crisis on care this winter.

Under the PFI deals, a private contractor builds a hospital or school. It owns the building for up to 35 years, and during this period the public sector must pay interest and repay the cost of construction, as well as paying the contractor to maintain the building.

However, the total cost of the deals is often far more than the value of the assets. As a result, Mr Lansley says, the 22 trusts “cannot afford” to pay for their schemes, which in total are worth more than £5.4billion, because the required payments have risen sharply in the wake of the recession.

Mr Lansley said: “Over the last year, we’ve been working to expose the mess Labour left us with, and the truth is that some hospitals have been landed with PFI deals they simply cannot afford.

“Like the economy, Labour has brought some parts of the NHS to the brink of financial collapse. Tough solutions may be needed for these problems, but we’ll help the NHS overcome them. We will not make the sick pay for Labour’s debt crisis.”

He said hospitals would not be allowed to collapse financially.

“There are many hospitals that are well run, do not have a legacy of debt and do have projects which are perfectly sustainable. My point is that we have looked since the election and are working together with individual trusts to arrive at a place where they are financially, and in terms of the quality of their services, sustainable for the future. We can only do that if we work closely with them,” he said.

“This is about making very clear that we are not only working on unsustainable PFIs, but also working with legacy debt that the NHS has been left with, working on the IT programmes which were on an unsustainable scale of contractual commitments that didn’t meet the need of the NHS’s customers.

“Across the board, we have to tackle Labour’s legacy of poor value formoney and debt.”

Over the next few weeks, Department of Health officials and executives at the 22 trusts will develop detailed plans for dealing with the crisis. Their proposals are expected to include significant cost–cutting and the renegotiation of PFI contracts.

Money will also be moved from NHS trusts that are in better financial shape to cover the debt costs at those that are struggling. However, officials are braced for the need to use Whitehall funds to bail out some hospitals.

Among the trusts which have contacted Mr Lansley to inform him of their severe financial problems are several London institutions, including South London Healthcare, Barking, Havering and Redbridge, and North Middlesex.

Outside the capital, other trusts to have approached the health department include Wye Valley, Worcester Acute Hospitals, Mid Yorkshire, and Walsall.

After the general election last year, Mr Lansley ordered officials to establish why some NHS hospitals were under–performing. The health department is assessing the financial position of every hospital. It is understood that the PFI costs have emerged as a leading factor in poor patient care in some areas.

The Health Secretary decided to disclose the list of hospitals in difficulty and is expected to announce the rescue plans for each trust next month.

Taxpayers are having to pay more than £200 billion for schools, hospitals and other projects whose capital value is little more than £50 billion.

In one example, a hospital in Bromley, south east London, will ultimately cost the NHS £1.2 billion, more than 10 times what it is worth. Another hospital was charged £52,000 for maintenance that cost £750. The annual cost of the schemes is almost £400 for each household.

The public payments for PFI deals are typically linked to inflation and therefore the cost to taxpayers has increased by up to a third since the beginning of the credit crisis, according to the National Audit Office. Last month, MPs on the Treasury select committee effectively called for a moratorium on new PFI projects, which it said were “like a drug” as the costs were not apparent at the outset.

George Osborne, the Chancellor, has tightened the rules on the deals.

Earlier this year, John Healey, the shadow health secretary, admitted in an interview that Labour ministers had failed when negotiating the multi–million pound schemes for hospitals.

“There is definitely a case for saying we were poor at PFI, poor at negotiating PFI contracts at the outset,” he said.

Companies who run PFI schemes boast profit margins of up to 71 per cent on the projects, but have come under growing pressure from MPs and ministers to return some of their “windfall profits”.


Men biologically wired to care for children

In a blow to the nanny state’s view of fatherdom, new research has found that there is a biological reason why so many men suddenly discover their caring side when they become fathers.Men biologically wired to care for childrenA study found that men’s testosterone levels fell by around a third in the days and months after their partner gave birth.

The more caring side of a man’s character emerged as levels of the hormones fell, said scientists, who believe that the process is nature’s way of trying to ensure that fathers stay for the long  haul of child–rearing.

They found that men with higher testosterone levels – associated with dominant and aggressive behaviour – were both more likely to secure a partner and father children.

But after the birth itself  testosterone levels in these men dropped.

“Humans are unusual among mammals in that our offspring are dependent upon older individuals for feeding and protection for more than a decade,” said Christopher Kuzawa, a faculty fellow at the  Institute for Policy Research at Northwestern University in Chicago, and a coauthor of the study, published in the journal Proceedings of the National Academy of Sciences. “Raising human offspring  is such an effort that it is cooperative by necessity, and our study shows that human fathers are biologically wired to help with the job.”

Lee Gettler, an anthropology doctoral student who also worked on the study, added: “It’s not the case that men with lower testosterone are simply more likely to become fathers.  On the contrary, the men who started with high testosterone were more likely to become fathers, but once they did, their testosterone went down substantially.”

It was the act of child care that seemed to reduce testosterone, he explained.

“Our findings suggest that this is especially true for fathers who become the most involved with child care.”

The biggest effect appears to be temporary, in the period immediately after bringing home the baby, with levels rising slowly after that, although not returning to pre–fatherhood levels.

The team studied 624 men in their twenties in the Philippines and followed them for four–and–a–half years. Dr Allan Pacey, a male sexual health expert at Sheffield University, commented: “To see  dramatic changes in response to family life is intriguing. The observations could make some evolutionary sense if we accept the idea that men with lower testosterone levels are more likely to be monogamous with their partner and care for children.

“However, it would be important to check that link between testosterone levels and behaviour to be certain.”

The study found that testosterone levels fell on average by 34 per cent when men became fathers, with the biggest falls in those most involved in childcare.

Dr Pacey added that, as high levels of testosterone were also associated with a strong sex drive, lower levels could reduce the chances of a man ‘straying’. However, he cautioned that the paper did  not prove that.

He added: ‘Testosterone is the key hormone that defines male physiology. We know that levels correlate with a man’s sex drive, his risk–taking behaviour and social dominance. It has also been suggested that it may increase his attractiveness to women and help him find a mate.”