HORROR STATS. TOO POSH TO PUSH?
Are women who give birth in private hospitals more likely to be “too posh to push?”
A new Australian study released today revives this old chesnut and re-ignites ongoing tensions between midwives and obstetricians.
The landmark study of nearly 700,000 women in New South Wales – to be published today in the British Medical Journal’s open journal – shows that only 15 percent of women in private hospitals give birth with no intervention, while the figure in public hospitals is 35 per cent.
Leading midwife expert Dr Hannah Dahlen told the Sydney Morning Herald today that statistics showing that private patients were 20 percent less likely to have a normal vaginal delivery were “horrifying.”
Dr Dahlen, a professor of midwifery at the University of Western Sydney,
rejected the idea that women in private hospitals were more “risk averse” and asking for more intervention.
”A recent Queensland study surveyed women to see if those in private hospitals were more likely to request a caesarean section but found there were no difference,” she said.
”The findings … suggest a two-tier system exists in Australia without any obvious benefit for women and babies and a level of medical over-servicing which is difficult to defend,” she said.
Senior specialist and the president of the Royal Australian and New Zealand College of Obstetricians, Rupert Sherwood, told the SMH: ”We’ve always known the intervention rates are different between public and private hospitals,” Dr Sherwood said.
”We have no idea if the women in this study were choosing interventions like caesarean sections or not because the researcher did not ask women that.
”But we have good evidence that the women giving birth in private hospitals are more risk averse.”
It’s a worrying trend – but what’s behind it?
Are busy obstetricians scheduling caesareans to make their work flow easier? Are women in the private system more “risk averse”? And why would that be?
At The Hoopla, we don’t like competitive and judgemental birth stories. We understand a woman’s need to make her own choices, and that, in the arresting confusion of the delivery suite, all the best-laid birth plans can go right out the window.
But it’s important to keep an eye on worrying statistics about unnecessary intervention.
Is there a problem with obstetrics training? Is it a medico-legal issue?
Do doctors need to back off in the delivery suite and let women’s bodies do their thing but be ready and waiting to act only if things go wrong?
Over to you.
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45 Responses to this article
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sam September 10, 2012
Having had both a virginal birth and a caesar, I know which one I preferred. After the first I was up and feeling pretty good after about an hour. With the caesar i felt like hell for about 8 weeks after. Having said that I do feel that women should have the right to choose.
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Carz September 10, 2012
Having had both a virginal birth and a caesar, I know which one I preferred
@Sam, sorry but that has to be the funniest typo I’ve seen all day.
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FerrelBerryl September 10, 2012
I suspect it has very little to do with the patient. My girlfriend and I gave birth 3 weeks apart. Similar age, both well educated. She had an obstetrician, I went with midwifery care at my local birth centre. Her obstetrician wouldn’t ‘let’ her go post dates (despite 42 weeks gestation meeting the clinical definition of ‘normal’). I went to 40+14 with close monitoring. Her obstetrician used syntocinin as ‘standard’ to push labour along as soon as labour was established. My midwives assessed each woman and treated on a case by case basis. Her obstetrician manually breaks waters. Her obstetrician performs a c section as ‘standard’ at 12 hours. All through her labour I was telling her this guy was a quack and most obstetricians would be pretty horrified with his approach. She was firm that he was ‘the best’ based wholely and solely on his fee schedule. No prizes for guessing which one of us ended up with an ‘emergency’ c section, an infection in her uterus, 8 weeks recovery and treatment which interfered with the establishment of breastfeeding. I had a textbook, straightforward labour and birth. At no point was she ever given a reason as to why things might have gone wrong but I’d bet my hat that it had everything to do with the use of syntocinin.
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Janet Georgouras September 10, 2012
Perhaps there are two factor which would contribute to this discrepancy in intervention statistics. Firstly, the women in private care are more likely to be wealthier and therefore may have their children later for career purposes, whereas public hospitals might have the majority of younger women births. Secondly, a private doctor might have more incentive to be interventionist than a public doctor or midwife, possibly for potential negligence issues. In public hospitals, emergencies for public patients probably happen at the last minute for cost purposes.
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Kathy September 10, 2012
I’m currently pregnant and my baby is breach. Direction from OB is a Caesarean is required. This labels me as wanting Elective surgery. I’d prefer to push but don’t have a choice. I am going private. This survey may not have included this as an issue or non choice by the mothers…
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kirrilee September 10, 2012
There are studies that show that women with midwifery-led care are much more likely to have an uncomplicated vaginal birth, and especially if they have the same midwife for all prenatal care and birth. There are also studies that show that once a woman is induced, she is much more likely to be subject to the ‘cascade of intervention’ and much less likely to have an uncomplicated birth. There are also suggestions that in some cases when a baby becomes distressed and a c-section is needed, that it is the result of the interventions used in the first instance. I think the problem is the general medicalisation of birth and the viewpoint of an Ob. An Ob is trained to look for problems and perform a C-Section. How many Ob’s in training have even seen a completely uncomplicated, un-interfered with birth?
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kirrilee September 10, 2012
Having said all that, I absolutely believe in a woman’s right to choice, and thank God that medical options exist. I just find the general culture around birth not very supportive for the process of birth. I have a hard time believing that this many women were unable to birth vaginally. And Kathy, there are a few hospitals where vaginal breech birth is supported – the RHW in Sydney is one.
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The Huntress September 10, 2012
Having worked in a private maternity hospital and being disturbed by the high rate of medical intervention, I actually spoke to one of the obstetricians about it, curious to know why (I was a student nurse at the time).
Interestingly, this (female) obstetrician gave me a very carefully considered answer. She had worked as head of a continence clinic at a major womens hospital for over 12 years. In that time she saw countless women who had been through childbirth who were urinary (or often doubly) incontinent; a situation that could have been prevented given better medical monitoring of childbirth. This obstetrician chose to medically intervene sooner in many labours to save women the pain of incontinence later in life. A consideration most women don’t consider when pregnant.
I doubt very much that women who enter the private system are more risk averse – indeed if they were high risk they would be better off in the public system. But, all in all, a woman has a right to give birth (given that it’s safe) in a manner that she chooses and feels comfortable with. I personally chose to have a c-section (had to fight hard for it in a small rural town with no private system and in the middle of nowhere), but ended up having an emergency caesarean anyway. It was excellent, I felt satisfied with how it occured, mainly due to the fact I had control. Something very important for pregnant women, when considering their options.
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Kaz September 10, 2012
Without a doubt doctors are more intervention-oriented. Sometimes this intervention is life-saving, and we can be truly thankful for it, like I was when my niece was born very prematurely.
But more often than not its about doctors – and the women who listen to them – not trusting the normal process of birth in healthy, low-risk women. This is why some women choose homebirth (as I have, 3 times).
Its hard for me to afford homebirth, but I feel that’s what I have to do to maximise my chances of having a relaxed and normal birth where I am trusted to trust my body to ‘get on with it’, without fuss, intervention or drama. How easily do you think you could go to the toilet with a team of people hovering over you, monitoring progress with machines etc? In my experience birth can be as normal and simple as a private poo. Sorry if the (limited) analogy offends, but there we are.
I really wish more women had the chance to feel safe and trusted and supported, whether at home or in a hospital. Australia has a long way to go with attitudes towards birth. Hopefully we will head more in the direction of countries like NZ or the Netherlands than America. But I’m glad to see a little balance in the media for once. Appreciate your work, Dr Hannah Dahlsen.
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Matt September 10, 2012
When my wife was having our first baby, the mid-wife at the hospital told me that mid-wives are considered “The guardians of natural birth.” This shocked me somewhat.
As a father I want what is best for:
a) My wife
b) our baby
Having pre-conceived ideas either way regarding natural or intervention is dangerous thinking. My wife wanted a natural birth but after 14 hours the baby’s heart rate plummeted and at that point there was intervention all over the place. The result, a beautiful baby boy and an exhausted wife (with a few stitches).
My point is there are just as many horror stories regarding Obstetricians who intervene to readily as there are Mid-wives who refuse any intervention. My view, you gotta do what’s best for Mum and Bub and take it as it comes.-
The Huntress September 10, 2012
VERY sensible thinking, Matt!
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Carli September 10, 2012
It’s the fact the study focused on healthy and wealthy women who were not pre-term or overdue that concerned me. The study showed these interventions do not show any association with a decline in death rates either.
There was a terrible article in a Fairfax publication yesterday which was written by an Obstetrician and an Ethicist, entitled ‘No mother or unborn child deserves the risk of a home birth’. It angers me that this might have been a pre-emptive strike with knowledge this new journal-published study was about to be released. Six to seven babies die each day in Australia and the majority are in hospitals so I’m also a little tired of the home-birth horror stories (and that’s coming from someone who had private c-sections).
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Debbie September 10, 2012
I’d just like to know hat th stats actually say because “15 percent of women in private hospitals give birth with no intervention, while the figure in public hospitals is 35 per cent.” does not mean ” that private patients were 20 percent less likely to have a normal vaginal delivery”.
And there are so many issues about who ends up in which system (as Kathy notes) which I’m guessing the research controlled for in various ways so basically this article is based on Dr Dahlen getting a chance to have her say and inviting comments. Nothing wrong with that – but Hoopla – I think you usually deliver better.
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Brook McCarthy September 10, 2012
You didn’t ask whether women were having obstetrician-assisted births because they were higher risk. If a woman had a high-risk pregnancy, she’d be more likely to go private than if it were fuss-free. Therefore, the statistics would be skewed.
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Bec September 10, 2012
As a first time mum who had an emergency ceasar 6 months ago because my baby was breech this article really interests me. My OB was very supportive of vaginal births and was keen to help my baby turn so I could achieve one (through an ECV). However I went into labour at 36+4 (day before my ECV) and had a ceasar. My OB approached me in recovery and told me he would support me next time to try for a VBAC. However, friends (3 of them) who delivered in the same hospital with a different OB (all with the same OB though) were told to have a ceasar next time. With quotes such as “Why ruin two holes” and “keep the other for recreational use”. All 3 said they would have a ceasar again. Maybe this is where some of the problem lies…
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Vanessa September 10, 2012
I chose a private obstetrician because I wanted a caesar and the public system didn’t offer me that choice. Not all obstetricians would allow me an elective caesar, so I I’m not sure about this theory that obstetricians are pro-intervention for their own convenience.
My friend went to see the same obstetrician and said she wanted a natural birth unless there were extreme circumstances.
I wanted a say about the birth of my son. I wanted to make my own decisions about what I believed was best for my baby and best for me. Choosing a private obstetrician allowed me those choices.
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Sara September 10, 2012
This is a really interesting discussion – thanks Hoopla people! I have had two babies in the public health system, both unassisted vaginal births with no problems. I know I am fortunate. I too would love to have more questions asked, like those that have been suggested by other readers – like age of women, whether it truly was an elective caesarean or for projected medical concerns etc. I don’t necessarily agree that women should have a choice as to how they give birth. Caesarean should be an emergency operation, not something to protect the ‘recreational hole’. What on earth are we coming to?
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Gabrielle September 10, 2012
I think it is cultural. I believe many women think that going private provides “better” obstetric care than public in much the same way that some people believe that private education is “better” than public. I wouldn’t be surprised if couples choosing to birth in the private system end up sending their kids to private schools. I work in maternity care and in my experience most women will a) do what their family or friends or gp recommends without doing any research in to different models of care. And women under private care do whatever the doctor says because s/he ‘knows’ best. obstetricians in private practice can basically do & say whatever they like with little accountability (I have heard the most outrageous reasons given for interventions and not infrequently the woman’s ‘faulty’ body is to blame). So a big yes to transparency and accountability. And a big yes toTRUE informed consent, evidence based practice and informed choices for women.
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Trish September 10, 2012
C-sections are more expensive given they involve a fully equipped surgery and surgical team rather than midwives in a birthing suite so public hospitals are obviously more reluctant to go for a c-section unless it’s absolutely essential.
I know it’s an unpopular view but I suspect this is the real difference in that a lack of money hinders the options available in public hospitals. In private hospitals if there is a risk that a woman might experience undue tearing or other such fallout that affects the mother only (ie: not the baby) and is not a matter of life and death then they tend to be more open to the idea of intervention.
I’d be curious to hear of the longterm benefits or otherwise of this approach. For all the concern surrounding higher rates of c-section in private hospitals, perhaps it’s because a lack of financial constraint actually affords women more choice and their comfort and physical recovery can be factored in more so than in the public system. Not necessarily a bad thing, dare I suggest!
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annie September 10, 2012
Trish, money has nothing to do with it. In the public system each mother and child is classified under the same criteria regardless. Just because you are 16 or 40 doesnt make any difference. The difference is size and shape of pelvis size in comparison to baby.you score better for lifestyle non smoker not diabetic not obese no other health conditions family support distance form regional hospital if your in the bush etc .
The public system has doctors and midwives all around the clock in the hospital, they discuss each one and think and plan very carefully on the most part. The reason why intervention is high in the public sector is that they are less likely to have a team approach or backup, so to plan to have everyone they need around they plan a LUSCS. In the public sector the doctors dont have rooms full of women who expect the doctor to be there on time, or plan holidays around their needs. The public sector doesnt care about money but the whole team cares about outcomes. And when you consider that high risk women will be in the public wards what a fine job the team does do to keep interventions to a minimum. We have a long way to go and I hoppeople are watching call the midwife!-
Trish September 11, 2012
Annie, if you read Rebecca’s comment just a few comments below you will see evidence of what I’m talking about. Her experience about being forced to deliver a posterior birth without intervention is a perfect example. In the public system there’s a prevailing view that natural delivery in that situation is quite acceptable, whereas private hospitals are more willing to intervene in that sort of scenario – and in the long run the mother is the winner
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jane September 10, 2012
Wendy Harmer
Thank God for this wonderful blog!!
The thinking womans Mumma Mia!!
Smirk
Thanks Wendy
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Jennifer September 10, 2012
as someone who used public hospitals for my children’s births,once under midwifery care and once in the country with a private obstetrician, I have to say that I felt safer in a public hospital, knowing there would always be anaesthetists available if something went wrong. In a private hospital, anaesthetists are on call, and there could be a delay in surgery for emergencies, and to reduce the risk of delays, it feels like private patients in private hospitals are offered Caesareans (or encouraged/pushed for intervention) to allow for timely arrival of an anaesthetist, whether out not it is ALREADY medically indicated.
As a midwife, I have read widely, have viewed birthing and Caesareans in both settings, and while the food may be fancier in a private hospital, in Victoria at least, staff numbers (midwives and special care nursery staff) are higher, and support is more available I’m the public setting.
The Cochrane Collaboration review of birthing suggests that for best care, around 15% of births as Caesareans is enough. Morethan that is considered excessive. They are life saving, but major operations. Most people avoid surgery unless it is necessary, and the same should be possible in birthing. or rates in Australia are around double this recommended amount, with some privacy hospitals having rates above 45%, with no greater level of safe outcomes, and what may be a higher rate of subsequent Caesareans.
This shouldn’t be about putting obstetricians against midwives, or women against their care providers. This debate should be about ensuring best outcomes for mother and baby in a way which supports their own beliefs or choices, but which ensures they are informed. Some highly skilled obstetricians agree that something needs to be addressed to ensure best practice its followed rather than “risk averse practice due to INSURERS perception that the risk of Caesarian is more easily quantified”. -
Rebecca September 10, 2012
I hear what you are saying, but my first experience of labour nearly killed me- midwives kept telling me everything was normal, I was left for 36 hours with a posterior baby- in a horrific amount of pain, it nearly killed me and the baby- when the midwives finally decided they might call of a doctor to look at me- the baby was ripped out with forceps, lost a part of his earlobe, tore my pelvic floor muscles right off and then I had a child with terrible reflux for a year. I think that perhaps the difference is that women are more likely to be left without a doctor looking at them as closely in a public hospital, so the midwives tend to deliver the baby- but when you go to a private hospital- your OB has a more vested interest in your health. I know a few women who have lost perfectly healthy babies at our local public hospital, I nearly was one of them. I think its more about the lack of doctors in the public hospitals than anything.
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Alice Shaw September 10, 2012
Having lost my first baby 20 weeks into the pregnancy, I read everything I could about the safest way to give birth when I got pregnant again (which thankfully happened twice more). I was under the care of an obstetrician due to being labelled “high risk” and found on both occasions I was well looked after and supported. I gave birth vaginally both times but was not prepared to continue labour for more than 12 hours. I just couldn’t risk losing another baby. That’s just my story and I am very lucky to have had two healthy babies. I would be concerned about being encouraged to have a caesarian for no reason but I also think women need to be supported in their choices and given as much information as possible so as to be able to make an informed decision when the time comes.
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sue bell September 10, 2012
There are many reasons for having a non vaginal birth. My first labour in a well know public hospital was 60 hours, followed by anaphalactic shock when wrong medication was given, followed by being left on a trolley outside theatre for 12 hours because they forgot me. Second child, the pregnancy was terribly managed, my blood pressure was never controlled. I presented at hospital in terrible pain, I had been begging my doctor for an appointment but it was deemed not to be needed, and was told, very rudely by the staff (public) that I had Braxton Hicks contraction. Then they took my blood pressure. I spent a week in a medically induced coma, had a daughter at 31 weeks but hospital had no premi care. Baby died after a few days as they punctured her lungs on intubation. Next baby was x-rayed at term, her head was far too big for my pelvis, it would have been another 60 hour type labour, I chose a caesar. final baby caesar was the only option.
Too proud to push? I pushed longer with my first birth than most people do for all their births. Thank science for caesars, and do not judge others as you have no real knowledge of why these decisions are made. -
Rhoda September 10, 2012
I had 3 breech births by vaginal delivery. Actually asked they be delivered normally unless there was a risk to my babies because obstetricians seem to go automatically into caesarian mode if the baby is in the breech position. My take was that a knife cutting into my stomach should be avoided if at all possible. It is a major operation.
I went with my instinct and thankfully all went well with my deliveries.
A caesarian section is a major operation. Make no mistake.
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Glenis September 10, 2012
For the birth of my child I had a private doctor, private hospital, assisted delivery and I was very happy.I was tired of pushing after 10 hours and was glad for the intervention. Not every one’s cup of tea but it suited me.
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Carolyn September 10, 2012
This old chestnut? Are we allowing for the fact that women with more complicated pregnancies might choose to go private for the extra care and attention that comes with it, driving up those figures?
I have had babies in both the private and public system and am going back to private for my third in a couple of weeks. I like having the extra care, and not once has a caesarian been suggested to me for my (so far) trouble-free pregnancies.
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Ro. Watson September 10, 2012
So much push and pull in so many womens’ activities~ I was present at only one vaginal birth and I fully got her effoert~ and those about her. Another girl child was born~ some years ago now!!
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Ro. Watson September 10, 2012
@ carolyn~ may your delivery be as easy as is possible~ It is still surprising to me how women can deliver something the size of a coconut from such a,well, small place. Best of wishes to you and yours.
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Megan September 10, 2012
The reporting of this study is very light-weight as far as which risks were allowed for in the study design. The only thing I can find is a reference to the age range of the women (20 to 34, so no older mums), neither early or overdue, and babies in healthy weight range.
I ended up in the private system simply because my ‘local’ hospital was inconvenient for me to get to, and I preferred to go to the hospital right next to where I worked, so I didn’t have to take much time off work for appointments etc. Because I didn’t live within the catchment area of this hospital it wouldn’t accept me as a public patient, so I had to go private.
I wanted a natural birth as possible. Little did I know that by choosing private care, I pretty much lost that option right at the start. As an older mum (39), my OB wouldn’t let me go beyond 40 weeks, so I was induced and ended up with a c-section (classified as ‘emergency caesarean’ as I was already in labour when the c-section was ordered). Apart from my age, there were no other risk factors. I had a healthy baby, so I do try to be philosophical about it, but there’s no doubt that I regret the cycle of ‘escalating interventions’ that I was caught up in.
So to any pregnant friend who ask me for advice, I caution them to be aware of the high intervention rates of private OBs and to take that into consideration in their decision.
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Ro. Watson September 10, 2012
Too much medical intervention is not.new….. Whilst ultimately I think choice is illusory for any individual because of what life pops up or out~ really grrlls,get a grip
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TMH September 10, 2012
Bec, I had 2 great VBACs–good luck next time around with a supportive OB. I had no troulbe recovering from my Caesarian but I wasn’t eager to repeat the process!
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ginnej September 10, 2012
Great discussion gals! and we should be discussing this stuff beyond the academic wrangling that happens around birthing. I first started reading and researching (in a non- academic way … as a consumer) in 1989 pregnant with my first child. Things have not changed much tho
The messages i gleaned from the literature then were;
intervention tends to cascade, more intervention happens in hospitals compared to home birth, private hospital care is more interventionist than public care, doctor led care is more interventionist than midwife led care … the stats have just got more alarming in recent years.
It was easy to access home birth in 1989 but elective caesareans were less accessible (and perhaps acceptable) … now home birth is less acceptable and accessible while elective caesareans are close to the norm.
Women should have the right to choose either option, the education to make the choice informed and empowering and a woman centered maternity system that supports her choices.
Personally I’m a homebirther (*2) and wish all women could experience the sheer exhilaration and sense of strength and empowerment that i felt from being able to give birth naturally, in my own time, in my home, in my own style, all with gentle guidance and trusted, professional support from midwives.
While part of my experience was luck that it all went according to plan, some of outcomes were no doubt influenced by good (midwifery) management too. As the literature suggests, if a woman wants (or needs) intervention then hospital is the place to be and private care scales up the level accordingly. -
Ali September 11, 2012
I consider birth plans to be the real villains. A birth plan is redundant as you are indirectly choosing a birth plan when you choose your caregiver. Surely no one expects when they choose an obstetrician in a private hospital that the obstetrician will then ignore all the various tools at their disposal? Similarly, choosing a midwife at a family birth centre say, will favour another focus. There us nothing wrong with any of these choices, but people must understand what they are signing themselves up for. The only things a birth plan is useful for is who will look after the dog and whether the car is filled up with petrol.
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catecat September 11, 2012
There seems to be a big misconception in the media and popular culture that CS is always ‘safer’. This seems to ignore the fact that it is major abdominal surgery which carries potential complications (for both mother and baby) and a much longer recovery period. When genuinely needed, it is a lifesaving intervention but it is certainly not ‘risk free’.
Having worked as a midwife in the past, I would like to add that private patients with complex, high-risk pregnancies are usually transferred for care in tertiary referral PUBLIC hospitals as most private hospitals are not able to provide care for very sick mothers or extremely premature babies.
I loved the cracker The Huntress posted about the doctor’s comments on vaginal birth and incontinence. Except in extreme cases, rubbish! There are quite a few studies out there which show that hormonal factors and pelvic floor exercises are also relevant. Women who have had only CS births, or no babies at all for that matter, can also have continence problems later in life. My own babies (delivered vaginally, public hospitals) were all whoppers (no,Mrs Woog, my bum hasn’t fallen off yet) but I am certainly keeping up the Kegels just in case:)
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The Huntress September 11, 2012
LOL Glad to hear your bum is still intact…
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shelley September 11, 2012
Agreeing whole-heartedly with @catecat. Women have choices, they have fought hard to get them, but it is proven if you offer lots of choices it makes it difficult for a decision to be made. Generally, a womans body is made for childbirth, even a breech presentation. Thing can and do go awry – I managed to get my breech baby to turn around, but it happened at about 34 weeks and her head was a forehead presentation so no go for vaginal birth. @Matt has a good point but at the same time, if you trust your mechanic to fix your car then trust your midwife to birth your baby with both mother and baby in mind. And if some women want to protect their recreation hole well good luck with that too but it sounds pretty shallow. It is a complex arguement but for more pro-active information check out Rhea Dempsey at Birthing Wisdom dot com.
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Things aint always what they seem September 11, 2012
I just understand why women judge other women’s choices so often and so critically without knowledge of the “why?”. If you have a vaginal birth great but sometimes a CS is the only option. I laboured for 23 hours before being taken in for a CS – at that point my heart stopped on the table and I had to be revived. Turned out that my baby only had an 8inch cord and would NEVER have been born without intervention. I was in a private hospital with wonderful staff – if anyone thinks that makes me too posh to push, be my guest. Would I go CS again next time so that never happens again – in a shot! Most sensible advice on this chat here came from a man – go Matt! Its about whats is best for mother and baby.
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Things aint always what they seem September 11, 2012
Whoops thats “dont” understand why!
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Benison O'Reilly September 11, 2012
Hmm, as a professional medical writer, I smell an agenda in this study: the old midwives versus obstetrician turf war. According to the study an epidural is ‘an intervention’ – seems a nice way to bump up the numbers to me. No woman should feel guilty about seeking pain relief.
If you have a healthy kid who cares how he or she comes into the world. Parenting is about the years afterward – I have an 18 year old and I’m still learning!
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Jaki N September 11, 2012
My 1st born was 10 weeks prem & an emergency CS & due to fibroid surgery my 2nd was an elective CS. All that mattered to me was delivering a healthy child & I have never felt cheated of a “natural birth”. Incidentally, I breastfeed both daughters for 15 months and I gave birth at 37 & 41. However it happens if the result is a healthy child stitches & pain relief etc are all soon forgotten.
Benison is right – my girls are 20 & 16 – CS’s were the easy part
of parenting!! -
Margi Macdonald September 12, 2012
A scientist adds his voice to the general discussion
http://betternature.wordpress.com/2012/09/12/balanced-birthing-options/ -
Helen K February 20, 2013
Another article today to get me angry – what is it with todays topics??? (and maybe this is a reflection on me – but why do I feel I need to defend my actions because I didn’t have the ‘ultimate’ birth experience ie. vaginal??)
Reiterate what Matt says – the test needs to be what is BEST for the wife and the child – but I would quality ‘best’ as relating to the HEALTH – including mental health – and RISK to both (but not the CONVENIENCE, except in exceptional circumstances). I think (but this is my opinion) that surgery should always be avoided if possible – I hear too many stories from my nurse husband – who works in a public hospital and has shared many stories about surgery complications – as well as other friends in the health / medical professions to not be aware of the potential dangers.
My story – both my children were delivered in private hospitals, and both were caesars. The first was elective – my son was breech. I know that he could have been delivered vaginally and my obsterician would have done this if I insisted (as we discussed it) and if it was a smooth birth, it would have been best for my recovery. However we were told, and undertook our own research, on the increased risk of brain damage that could happen with delivering a breech baby. While the risk is still small, it is still more of a risk than an elective caesar, and it would impact on our son for his whole life if he was one of the ones who was unlucky that way – due to a CHOICE we didn’t have to make. We took many actions to try to help him turn, and had ultersounds each check up to confirm (in case the ob had missed this and it could have been a natural birth) but no luck – and I had a very calm, smooth, delivery – and a quick recovery. Back on my feet the next day (excruciating pain for two days, but then generally ok and back doing my regular walks, etc within a week).
Baby two – aiming for VBAC and all looking good until my waters broke, no labour, muconium in the water, an examination showing that my little girl had the umbilical cord twisted tightly around her neck and was struggling to breathe. Again, not prepared to risk her health – an ‘emergency caesar’ was performed (although still a very smooth and unpanicked process as no labour had commenced) – I was up and about, walking around the block etc, within two days (quicker than the last one). I recognise that I was fortunate, had great assistance (and emergency facilities for both me and the babe if anything went wrong), however these caesars were certainly not because I was ‘too posh to push’ (hate this expression!)
And also, can we start supporting one another, rather than battling against each other (and I accept that is the purpose of your article, Wendy, in continuing to examine what is the best for health of child and mother but this topic so often descends into a defensive ‘I’m right – you’re wrong’ approach, whereas most of us are just trying to do our best. I would have loved to have experienced a natural birth – but it didn’t (and won’t) happen (we’re now complete with two!)
Most importantly – I have two beautiful, primary aged children, I am healthy and together with my husband (and broader family – thank god for grandparents and aunties!) able to care for them and watch them grow up to be wonderful, caring people – that’s surely the aim!
