Monday, September 2, 2013

Call the midwife!

Caesareans are now the most commonly performed surgical procedure in the United States. Hardly a statistic to encourage prospective or pregnant mums, and the rate of a surgical delivery in Australia is only a fraction below that of the US, where it has now reached 1 in 3 births. Yet World Health Organisation recommendations say the C-sec rate should never be amore than 10 -15 percent in any area or for any reason, so clearly something is very wrong.

The fear with which many women approach the unknown “pain” of labour is driven by media stories and by obstetricians, many of whom have private patients insured for all eventualities. The rate of surgical delivery among privately insured women is notoriously higher than for those in the public system, which says a lot about the spurious reasons for surgery! Only when obstetricians and hospitals are somehow rewarded for keeping surgical deliveries to within WHO guidelines, might we see a change. I have a friend who is a long-time practising obstetrician and visiting specialist at three maternity hospitals in NSW Australia. The intervention rates at this doctor’s hospitals are well within the WHO-recommended range, yet when he presents to his professional colleagues on how they might emulate his approach, his words are dismissed. His peers make it plain that lowering their C-sec rates is not on their agenda and that such rates should not be viewed as a competition.

Damn shame! But if the doctors have vested interests in continuing high surgical rates, what hope is there for the women in their care? Time to “call the midwife” if you ask me! All you need to know about avoiding a surgical delivery ...

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