This article appeared in the Australian yesterday. Seems to me that slowly people are getting picture that the fear generated in society (by the medical establishment) is really what is affecting childbirth at the moment.
The down side of these articles is that they never really offer a solution. We all know what it is. Good education of our young people surrounding fertility and birth, good antenatal access to care providers appropriate to the woman’s needs, no scare providers with non-woman centred agendas.
Acknowledgement that birth is a normal life event and midwives are specialists in assisting normal birth. Doctors have a vital part in dealing with complications of pregnancy in birth but have no place in a healthy pregnant woman’s life.
Overblown fears about childbirth are a driver of Australia’s rising rate of caesarean sections, says a midwifery expert who denies it’s a case of women being “too posh to push”.
Dr Jennifer Fenwick says the good health of the nation’s women offered no explanation for the rising number of caesareans now performed – which has risen from a single digit rate in the 1980s to now account for more than 30 per cent of all births.
The rate was “absolutely too high”, she says, adding that women’s fears and a culture of negative talk around vaginal birth – both in the medical profession and broader community – should be addressed.
“The messages are that birth is dangerous; you’re better to have a caesarean section,” says Dr Fenwick, who is Associate Professor of Midwifery at the University of Technology Sydney.
“What we haven’t done is say (to women) ‘let’s talk about your fear .. Let’s try and help you understand that birth is a really normal, healthy life event and your body is very good at having babies’.”
Dr Fenwick headed a study which took in 210 women, in Queensland and WA, who had undergone a caesarean. The research focused on 14 of the women who had the procedure for their first birth, when there was otherwise no medical reason for it.
“When we listened to, and looked at, what they were saying there was a real sense of fear and terror around giving birth vaginally,” Dr Fenwick said.
“Some of the words the women talked about – their perineum ‘blowing apart’ … the terror at their vagina’s ‘exploding’.
“We have almost lost the culture of talking about birth in a good, positive way.”
Dr Fenwick said another cause for rising number of caesareans was that women who had the procedure once were increasingly likely to do the same for their next child.
The research found that women who underwent caesareans felt the health care professionals they had contact with endorsed their decision as the “safe” and “responsible” choice.
Yet, Dr Fenwick said caesareans carried much greater risk for both mother and baby than a vaginal birth, while evidence also pointed to a greater chance caesarean-born children will go on to develop diabetes or asthma.
Women who underwent caesareans also had the same rate of pelvic floor dysfunction in later life as those who had vaginal births, she said.
In terms of cost to the hospital system, Dr Fenwick said each vaginal birth without complications cost less than $3,000 but a caesarean section started at $8,600.
“There’s no doubt that some women absolutely should have a caesarean section … but the rates that we are seeing do not add up in a country like ours, where we have a healthy population of women,” Dr Fenwick said.
“The (notion of) too posh to push, no I don’t agree with it, but there is certainly some terror and fear around a baby coming vaginally.”
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