Should c/s rates be published? Naming & shaming...

[Oliviasmum07]

Yes! I strongly agree that these statistics should be made public! It is astonishing to hear about these unnecessary c-sections taking place in our hospitals. More awareness on the issue is needed! Child birth is a natural process & should be followed through in the natural way (vaginal birth!) unless you have a medical problem that could cause you or your bubba any trauma. When i fell pregnant i was amazed at the amount of people telling me i "should" have a c-section LESS PAIN! was there response. Pain is part of child birth!! I don't look back now & think about wow! how much pain was i in.. i look at the end result my beautiful healthy girl who entered this world in a natural way.

[krisp]

I fail to see how this is constructive. The whole "naming and shaming" thing bothers me. Having had one emergency CS and a VBAC, I'm left to ask who should be ashamed about my first birth- the hospital for helping to safely deliver my baby after a long and very difficult labour or me for not birthing as nature intended?
I don't really like the "shame" tag at all. Yes by all means publish CS rates, but leave out the shame bit please.

[no3onboard]

In this instance it's not a matter of one type of birth versus another type of birth. I agree the choice is a woman's - if she wants an elective CS she is absolutely currently entitled to find a doctor who will perform that service - but there are also other women who very much hope for a vaginal birth and to avoid a c-section. There ought not to be secrecy surrounding what amounts to the chances of having a c-section in a particular facility.

Even in hospitals with a "high" rate of c-section there are many, many women who will give birth vaginally. So what do hospitals have to lose by consumers having access to their individual birth-type statistics? I don't see a need to keep this information under wraps. With most medical procedures caregivers provide information on the risks and benefits of various procedures, so why should the risks of c-section, and indeed vaginal birth, be any differently undisclosed?

[Lianne]

I guess the stats need to be considered in context eg. elective vs emergency but ... I really can't understand why you'd want to have an OPERATION ... I'd much rather just have a BABY!!

I'm FOR any attempt at better educating prospective mothers and encouraging them to have faith in what their bodies are designed for.

Unfortunately the name 'elective' doesn't give a good picture either. I had an elective csection with my daughters but I didn't have a choice, it just wasn't concidered an emergency situation. My 2nd daughter was lying across my stomach so there was no way she was going to come out and after many attempts and different things and many weeks, at 41 weeks I had a csection.

Lianne

[BellyBelly]

The whole women's choice thing is not really relevant in the big scheme of things, so we have to wonder why the stats are so huge.

Is there any truth to the assertion that many women are choosing a primary cesarean with the understanding that there is no medical reason?

The first national data from women themselves clarify that demand from women for a planned initial (or "primary") cesarean with no medical reason is infinitesimal. Despite some professional and mass media discourse about "maternal request" or "patient demand" cesarean when there is no medical indication, just one woman (0.08%) among 1314 survey participants who might have initiated a planned primary cesarean without medical reason did so. Just that one woman (0.4%) out of 252 survey participants who actually had a primary cesarean initiated a planned cesarean without medical reason. Two other women with a primary cesarean said that it was scheduled ahead of time without medical reason and initiated by a health professional.

All others (98% of women with primary cesareans) believed that there was a medical reason for their cesarean. The most common reasons cited were concerns about fetal distress, position of baby, size of baby, and prolonged labor.

Full article here: Mothers Report Cesarean Views and Experiences: New National Listening to Mothers Survey Results | Alerts :: Childbirth Connection

[mako]

I really don't see the point in "shaming" the hospitals with high rates of c/s birth rates as there is so many different circumstances which impact the reason for women having c/s births.
I for 1 had my baby delivered by c/s last year and by no means did i really have a chioce even though it states on all my records that it was "elective". I had a scan on the Monday night and sent to the delivery suite to be monitored as my fluid levels had decreased significantly and my placenta had stopped functioning.I was sent home to pack my things and told to come back the very next day to have my baby.

As far as I'm concerned my c/s saved my babys' life as along with the above medical issues he also had the umbilical cord wrapped tight around his neck and was knotted. I was told the next day that he would not have survived a single contraction or much longer in the womb the way things were. He was born 3.5 weeks early and in reasonable health.
He is now a very healthy 1 year old thanks to my OB and her decision.

I don't want to scare people but just wanted to share my situation... I certainly would not hesitate having another c/s in the future.

[julie_ann_jules]

I voted YES. The results are now
Yes 39% (512 votes)
No 45% (584 votes)
Only in extreme cases 14% (190 votes)

I have had two traumatic c-sections and I'm now planning a VBAC! I had no idea that the hospital I went to had such a high number of c-sections. If I did I would have found another hospital. I believe it is our right to know.

[Freya]

I didnt vote because I dont think the whole "name and shame" thing is black and white. Too much grey for me. Will take alot of tinkering to get it acceptable to everyone I guess. I do agree that a) every hospital should be forthwrite with their statistics, and b) it has more to do with interventions and women's misinformation.

I would think its rare that there are cases of vaginal being more life threatening than csection. I fully intend to vaginal birth any baby I have thats breech for example because I dont think the risk is that great that I would need to undergo major abdominal surgery, that comes with its own risks, without trying a vag birth first. I would be considered putting my childs life at risk if you go off the scare mongoring of a high majority of OBs and hospitals.

[ranger 2]

I really disagree with Sandra Kanck when she opens her mouth it is usually only to change feet . I get really angry with what she comes out with because more often than not she has no idea what she is talking about.There is no need to "shame" hospitals with high rates of c/s as there are many different circumstances to why women have a c/s .
I had to have a c/s with Johanna if I didn't she probably wouldn't be here.

Jodi

[maz]

hmmm

My local paper did this big OBESE MUM RISK article on the front page today.

They were VERY quick to point out that more then 60% of pregnant women in my area are obese.

Yet - I bet they wouldnt give the c/s rate so freely or own up to doing so many of them (which I know they do)

My vote...yes...if I would have better education, their statistic for c/s and their methods from the start from there I may not have had to go down the dreaded c/s path.

ETA - the stastic's should out line emergency c/s and Doctor elective IFYKWIM

[Tanya]

I really disagree with Sandra Kanck when she opens her mouth it is usually only to change feet . I get really angry with what she comes out with because more often than not she has no idea what she is talking about.There is no need to "shame" hospitals with high rates of c/s as there are many different circumstances to why women have a c/s .
I had to have a c/s with Johanna if I didn't she probably wouldn't be here.

Jodi

But why did your labour end in c/s? Was there intervention that some women would prefer not to have? That's the thing women need to be able to make these decisions and they should be informed of what is the norm at their chosen hospital/obs.

[JellyBean]

Yes- absolutely.

It is our right as Australian citizens to know what goes on in the hospitals in our country so that we can make informed choices about birth. It doesn't mean that the hospitals need to be 'shamed' as such- but the statistics should be available to the public. Why should people fear knowing the truth? I also think there should be a law to protect doctors from being sued, as i think this is the main reason doctors go into a pre-emptive-panic and recommend c/sections just because there is a 'chance' or a 'risk' of something going wrong. There are less risks involved in a natural birth, but doctors do not have full control of a natural birth so it seems to make them nervous?? I think they need the freedom to relax a bit more and let nature take its course. In the instance where something DOES go wrong, then appropriate action can be taken. But doing invasive surgery 'just incase' defies common sense in my opinion. Especially when it is common knowledge that c/section increases risk in future pregnancies- where is the logic in that? Ok- I am ranting here. Rest assured it is the medical system I have issues with- not women who have had c-sections!!

[bec_cromo]

I'm not against c/sections if they are needed....but some women choose to have them because they want to choose what day they want their babies born on, others have to have them because of medical reasons....there are many different reasons why women have them....

a lady i work with, her daughter is having a c/section in december because of health problems...

as i'll be having my first baby in february, im going natural birth....but if need be, anything happens i'm reassured that the option to have a c/section is there...if they need to get her out quickly and they have to do a c/section i'm all for it....i want my baby and me to be safe....

depending on the situation, theres no real right or wrong answer to this topic....its good that we can all express our points of view and opinions

[Tashie D]

It's good to know hospitals stats on all sorts of medical procedures and issues etc, but I don't think the word "shame" should be in this sentence.

I found that a bit offensive when I first read it, as I have had both a natural birth and a c/s due to medical reasons, and will need another c/s this pregnancy too, not to any fault or choice of me or the hospital that I'm going to.

So, yes, stats are good but negativity isn't.

[HOPRAH]

ABSOLUTELY! Get that knife away from me thanks!!!!

[*Belle*]

I vote no - I had emergency c/s for my first child as she got stuck in my pelvis and baby heartrate distress, I held off for 36 hours before having emergency c/s and tried everything my OB was very supportive. I pay for the Ob and chose the hospital I wanted, The birth of my 2nd child was elective c/s, as I could not go through the trauma again due to having PND and risk the health of my baby. Im sure there are mothers out there like me and chose the hospital and OB due to medical reason and think its unnecessary to "shame" anyone under the circumstances I had my c/s. If I was a mother who hadnt given birth before and chose a hospital which had midwife program and an OB allocated at the time of the birth (eg, a public hospital like RNS) I would want to know the statistics.

i find it interesting and weird that a few posts on here advise that c/s is a major surgery - for those who undergo the surgery we have done our research thanks and know this or most people would have, if they choose to educate themselves before birth to prepare themselves for all options in the birth. Some of us needed the emergency c/s for safety of the baby and are grateful for a wonderful OB and hospital support and do not think its needed to shame them.

I find the above comment bit harsh actually - Just curious HOPRAH - what if your 2nd birth doesnt go well and they say they recommend a emergency c/s? would you choose to have the emergency c/s? you have to sign a consent form when you have a c/s regardless of emergency or not.

[fionas]

I apologise in advance if I'm repeating points made by other posters - sorry, I just don't have time to read them all right now.

But I think the "name and shame" term is divisive - it inadvertently implies that women should feel ashamed if they have a caesarean and that is not helpful.

Hospitals' caesarean rates are already reported and people can do a Google search and it's not that hard to find them because hospitals have to report those rates to the Government.

I think the question should be "should caeserean rates be easily available and transparent so that women can make an informed choice." The answer to that question is of course yes.

But despite the fact that these figures are already available via the web, I don't know what a hospital's response would be if I simply rang them and asked. Maybe they would tell me, maybe they wouldn't. They should HAVE to give me the figures if I ask.

Similarly for private obstetricians, I am sure it would depend on which one you rang as to whether they would reveal their stats. It should not be up to their discretion, they should have to disclose those figures when asked.

I hate to use the jargon word "transparent" but that's what this is about.

[Angel77]

I am due with my first and want to have a vaginal birth, but if my obgyn recommended it I wouldn't hesitate to have a c-section. Why should women feel "ashamed" of having a c-section? Its just another thing to add to the pile to feel guilty about, much like stopping breast feeding if its not right.

No one should tell anyone else how to have a baby nor should they place guilt an assumptions on such.