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

Cate, you don't HAVE to go to hospital - you can stay at home. You can rock up at a hospital locally and say you're about to push, no time to get to the aforementioned hospital.

Just because you have an appointment doesn't mean you can't cancel it!

Taking my own advice for the next time LOL.

edit:
"He couldn't perform a c/s on me without my consent." - my Obs could have; DH would have agreed if I didn't.

I'm backing out of this discussion: feeling like a COMPLETE waste of space again because I WAS bloody firm, I was bloody fighting... but why did I even have to? Why did I fail so badly that I couldn't even fight properly?

I don't think women SHOULD have to fight, RH, not just with their obs but with their husbands as well. My DH was crazy scared, but would not have tried to budge me, and for that I was grateful. I also think having my obs be someone who was with me from conception (he was my fertility specialist) to birth meant he knew when I got that 'look' on my face, that I wasn't going to be moved.

But you're right, why should you have had to fight? Why should any woman have to fight to be heard, when it's about their bodies and their babies?

I think you copped a really bad set of circumstances, RH and I didn't ever mean to insinuate that you didn't fight hard enough. I'm just saying it can be done, I myself have done it. But obviously with the right set of circumstances. I know you tried your level best RH, but while your experience makes you feel like a woman will never have power over her situation, I'm saying that that's not always true. It's not always true that you will have to accept anything they decide to do to you. That's why I talked about my experience. Because I think by saying a woman will NEVER have control, women will stop fighting for what they want. And that would be a tragedy.

ETA can your DH agree on your behalf for a c/s? I didn't think he could unless you were unable to consent yourself (eg in a coma). If that's true, it's bloody outrageoous!!

:

---

I voted no because I think that every woman should have the freedom to birth the way she wants to.

Also, the way that elective c/s's are recorded and what constitutes an elective, is very wide.

I had two failed VB attempts and for the 3rd, I was advised to have a c/s for risk reasons and the fact I had developed a condition which made a c/s most advisable.

It was still listed as and elective.

We don't know the reasons behind every birth story and we should not allow others to judge, IMO.

---

I believe we are exceptionally lucky in this country to be able to access some of the best services in the world when specialised assistance is required before during or after birth. This is certainly not the case in some countries.
We have exceptional ante natal and post natal care available to us here in Australia and excellent facilities for women who have need of special care during labour. We also have wonderful services to help pre-term or seriously ill babies.

The language of birth should never reflect an assumption of "failure" in the event that specialised assistance is required and it is important to acknowledge that there are some very real circumstances where assistance is absolutely necessary.

It is when these undeniably valuable procedures start to become the standard form of birth management that we need to re-evaluate our approach. Medical and surgical management of pregnancy and childbirth should be available to all of us if and when problems arise.

The World Health Organisation has delivered (amongst other things) guidelines which suggest a reasonable percentage of women who will need such medical/surgical assistance; 5% - 15%.
In hospitals where these percentages are inflated by as much as 3 or 4 times what would be considered normal we need to know why this is the case.

Are women being given the support and encouragement they need during labour. Are women being assessed according to their individual progress or are they being assessed according to a model of what individual obstetricians see as ?normal? for all women?

Obstetricians are people and are subject to all the faults and failings of normal human beings. We tend to elevate them to a far higher status than that but ultimately they are just people and should be subject to the same accountability as the rest of us. Some of them are wonderful people and some are not so wonderful. Some do their job well and some not so well. Just like the rest of us.

Surely when considering the matter of whether or not we should have the freedom to give birth in the way we choose we need to know the philosophies and practices of the people who are attending us during this time.

We don?t need or want to know if a particular woman made the right or wrong choice at some point in her labour. Women don?t ?fail? during birth ? not ever. Women experience birth in the most incredible number of different and unique ways.
We do, however, need to know if the birthing institutions and attendants have the same commitment to providing what is needed to facilitate a straightforward uncomplicated birth as they have to assisting when problems arise.

We do need to know if the number of caesareans being performed appears, overall, to be a reasonable number. We need to know if there are a lot of infections occurring in a hospital. We need to know if all babies are being given complimentary feeds without needing them. We need to know if women are being slapped and told to be quiet when they are in labour (yes this happened). We need to know if women are being given honest information about all the options available to them.
We have an absolute right to know everything there is to know about the place where we are going to give birth and the people who will be with us at that time.

We absolutely need to give all women the respect and love and support they need regardless of the circumstances of their birth.

Okay, blonde moment here. I just worked out how to vote. I voted yes BTW.
Now it is:
622 votes for yes (43%)
611 votes for no (42%)

Sushee, thanks for your positive story. I plan to stand my ground next time too.

Sushee, that's just it. I tried my best. I failed. The midwife the next day went out of her way to let me know how much I failed - she knew I would anyway.

I had about ten to fifteen people in the room when I gave birth. Aside from DH (sat at the back looking pale with midwives worried about him) I hadn't met any of these people before late that morning - when I was already 8cm dilated.

I feel so much worse because I failed. I knew and I failed. It wasn't worth the fight for me, nor was it worth the education. It just means I did my best and failed. I'd rather have just been dumb and failed. I'd rather have not known about all of this and failed, then I could blame something other than me just being a failure.

If you can fight and win, qudos to you. I'm obviously not good enough to do that. Believe me, I feel BAD about that. And would rather just not fight because then I didn't do my best and failed, maybe I could do better next time. And I know I can't.

And yup, DH can agree to a section for me. It's fine and good - they have a signature, they can chop me up now. Lucky them, they're OK. They got DH's say-so for the episiotomy - didn't even tell me they wanted to do it because they knew I wouldn't agree to it.

RH,

By the sounds of it, I personally think there were a lot of people who failed YOU. I don't think you failed. One person can only fight so much. And when there is that much opposition, so little support and so much control taken away from you at a time when you're in pain, vulnerable and scared, I don't think ANYONE should be thinking, let alone saying, you'd failed.

I don't think birthing the best way you could despite the odds is failing at all.

But that conversation is for another thread.

Okay, blonde moment here. I just worked out how to vote. I voted yes BTW.
Now it is:
622 votes for yes (43%)
611 votes for no (42%)

Sushee, thanks for your positive story. I plan to stand my ground next time too.

I'm glad to hear it, spice :). I think the day we stop fighting, and stop informing ourselves, will be a sad day for women in general. Some of us will be forever scarred by our experiences; the rest of us have to keep fighting so that sort of thing stops happening to women.

:

---

Girls, for those of you who think you can fight, refuse or talk your way out of surgery... you can't. Sorry to sound defeatist but BTDT and it really makes me cry to think other people believe that anyone cares about you when you're giving birth. They don't.

---

I swear no one ever reads past posts...and it was just 3 post before yours!!!

[quote] UPDATE

My friend who had the c/s booked for her for tomorrow gave birth to a beautiful little boy at 7.05 this morning, via VBAC. If you have a voice...us it!! Dont think cause a DR or Ob has a degree they are necessary right. Listen to to your body and believe in yourself!!!! [QUOTE/]

She talked her way out and went against what they said and look what happened! She got her VBAC and a labour of only 5 hours too! THIER WORD IS NOT GOSPIL!!!!

RH - the midwife you had should have been slapped in the face!!! How dare she make you feel this way! It totally infuriates me the lack of sympathy and RESPECT any mother gets in hospitals after doing the most beautiful thing in the world...having a baby is one of the most complicated yet selfless acta a woman can do and no matter which way the out come of birth is...a woman should be made to feel like royaltiy.

Maz, the point of RH's post is that she has a voice, a pretty bloody good one, and her story really underscores situations where the 'system' comes to believe it is more important than its parts - that is, when hospitals and medicos forget that for each woman they see it's another day at work but for the woman it's a unique and momentous occasion.
Clearly, there is still a lot of healing left for you to do, RH, and I do agree that there are situations where women are dehumanised in birth - this is more to do with being disempowered by others rather than not being empowered in yourself. I agree that others failed you, and that there was no failing on your part when you were clear in your intentions. When you've done all you could do, then it's a massive failing on those people rude enough to call themselves your 'caregivers' when you feel the way you do two years later :(
Publishing statistics of the breakdown of birth procedures is empowering to women. There is no downside to the situation.

:

---

Hi everyone,
I am not sure how to vote but I would say Yes.
My last baby was born via caeser and in my eyes there was no need. My doctor was saying he (my son) could be born naturally but her boss (who I never met and wasnt even there) told her by phone to do a caeser. I was upset as I never want another one after my first baby was a caeser. When we got up to theatre my doctor said she would check me again and said good news I can deliver right now no need for a caeser, I was so happy, until the phone rang - yep her boss again and Ihad a caeser. The next day I ask the same doctor (off the record) was the caeser necessary and she said no, that he (my son) could have been delivered normal. When I ask why she didnt do this she said she had to do what her boss ordered (I always thought the mother was in control hmmm) and that the hospital has to do so many caesers (more money for them). So i think hospitals caeser records should be available to expecting parents so they can decide!

---

Cate, that's shocking. Much love and healing to you. :hug:
x

i dislike the whole c/s rate debate. because no matter what reasons ppl have had a c/s it doesnt seem to come into the statistics, And when people hear the rate they dont think of all of all of the reasons behind a c/s just that their is x% of them.( i dislike i am just another statistic) yes there is a increases for many reasons there is also an increase in survival rates which babies would not have survived without a c/s
if they are going to do statistics i think the resons for the c/s should be available if its going to be a basis for where ppl will choose to deliver

I think having as much information as possible available, when choosing which hospital you want to birth in, is valuble in making an informed decision. I agree that the 'shaming' angle is unnecessary. Some c/s are life-saving procedures, but true emergencies are in the very low percentages. If a hospital has a c/s rate of around 50% - then obviously this is extremely high and women should have access to that information, as this would indicate that perhaps, the decision to c/s at that hospital is perhaps being made a little too prematurely.

Information is necessary for an informed decision to be made with confidence. All women deserve an empowered birth and for this to be an ultimate outcome, full disclosure of birthing environments and attendents is paramount.

Actually, Maz, I have read the whole thread.

I just know that someone listening to a woman in hospital is SO unlikely that the above story was the exception rather than the rule. I don't want people to think that this is normal or even achievable. It might be, maybe, just maybe, if you're lucky and it's so busy people forget to check on you. But don't take this as normal.

I'm not going to talk next time - because there will be no-one there for me to argue to. DS may well be around; he can go in the paper for being a child that delivers his sibling... because clearly the mother has nothing to do with it LOL. That's the point - TV, the obs and midwives do all the work. Papers and news programmes, the mother never delivers the child, it's the sibling or the taxi driver or whatever.

We need to start empowering women with steps like people talking about the MOTHER GIVING BIRTH and not how she needed "unqualified help" or her child being told what to do down the phone by a midwife... that's not needed! Trust your bodies! TELL women that even when they're not pregnant or considering children or childbirth!

Sorry, a bit off topic there. But women are educated before they even go to the hospital pre-natal education to think they can't have a baby by themselves, this needs to change too.

nickers the US has an ever increasing cs rate and MORE babies are dying during birth as those cs numbers rise, that's why there is global concern with the WHO over this. Unnecessary cs's DON'T save babies, they endanger them.

In 2006 i was one of 0.8% of women to deliver at home in the greater glasgow area and i'm DAMN proud to be that statistic!!! :D

Bx

you should be proud of that stat bx that is great you got to birth your baby at home!
i agree unneccisary c/s dont always save babies but c/s also DO save babies. My son would not be here if i didnt have one.
Im not all for c/s not by any means, it breaks my heart i was unable to have a vaginal birth (and a lot of girls on here know that) but I also cannot knock something that saved my son's life.

I think the thing is for most people who don't agree with the current stats when it comes to C/S. Is its not C/S thats wrong its the over use and unnecessary use that is scary and unfair and alarming. There are plenty of babies and mothers that wouldn't be here without C/S but there are also babies and mothers who have lost a lot because of unnecessary c/s. This is the problem. Not because you made an informed decision, or because it was a life or death choice. But when you are told you "Need" to have major surgery because of xyz, then later find out you were lied to that is a problem. And this is why I think these stats need to be released.

If a certain hospital was over medicating with morphine, you wouldn't want morphine completely banned, you wouldn't judge those that had morphine that needed it, in fact you wouldn't judge those that had morphine that didn't need it you would judge those that prescribed that morphine. And this is how I think most women like myself who were forced into an unnecessary ceaser feel.

Two really good points there Cailin :clap: Babies and mothers have died as well as been saved due to unnecessary c/sections... but at the same time that doesn't mean that c/sections are inheritantly wrong (like in Cailin's morphine analogy). Australia and USA have the one of the highest infant/mother mortality rates and also the highest c/section rates. There is a correlation. The WHO are concerned... so I am concerned... I can't see why I or anyone should feel ok about ignoring WHO concerns.

I haven't read all of the posts, but in NSW I did see stats published on c/s rates, along with use of drugs (split by type) and various other indicators of care, quite detailed (days in hospital, admission to special care, I think even types of intervention required, etc). I think it was about 5 years ago, so fairly recent, and definitely a public document. It was for both private and public hospitals. You could easily tell the difference between elective and emergency caesarians, even though I understand 'elective' is a very loosely coined term! Personally, I was particularly interested in knowing how many emergency caesarians were being performed, since I think that those are more in the hands of the carers in the hospital.

So I think the stats of c/s themselves are not enough and I'm wondering why it isn't Australia-wide that the stats I spoke of above are published?

Actually, when it comes down to it, I'd also want to see stats on the individual obs and their c/s rates. But I'm betting the AMA would have something to say about that. ;) I personally asked my ob for his stats (off the top of his head) and was satisfied. And once I had a c/s for placenta praevia I was sure to ask him about his vbac views.

ETA - I found the report - it was called NSW Mothers and Babies 2004 and published by the CSIRO. Not sure if I can post it but here is a link: http://www.publish.csiro.au/?act=vie...id=NB05S14.pdf Go to page 95 in the doc for the hospitals info. Page 97 has the c/s rates, split into elective and emergency.

I hope they do a report like this every few years.