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thread: 90% Caesarean Rate in 2 Decades?

  1. #1
    ♥ BellyBelly's Creator ♥
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    Feb 2003
    Melbourne, Victoria, Australia, Australia
    8,982

    90% Caesarean Rate in 2 Decades?

    Push or pull
    ============

    By Jane Martin
    Sunday Telegraph

    March 11, 2007 12:00

    AUSTRALIA has one of the highest caesarean rates in the western world.
    Are vaginal births truly risky or have we actually become too posh to push?

    About 40 per cent of all births in Australia are caesareans and some medical experts believe they will soon become the norm.

    David Ellwood, a professor of obstetrics and gynaecology at the Australian National University suggests 90 per cent of births in Australia will be via caesarean within the next two decades.

    The World Health Organisation says a caesarean rate higher than 15 per cent is an indicator of "inappropriate usage". So why is Australia's caesarean rate rising?

    "Caesareans are seen as the new improved childbirth; the nice, clean, managed way to have a baby," says Michelle Hamer, author of Delivery by Appointment, Caesarean Birth Today (New Holland).

    Hamer says the popularity of caesareans is partly due to predictability.
    Vaginal births are increasingly seen as risky rather than natural by expectant mums and their doctors.

    "Our society doesn't tolerate risks or uncertainty any more," says Hamer.

    "Women don't want to be in a situation where nobody can definitely say what will happen next.

    "At a time when more obstetricians are being sued when labour goes wrong, I don't think any obstetrician has been sued for performing a caesarean.
    It's seen as a 'safer' choice."

    The caesarean candidates


    Women in Australia most likely to have a caesarean are first-time mothers in their mid-30s with private health insurance.

    Figures from an Australian Institute of Health and Welfare report say while caesarean rates are 15.9 per cent for mothers under 20, rates rise to 43.2 per cent for women over 40.

    Increasing obesity rates may also be impacting on the caesarean rate as obese women are six times more likely to have a caesarean, according to US statistics.

    In 90 to 95 per cent of cases, caesareans occur on the recommendation of a doctor or obstetrician says Hamer in her book. But some women choose a caesarean.

    "Informed women are increasingly choosing pain relief and surgical delivery, which fits the pattern of their otherwise busy, productive and technology-based lives," says obstetrician and gynaecologist Dr David Molloy.

    The too-posh-to-push phenomenon may be overplayed, but Hamer says some women she spoke to while researching her book didn't want to go through childbirth because they were concerned about the impact on their bodies.

    "Some women are choosing caesareans because they don't want to have their vagina damaged and they don't want pelvic floor problems and incontinence," says Hamer.

    "Some women don't want to grunt and sweat and think labour is too revolting."

    The pros and cons


    In some cases, a caesarean birth is a necessity. Caesareans save the lives of mothers or their unborn children every day.

    However, some people can see it as an easier option. But is a caesarean as convenient as it is portrayed?

    A caesarean birth involves major abdominal surgery and while the delivery of the baby may be quicker and less painful, caesarean mums can suffer longer after their baby is born.

    "You are recovering from surgery at a time when you want to be at your very best tolook after your baby," says Hamer, who's had four caesareans.

    "You have a child and you want to hold him, feed him and give him attention but your body is in shock and you have to care for yourself after surgery.



    "You do recover but you also carry a scar in your uterus that can have implications for further pregnancies."

    After a caesarean, women are at greater risk of bleeding, bladder injury, ongoing pelvic pain, wound infection and deep vein thrombosis.

    Women who have a vaginal birth are at greater risk of incontinence, vaginal pain, prolapse and stretching of the vagina.

    A 2003 study in the British medical journal, The Lancet, found caesareans increase the risk of unexplained stillbirth in a following pregnancy, and, says Hamer, only 20 per cent of women in Australia who have a caesarean go on to have a vaginal birth later.

    There is also evidence that a caesarean affects the placenta's ability to provide optimum levels of oxygen and nutrients to a future baby.

    The badge of honour

    Some caesarean mums later regret they didn't experience childbirth. They wonder how it feels to have labour pains and to push their baby in to the world.

    An article in the Australia & New Zealand Journal of Psychiatry, says the self-esteem of first-time mothers is highest for women who have vaginal births.

    "Women who had caesarean deliveries were significantly more likely to experience a deterioration in mood and in self-esteem," says the report.

    A fact sheet published by The International Caesarean Awareness Network states that a caesarean can lead to "psychological outcomes such as negative feelings, fear, guilt, anger, and post-partum depression".

    "There is a badge of honour that if women put themselves through as much pain as possible during childbirth, they've done better than the girl in the next bed," says Hamer.

    "If you do it without drugs or only use gas you're at the top of the scale. If you have a forceps-assisted epidural, well, never mind.

    "After each caesarean I felt I had 20 demerit points. What kind of mother could I be? I had to get someone else to remove my baby for me.

    "I think women who've had a caesarean are often treated as second best because they did it the 'easy way'."

    McMothering


    Hamer wonders if we are at risk of creating a childbirth culture where women no longer try and give birth naturally but who automatically join a conveyor-belt system that ends with the surgical delivery of their baby.

    While caesareans have their place in childbirth, Hamer believes women should become more educated so they can make informed choices if they are faced with a decision on how to deliver their unborn baby.

    Then they can have no regrets or questions later about how their baby was delivered and their childbirth experience.

    "Drive in to any takeaway hamburger chain worldwide and you know what you'll get; it's predictable. Go to an independent burger store down the street and you don't know what the burgers are like," says Hamer.

    "McMothering offers a streamlined, fast, efficient birth system. You have a drive-through birth and you won't end up with beetroot when you hate beetroot. But sometimes, I think something meaningful gets lost along the way.

    "I think it needs to be recognised that you don't have it easy whichever way you choose to have your baby. Both types of birth - vaginal or caesarean - take a toll on a woman's body.

    "At the end of the day we have to look at the beautiful baby we got and remember that's what matters - no matter how that baby gets here."
    Kelly xx

    Creator of BellyBelly.com.au, doula, writer and mother of three amazing children
    Author of Want To Be A Doula? Everything You Need To Know
    In 2015 I went Around The World + Kids!
    Forever grateful to my incredible Mod Team

  2. #2
    Life Member. Every Australian needs a Farmer.

    Dec 2005
    In Bankworld with Barbara
    14,222

    The thought that 90% of all births in 20 years time could be c/s absolutely terrifies me - my daughters are going to have to give birth in that 'culture' and I don't want that for them at all.

  3. #3
    Registered User

    Mar 2006
    Brisbane
    1,731

    Thats terrible. I don't agree with the prediction of 90% in 20 years. I think they're underestimating women. At least I hope they are, lol. I understand that some women have a psychological or physical need for a c/s and that's okay, but the majority of women would have to understand that vaginal birth is safer and ideal for 'most' situations. 90% is a scary figure.

  4. #4
    Registered User

    Mar 2006
    Brisbane
    1,731

    I can't wait for his birth announcement Good luck hun.

  5. #5
    BellyBelly Member

    Jul 2006
    Melbourne
    3,715

    How scary! I'm with Natalie, I think, well hope, that they are grossly underestimating women. Although I guess we wouldn't have predicted thar our c-section rate would be 40 % by the year 2007!

    I partly agree with the 'Badge of Honour' section. I know a few women who feel guilty after having a caesar, one in particular who, although she chose to have her second caesar instead of a VBAC, now feels like she's missed out on something in life and is quite upset about it (she's not having anymore kids).

    Is there anything we can do about this? I really don't like the thought that that figure could even be mildly realistic.

  6. #6
    ♥ BellyBelly's Creator ♥
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    Feb 2003
    Melbourne, Victoria, Australia, Australia
    8,982

    You can get vocal about it and demand more choices for women, like midwifery-led care, as without consumer demand there is no change - but what mother or woman out there has time or inclination to send in emails or letters to editors to complain or demand choice - its a tough one. The closure of the Rosebud Maternity Unit here in Melbourne is a big thing we are all working on in the birth world, all writing in and ringing into the radio stations to try and be heard that because they only have two obs they dont need to close. It is a perfect opportunity to start a midwifery-led centre for low risk women. But only those passionate are writing in, mostly midwives etc - we need lots of consumers to get in on the deal too, so we can show its an issue we are serious about and interested in.
    Kelly xx

    Creator of BellyBelly.com.au, doula, writer and mother of three amazing children
    Author of Want To Be A Doula? Everything You Need To Know
    In 2015 I went Around The World + Kids!
    Forever grateful to my incredible Mod Team

  7. #7
    Registered User

    Mar 2006
    Brisbane
    1,731

    I do agree with the badge of honour thing.

    With baby no.1 I had an epi, gas and pethidine.
    no.2 I had gas
    no. 3 epi and gas
    no. 4 gas and then a pethidine but she was born before it could take effect.
    no.5 gas (and got him out as they were calling for the ob because he was stuck)
    no.6 gas
    no.7 gas

    I have sometimes been made to feel 'inadequate' because of the drugs, especially the epi's. I have at times felt I failed because I didn't have a completely natural birth and I think thats wrong.

    My best friend had her beautiful daughter by c section when I had Rayanne and I would say she had the harder time so I don't think its an 'easier' option.

    Brooke, wanna bet?

  8. #8
    BellyBelly Member

    Oct 2006
    home sweet home.
    1,995

    I think that knowledge is power, and the more we as women know about the choices that we can make, the more empowered we are. I agree that 90% is a huge amount and perhaps we are underestimating women, or is it that we are not supporting eachother enough in whatever decision we make.

    I am in the process of making the vaginal / c-section decision myself at the moment which is on pshycological grounds more than anything and I am so thirsty for knowledge about the pro/cons of both methods. To be honest, a c-section frightens the heck out of me becuase I faint when I have a blood test, but a vaginal birth, even in my tragic circumstances felt totally normal to me.

    I think the best thing is to not judge other women's choices and to make sure we know as much as we need to know to make our decisions.

    Thanks for the article Kelly.

    Spring

  9. #9
    ♥ BellyBelly's Creator ♥
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    Feb 2003
    Melbourne, Victoria, Australia, Australia
    8,982

    I think articles like this make it sound more like a competition, and I hate it how they mis-use facts, like its generally the pregnancy and carrying of all the extra weight of the baby which has the most effect on the pelvic floor, not the birth.
    Kelly xx

    Creator of BellyBelly.com.au, doula, writer and mother of three amazing children
    Author of Want To Be A Doula? Everything You Need To Know
    In 2015 I went Around The World + Kids!
    Forever grateful to my incredible Mod Team

  10. #10
    Kirsty77 Guest

    Wow that is high. I guess you can see things are heading this way. Choice choice choice. Its up to the individual to be informed and decide what they want. In this day in time where medical science has come so far then we should have choices and options regarding pain relief and birthing options. Its wrong to say c/s should not be a choice that is allowed. Yes we were designed to have bubs vaginally but not all of us can and yep the ones who can't or choose to have a c/s, are made to feel bad about it. Its always going to be a big can of worms!! I personally never had either of my girls vaginally and never got that experience. I did experience labour with Gem, 23 long long hours!LOL so I can relate to that.

    But I'll take fries with mine to please.....is it to late to order!!

    ETA Good luck Brooke. I'll be waiting to hear what you have........I say a girl!

  11. #11
    BellyBelly Member

    Jan 2006
    Melbourne
    2,732

    I find the tone of that womam's comments offensive. Personally I would not have an elective c/s but to demean the mothering of women who do by calling it McMothering! But I suppose it is said to get a response and publicise the book, which it has done.

  12. #12
    BellyBelly Member

    Dec 2006
    922

    Ok i really don't want to offend anyone so I won't go in to details, but I don't think a c-sect should be an option, i don't think it should be a choice. Sorry
    I think that it is completely wrong to take away a c-sect as a choice for some women. Some women do choose a c-section as a lifestyle choice (but that is their choice and should not be questioned) some women may choose a c-section because of a previous birth. For me, I lost my precious son because of a cord accident. If I choose to have a c-section to bring my next bub safely into this world then that is my choice and I should have that choice. I don't think anyone can make comments about a c-sect choice if they have never lost a baby. Does it really matter how a baby enters the world, as long as it enters kicking and screaming. Until you lose a baby, you will never truly understand the pain. To lose a baby is cruel - to take away our choices is also cruel.

  13. #13
    Ex adm!n, quietly rusting....

    Feb 2004
    Melbourne
    11,171

    if they are concerned about the rising rate then why not remove that option, and only have c-sects for dire emergencies where mum & bub are in extreme danger. I know some will view this as robbing women of choices, but i'm just coming from the premise that perhaps it shouldn't be a choice, an extreme idea i know but just throwing it out there.
    I don't think it's fair to take away that choice at all. While yes I agree that there should be more education as some of the others have suggested I think it's not an option at all the remove that choice from anyone.

    I had an emergency c/s and if you read my birth de-brief you will see that I commented if I had to go through labour again I would never ever have another child. To make an elective c/s illegal for people like me denies the right to have more than one child. How can someone tell me that I can't have anymore children because I was let down by the health system?? I have since (thanks to BellyBelly) decided to go for a VBAC, but for those women that are in that situation, those that cannot face labour again why should they be told, nope sorry you must try a vaginal birth. In that case I believe the c/s rate wouldn't change it would merely be more emergency ones than elective as the stress of being forced into a labour causes the labour to stall etc etc.

  14. #14
    BellyBelly Member

    Oct 2006
    686

    My post is for "Tanby" - You say the choice should be taken away from women to have an elective c/s?... My baby was born in September at 36w1d after having an ultrasound which told me he had no heartbeat. I was induced into a natural labour and was given an epidural. This labour lasted 12 extremely long hours and at the end of this 12 hours I got to hold my beautiful, but sleeping, baby boy in my arms and say goodbye to him forever. I looked into his tiny little face and saw that he had my mouth, his daddy's ears and the colour hair his step sister had when she was born. I have CHOSEN to opt for a c/s for my next pregnancy because (a) I dont think I can face going through child birth again and (b) I dont want to take any risks next time and I want to hold my baby in my arms and feel the warmth of their skin and hear their screams. So unless I am mistaken you think my choice should be taken away as to how my baby comes into this world? You think I am taking the "easy" way out by electing a c/s? I think that until you walk a day in anothers shoes you have no right to say what is right and wrong for that person!

    My phrase of the day is - "live and let live"!

  15. #15
    BellyBelly Life Subscriber

    Jun 2005
    Blue Mountains
    5,086

    Yeah, I don't think the choice should be removed. There's always time and place for c/s, it's the uninformed decisions that are the worry.

    90% is very high! yikes! It would be terrible to see vaginal birth go the way of natural health remedies, left only to "alternative" lifestyles. I don't think it's right that "conventional" medicine never speaks of alternative natural remedies, and doesn't offer this information so that people can make informed choices on health issues in general. They think their way is the only and best way, and ridicule you if you want to try alternative methods first.

    So too, I think it'd be very sad to see people's 'informed' birth choices being based only on what the medical profession offer information on. If you walk in requesting a c/s, not only should they inform you of the risks of that procedure, but every other option should be openly weighed up too.. whether you want to hear it or not, and then the choice is made on all information available, and the carer might then be able to address any 'issues' that might be preventing vaginal birth or whatever.

    I don't have a problem with people making informed choices to have a c/s.. but if it's true that there is higher rates of depression etc after c/s, then I think it's sad that there are women out there making UNinformed choices, and suffering possible consequences unnecessarily.

  16. #16
    BellyBelly Member

    Jul 2006
    Melbourne
    3,715

    I don't think we should be taking away women's choice.

    As I've just posted elsewhere, I get really annoyed by people telling me that I won't be able to birth without drugs, and that I'm mad to even try. It would be hypocritical of me to even suggest that elective c-sections be ruled out. Each woman has her own, very personal reasons for choosing to birth the way she wants to (even if it doesn't work out as planned). Just because I don't understand why a woman would choose to have a caesar doesn't mean that I think she shouldn't. I'm sure, in fact I know, that there are those out there who think I'm crazy to be looking forward to birthing my baby!

    Each to their own I say

  17. #17
    Kirsty77 Guest

    Well said Shannon. Its just such a touchie subject. It is sad though that it is heading the way of a c/s becoming the norm. But I guess if you look back to when our grandma's were having bubs, how many bubs did they loose at birth because a c/s wasn't available. Yes in some cases a c/s isn't really medically neccessary but if it saves a life then it shouldn't matter how bub comes into the world. Most of us that have had c/s's would have loved to have had our bubs vaginally.

  18. #18
    Registered User

    Jul 2005
    Rural NSW
    6,975

    90%!!!??? Yikes! let's hope my DD (nearly 13yo) has absorbed something of my tough but worthwhile vaginal deliveries. All I can add is that I hope women fight for educated 'choice' not a choice based on fear. Well said Sherie.

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