Australian attitudes to pregnancy and birth under fire: article

**BellyBelly** · October 28th, 2007, 12:42 PM

WOOT! Go Sheila Kitzinger!!!

Cot crusader lashes Australia
Maxine Frith
October 28, 2007

AUSTRALIA'S medical establishment is under fire for its attitude towards pregnancy and labour.

British childbirth guru Sheila Kitzinger MBE will launch an attack on the nation's high caesarean rate and low levels of homebirth at a conference in Sydney this week.

The author of more than 20 books - including The Complete Book Of Pregnancy And Childbirth - accuses Australian obstetricians of ignoring women's needs in favour of their own protection and profits.

In an interview with The Sun-Herald, she said Australia was lagging behind other countries, which are moving to less hospital-based models of childbirth.

Less than 1 per cent of Australian women give birth at home, compared with 2 per cent in the United Kingdom, 10 per cent in New Zealand and 30 per cent in the Netherlands.

At the same time, 31 per cent of pregnant women have a caesarean section - double the safe level of 15 per cent recommended by the World Health Organisation and higher than the UK and the US.

But the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) has refused to endorse home births and defends the caesarean rate.

"That caesarean rate is far, far too high and there can be no reason why so many women need to be going through that," Ms Kitzinger said.

"To not endorse home birth is just outdated. Other countries are moving away from hospitals towards promoting home births or stand-alone birth centres that don't medicalise pregnancy and childbirth.

"Australia is behind the times with that attitude. It is a system that is focused more on the needs of doctors than the needs of women.

"Of course some women will need medical intervention but if they have had a healthy pregnancy, the majority should be able to give birth at home without problems.

"The problem is that they get forced through the hospital route by the obstetricians who don't allow birth to progress naturally because of their workload, or fear of getting sued, or because they are not listening to what women want.

"After a few hours they tell the women that labour is prolonged andthere are foetal abnormalities and suddenly they are being wheeled in for a caesarean without being given a choice. Then the woman is left damaged and traumatised and that can affect the way she bonds with her baby - it's a disgrace."

RANZCOG's president, Dr Christine Tippett, defended its official opposition to home birth. She said the high caesarean rate was due to complex factors, including litigation against doctors and the older age at which women are giving birth.

"The college does not endorse home birth because the data suggests that in the Australian context it is not safe," Dr Tippett said.

"In the Netherlands, the country is so small that if something goes wrong the woman can be easily transferred to a hospital. That is not the case here. I think that most women should give birth in a hospital, where all the resources are on hand.

"A small number of women may want to give birth at home but I think one of the problems is that they become very critical of anyone who doesn't want the same."

But the executive officer of the Australian College of Midwives, Dr Barbara Vernon, said: "We have had to agree to disagree with RANZCOG over home births and caesareans because we think their attitude comes more from a professional perspective than from any clinical basis.

"We are very concerned about the high rates of caesareans. The problem is that RANZCOG does not seem to understand that for women the way in which they give birth has immense significance."

Louisa Meek wanted a home birth for her son, Jack - now aged five months - but ended up having an emergency caesarean in hospital.

Ms Meek, 34, of Glebe, said when labour wasn't progressing at home she went to Royal Prince Alfred Hospital, where she hoped to give birth naturally. But she said after being left in the labour ward for six hours, staff came in and said she needed a caesarean, even though she wanted to continue and the baby was doing well.

"I felt like I was just an object on a factory line and no one was listening to me," she said.

"Even now I still get very emotional about it because it was so awful and really affected how I bonded with my baby. I'm not the only one. Four women in my mother's group have had similar experiences. You just feel that the obstetricians are indifferent towards you."

The Home Birth Australia Conference in Sydney this week will also hear from celebrity childbirth guru Gowri Motha, who helped Elle Macpherson and Kate Moss with their labours. Sri Lankan-born Ms Motha advocates her "gentle birth method", which involves a strict dietary, massage and exercise regime to enable women to give birth naturally.

**Tobily** · October 28th, 2007, 02:05 PM

I saw this earlier this morning! Isn't she awesome!! Talk about sticking the boot in! Needs to be more of it

**Schmickers** · October 28th, 2007, 04:55 PM

Good God some of the things that Christine Tippett actually tries to convince the public of aggravate me. Okay. Just getting out my high horse now. No, not that one. The higher one. Yup, that's the one.

RANZCOG's president, Dr Christine Tippett, defended its official opposition to home birth. She said the high caesarean rate was due to complex factors, including litigation against doctors ...

Well, at least she's finally being honest about the motivation behind Australia's disgraceful caesarean rate. But think about it: How many women out there have ever been advised that they need a caesarean section because the obstetrician is concerned about litigation?

I can tell you now - none. I can guarantee that there is not a single obstetrician in this country who would honestly write on their consent forms: "Caesarean required due to the risk of me being sued" and then give it to their client to sign. And yet - AND YET - the president of their professional body has gone on official record as stating that this is, indeed, one of their reasons for performing so many caesareans.

In other words, women of Australia - you are being lied to. Some percentage of you, out there, have been told that you need major sugery, surgery which carries a real risk to both you and your unborn child, because your obstetrician is frightened that he or she might get sued.

That is, quite frankly, disgusting.

"In the Netherlands, the country is so small that if something goes wrong the woman can be easily transferred to a hospital. That is not the case here. I think that most women should give birth in a hospital, where all the resources are on hand.

And once more, more scaremongering by the RANZCOG. Thanks for the geography lesson, Christine. While Australia is a large continent, though, 90% of our population lives on about 10% of our landmass. Our country is large, but the majority of the population lives witrhin well-defined, and well-serviced, urban centers or large regional centers. In Sydney, Melbourne, Brisbane, and any of the larger population centers, medical support is close at hand. All of our states have an efficient ambulance service. This argument carries little weight when applied to an industry (independent midwifery) that self-regulates itself well and will screen clients to ensure that they are not so isolated from medical support that complications might pose a risk.

And I like how she chose to compare us to the Netherlands. Lets try and make homebirth sound like some exotic European art. How about comparing us to New Zealand? Our neighbours across the Tasman? Fellow members of the Empire with very similar cultural backgrounds, and mountainous, inhospitable territories that pose similar challenges to our own? 10% of women THERE have homebirths, and their model of maternity care is midwife focused. Their caesarean rate is also much lower. Homebirths don't just happen in Europe. They're happening right next door.

...which involves a strict dietary, massage and exercise regime to enable women to give birth naturally

...how sad that some people think they need a strict dietary, massage, and exercise regime to give birth naturally...*sigh*

Dismount.

**BellyBelly** · October 28th, 2007, 05:46 PM

BRAVO Michael!!!!!!!!! That's the most bloody brilliant post I have ever read!!!!!!!!!

Love your work Michael huge kisses from me!!!!!! Excuse me while I wipe the tears of laughter off my face!!!!!

**BellyBelly** · October 28th, 2007, 05:49 PM

Do you mind if I share this with some people off the forums Michael? I just gotta spread the love

**Trish** · October 28th, 2007, 06:04 PM

Well done Michael. Not that I would expect anything less from you hun. And to think, your not even a midwife

Be sure to put that horse back in the stable too.

**MantaRay** · October 28th, 2007, 06:43 PM

I agree Michael, well said!

I think it is great that Shelia is trying to get the message out, but I think more vocal advocates are going to be required before people start taking notice. We are brought up to trust doctors so it is hard for many to accept that they might be lying to us (or not telling us the whole truth). When people disagree with the medical profession I think most people's first reaction is that the person must be an alternative crackpot. Hopefully though, once they hear it enough it will sink in.

**~Raven~** · October 28th, 2007, 07:07 PM

Well said Michael!

I thought I'd also highlight this bit...

The author of more than 20 books - including The Complete Book Of Pregnancy And Childbirth - accuses Australian obstetricians of ignoring women's needs in favour of their own protection and profits.

I can't get what I want to say worded right and have a child hanging off me so will have to come back to it

**Janie** · October 28th, 2007, 07:08 PM

I totally agree Melanie. And I think it will take years to sink in. The culture of giving birth in Australia seems to be so ingrained that I think it's going to take awhile to change. I hope I'm wrong! I hope it gets better rather than worse. I want to be able to look back at this period in our history and say "wow, wasn't it shocking how many caesareans were performed back then". 30% is a disgusting figure

**BellyBelly** · October 28th, 2007, 07:22 PM

We think 30% is bad - but that's an average. Some hospitals have 60-70% c/s rates (esp. in QLD) and some(disclaimer, disclaimer!) Obs, even higher than that.

**Janie** · October 28th, 2007, 07:42 PM

Really Kelly? That's shocking! Why is it so particularly high in QLD?

How can you find out, truthfully, what a hospital's c-section rate is?

**BellyBelly** · October 28th, 2007, 07:59 PM

Probably the same reason they deregistered all their private midwives, bar one

Things are changing though, which is great... some very dedicated women are working very hard all over Australia to make things happen.

**Schmickers** · October 28th, 2007, 10:45 PM

Do you mind if I share this with some people off the forums Michael? I just gotta spread the love

By all means. Hey, if it gets spread far enough I might add to my sig: "I pwned Christine Tippett and the RANZCOG"...

**SungaiKecil** · October 28th, 2007, 11:37 PM

schmickers i am in hysterics!!!

can i post that on my blog (with you referenced of course!!)

LG · October 29th, 2007, 07:03 AM

Michael! What a great post!

Bravo to Sheila Kitzinger! Great that this kind of article is making mainstream news - at least people might start to talk about natural birthing and recognise the normality of it.

**Adnil** · October 29th, 2007, 07:23 AM

I can't add any more to Michael's post - so well said.

I am so pleased things are changing, I think it's terribly sad that Australia is having such high intervention rates. We (as a whole) need to simply demand more.

The problem is that RANZCOG does not seem to understand that for women the way in which they give birth has immense significance."

That's exactly right. I think they are so 'medicalised in their thinking that they just see it as a means to an end. But that is just so oversimplified & not true...

**BellyBelly** · October 29th, 2007, 07:48 AM

The problem is they also have the very powerful AMA on their side too, who are keen to keep the ownership of birth in the hands of doctors and obstetricians. It's like they want to completely wipe midwives out of the picture and would prefer to have them as 'obstetric nurses' to do as the doctor says and monitor machines. GRRRR makes me SO mad. See what we are up against? We need people power... we need consumers....

**Roryrory** · October 29th, 2007, 08:03 AM

Reminds me of the conversation I had with my GP (which led me to changing GPs, by the way) in which she told me that ever since midwives "got involved in birth there has been a great increase in complications"

90% of our population lives on about 10% of our landmass

Schmickers I was thinking the same thing! Great post - I agree