I watched this with interest last night Kelly so I was so happy to see it in here.

I think the issue with c/section is varied.

Firstly I believe the medicalisation of childbirth in our country has meant women are giving over their power and their bodies. Women often choose not to educate themselves - they defer this to their *specialist*. When they do educate themselves they will still often defer this again - it's difficult sometimes to argue with someone with a degree that you don't posess! We are taught from a young age that "the doctor is always right!"

Women very often today are like cattle in the waiting rooms. Pee in a jar, weigh in here and check the b/p. I always look on maternity outpatient waiting rooms depressingly. There is no JOY!

Women are often not taught to embrace their bodies, love their bodies and trust their bodies to do just what they know what to do - birth babies!
We are fed hideous stories from our mothers and grandmothers. We are fed even more hideous visual images of *the beautiful* people of hollywood etc - stick thin women who look as maternal as the brick on the side of a house.

Birth and pregnancy is seen as a medical condition that requires treatment and intervention to ensure it goes *right*. Time restraints are put on almost all milestones of pregnancy and certainly of labour. The climate is often all WRONG for positive birth outcomes.

I believe also that birthing and pregnancy care has been snatched from the hands of women and given to the minds of men...
I believe very strongly (so shoot me down!) that birthing is womens business. I don't believe there is a place for a doctor (male or female) at a routine normal delivery. I believe this so strongly and I have been at many births. The climate often changes when an obstetrician (and sadly they are usually men) walk in the door. A woman sees him at times as a saviour - he will get her through when really it is her the woman her does this. The woman births the woman delivers. He is seen as the man with the answers. The scene changes from one of a Goddess birthing to - a patient requiring treatment. I know that that is quite emotive but again I believe it passionately.

Having said the above I have had the blessing to be involved with some pretty amazing obs that quitely enter a room and sit patiently and unobtrusively and wait... This is a quality that is THE most important for a birthing attendant weather it be an assistant, midwife, doula or obs. Birth is about waiting...

Today our health system is short staffed, underfunded and highly stressed. We need to get 'em in and get 'em out. Waiting around for 24 hours for a woman to push out a baby when a quick trip to OT would sort it out is often not the preferred option. Likewise waiting and feeding a baby while birthing a placenta... Why do that when you can have an injection and it's all over red rover?

Women are often not educated about what the birth process is about.
Birthing a child is one of the steps to parenting. A positive birthing experience sets the scene for positive early parenting. It is so closely emeshed so that it can't be isolated.

Women are led to believe that they don't have options. It appalls me that in SEQ there is only 1 public hospital that would support a VBAC of a woman 2 years ago. What is the go there? This woman did birth vaginally in that hospital but was seen as too risky for anywhere else. But was it that?
I wonder if it was that it takes time. It takes time to sit with a woman. It takes time to learn what is in her head it takes time to build trust and for her to build trust. It takes patience and time. Neither of these things are congruent with the health system.

It confounds me that the most educated (and the oldest) among us opt for caesarian at a higher rate. The risks of major surgery for the mothers body the risks to the baby are far greater but women are asking for caesarian. Only today I was talking to a woman... She has a 15 month old toddler and is due in January. I asked her where she is birthing and she told me and then went on to say she is having an elective caesarian. Why? Because her last baby was 8lb 5ozs and she got a second degree tear.

Now... Haven't the obstetricians and the system got a duty of care here? Haven't they got a duty of care to say... this isn't a good reason. WE can do some things to help you. We can let you use the birthing tub so your peri is nice and supple. WE can provide continuity of midwifery care so you feel safe and nurtured. WE can educate you on positions and guide you gently to use them in labour...

Caesarian is wonderful when it's needed. It's wonderful for saving lives. It is not and should not be an option unless there is a firm medical indication.

I am a firm advocate of womens choice. If a woman knows the risks attatched and is fully educated then she has made an informed choice.

However, we don't decide that our tonsils need to come out - we get a consult and then there are criteria that need to be met. Why is it different with major surgery to remove a baby? Why is it bandied about like it's not a biggy. Caesarian is a biggy. It's not a minor op. It has risks and side affects to both people.

As I said when it is indicated it is an absolute blessing. I firmly believe though that the balance is way out of whack...

I was so happy to see this on Today Tonight.