Queensland Mums Afraid to Give Birth?

Image via WikipediaBrowsing the Brisbane Times this morning I came across this article discussing an apparent increase in the number of women requesting elective caesareans for psychological and social reasons.

It's an interesting article for a few reasons. Everyone knows that the caesarean rate has been steadily climbing in the last 10 years - to the point that at 30% nationally, it is now almost triple the rate advised by the World Health Organisation for a developed country. Even the RANZCOG admits that our caesarean rate is too high - that is not in dispute. What has been in dispute though, is why.

Obstetricians argue that we are having babies later, we are fatter, and we are generally more unhealthy during childbearing than our mothers were. They have also been the loudest to proclaim that women are asking them to perform caesareans because they don't want to birth vaginally. Which brings me to the article - I quote.

A National Institute of Health and Welfare report on mothers and babies reveals...a total of 1197, or 6.5 per cent, of caesareans in Queensland were for "psychosocial" or "patient choice" reasons.

So, of all the caesareans being done in Queensland every year, only 6.5% are maternally requested. Six in every hundred. Or put another way, 93.5% of women having caesareans probably got pregnant planning for a vaginal birth. Yep, it seems we are bashing down the doors of obstetricians to book elective caesareans in order to save our pelvic floors, or avoid the agonies of labour.

Our maternity system has some major obstacles to overcome if we are to lower the caesarean rate to anything near acceptable levels. It's incredibly unhelpful to lay blame at the feet of women, and looking at the data near impossible to justify. How on earth have we gone from a caesarean rate of 17% in Queensland in the late 1990's, to double that in only 10 years? It's obvious that there are systemic factors involved here - we didn't all get that old and unhealthy and incapable of birthing babies in just 10 years. Humans just don't "devolve" that quickly. It doesn't make sense.

Hopefully the release of this report will put to rest the claim that large numbers of women having caesareans are asking for them with no medical reason. There are certainly implications here too for the private vs public debate - maternally requested caesareans are often blamed for the massive discrepancies seen in caesarean rates between public and some private hospitals. It looks like that argument won't really stand up any longer either - particularly for those hospitals with rates over 50% (and yes, we have some of those in Queensland).

Labels: Caesarean section, media

Best Breastfeeding Resources

Late last week my oldest, dearest friend gave birth to her second baby. Like many new mums, the early days of breastfeeding haven't been without their challenges. So by way of welcoming baby Christian earthside, here are some breastfeeding resources that I've found especially useful, both for myself and for my mums.

1. The Australian Breastfeeding Association (ABA)

The ABA is a major source of support for breastfeeding mothers, Australia wide. Their website is a wealth of information - check out their index of articles for detailed, accurate information on literally everything to do with breastfeeding newborns, babies and toddlers. Whether it's a supply issue, attachment problem, breastfeeding in public, or returning to work - you will find help here. The ABA also run free counselling services providing over-the-phone assistance for specific problems. Mothers can also access support groups in their area, enrol in breastfeeding classes during pregnancy, or purchase breastfeeding items via Mothers Direct.

2. Australian Lactation Consultants Association (ALCA)

While midwives, GP's and paediatricians may be able to provide basic breastfeeding advice, it might surprise you to learn that their training only covers the fundamentals of human lactation. Lactation Consultants have specific, specialised training in all aspects of human lactation. They are the breastfeeding experts! Their knowledge and experience in breastfeeding will far exceed that of any other health professional - so if you're having problems it is worth cutting to the chase and seeking out an LC. Many will visit you in your home, which has the added bonus of them actually seeing you feed your baby, instead giving advice in a more general context. You can locate an LC near you via the ALCA site.

3. UNICEF: Breastcrawl Video

This video shows infant-led attachment to the breast immediately after birth. Many of my clients are now asking to be supported in this after immediately after birthing. We know that there are many benefits to the establishment of breastfeeding in not separating mother and baby in the first few hours after birth, and in keeping disturbances to a minimum. Hospital routines such as weighing and measuring baby, administering Hep B and Vit K, and physical exams can be left until at least an hour or two after birth to give you and your baby this precious time - mostly it's just a matter of letting the hospital know that this is your preference in your birth plan, and having your partner or doula remind them of this after your baby is born.



4. Kellymom

Kellymom is one of the most comprehensive and authoritive sources of breastfeeding information and articles online. The site is maintained by Kelly Bonyata, an international board certified lactation consultant (IBCLC). Kellymom also offers an excellent collection of free handouts on breastfeeding and related issues.


5. WHO Child Growth Standards

The growth charts used to assess normal growth in babies are derived from data obtained from formula fed infants. Babies who are fed formula tend to gain weight differently to breastfed babies - and comparisons between the two can lead to the mothers of healthy breastfed infants being told their baby is not gaining enough weight. This often leads to weaning, or the introduction of supplementary formula. The World Health Organisation (WHO) has now released revised infant growth charts based on the normal growth of breastfed infants. These charts are slowly finding their way into use within the mainstream medical community.

Labels: breastfeeding, video