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