Friday, September 19, 2008

High caesarean rates in this country

I heard the Life Matters Maternity Teamwork interview of Dr Jolyon Ford, one of the keynote speakers at the ACM 'Breathing new life' conference (see next page in this blog). He had a lot to say about emergency obstetrics. I was disappointed with the interview, as the focus ignored the real issue in maternity care, and in reducing rates of caesarean, which is promoting normal birth.

The focus was on older, fatter mothers failing to progress, and distressed babies, and taking scalp blood samples from the babies. The age or size of a mother is not a clear predictor of her outcomes in childbirth. We have evidence that inductions of labour increase the likelihood of caesareans; we know that augmenting labour with oxytocics can cause distress in the baby; we know that continuity of midwife carer reduces a woman's likelihood of requesting dangerous drugs to deal with the pain of labour.

It may interest readers to know that in Victoria 37% of the mothers who gave birth at home in 2006 (the most recent published record) were aged 35 or over - a percentage slightly higher than the private hospital rate (36.3%) and considerably higher than the public hospital rate (19.2%). Giving birth at home means no inductions or augmentations, and no dangerous drugs or epidurals - they do it themselves. Bravo to the older women giving birth!
Joy Johnston

(a version of this comment appears on the guestbook of the Life Matters program)

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