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Caesar’s Legacy?

A Caesarean is meant to be a lifesaving operation rather than an operation of convenience. But figures show that many Caesarean deliveries are carried out where the threat of emergency does not exist. 

A Caesarean is meant to be a lifesaving operation rather than an operation of convenience. But figures show that many Caesarean deliveries are carried out where the threat of emergency does not exist.

The World Health Organisation recommends that the incidence of Caesarean section delivery should not exceed 10-15 per cent.

Yet in Australia, the rate is approximately 20 per cent, compared to five per cent thirty years ago.

In the 1970s the Caesarean rate worldwide remained constant at 5 per cent.

In Australia statistics vary between hospitals. However, if you are a women aged between 35 and 39 years and you are having your first baby in a hospital, you face a Caesarean rate of 40.4 per cent.

Earlier this year, British obstetrician Professor Fisk predicted that within the next ten years half of all babies would be delivered by Caesarean.

It cannot be denied that in emergency situations, Caesarean deliveries have saved lives. But where there is no emergency, there is no evidence to indicate that Caesareans reduce the possible trauma and risks of childbirth.

On the contrary, there is documentation to show that Caesarean delivery increases the incidence of respiratory distress in a newborn. It is known that the passage through the birth canal prepares the baby for independent breathing by massaging the respiratory organs and aiding the elimination of mucus from their system.

Furthermore, Caesarean delivery has a high incidence for post-traumatic stress syndrome for mothers and arguably also for babies. Many mothers need to overcome the psychological stress of missing the birth and may experience emotions of guilt.

Australia is not alone in experiencing an ever-increasing number of caesarean deliveries. In the United Kingdom, the figure is 20 per cent compared to 3 percent thirty years ago and in the United States, Caesarean deliveries comprise 25 per cent of all births.

So why the increase? There are several factors thought to influence these rising figures. In contrast, the Netherlands has a Caesarean rate of 7 per cent, thought to reflect a different clinical approach (rather than indicating a overall state of women’s health).

One thought is that midwives and obstetricians have differing approaches.It is often suggested that midwives tend to take a more wholistic approach whereas the medical fraternity of obstetricians encourage more medical intervention with a view that safety is their main concern.

There is no doubt that this is largely influenced by current trends in medical litigation and it seems the paranoia about legal liability is not without foundation. A recent Senate Committee report confirmed the increase in medical indemnity premiums for all obstetricians in Australia as a further factor affecting the way births are carried out.

The increasing number of international celebrity mothers opting for elective Caesarean has been identified as having a malign influence on mothers-to-be.

In an age obsessed by body image, it has been suggested that women are following their Hollywood counterparts by rocking up weeks early to be induced, hence avoiding the final growth phase that further alters their body shape, and choosing to deliver by Caesarean section.

At London’s Portland Hospital, the birthplace choice of many celebrity mothers, 950 out of 2,165 births last year were Caesarean and just 386 of these were emergencies.

Many women are misguided by being lead to believe that a vaginal delivery after a Caesarean is not advisable and in some cases not possible.

In Australia Birthrites: Healing After a Caesarean, is an organisation dedicated to helping women make informed choices relating to their birth and subsequent births. Birthrites has a particular interest in helping women heal following a Caesarean birth and supports women in their choice of a vaginal delivery after a Caesearean birth.

For further information: www.birthrites.org




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