 Australians set a poor example as caesarean rates skyrocket
Tory Shepherd for AdelaideNow Date: 12/26/07
SOUTH Australian women are having caesareans at over twice the rate
recommended by the World Health Organisation, latest figures show.
Over one in three women are having caesarean sections, and at some private hospitals the rate is as high as one in two.
WHO recommends a rate of 15 per cent, or one in six pregnancies.
The Pregnancy Outcomes Statistics report for 2006 shows that women are both choosing to have more caesarean sections and having more emergency caesarean sections.
Professor Alistair MacLennan, head of Obstetrics and Gynaecology at Adelaide University, said there was a complex range of reasons for the increase, including the older average age of first-time mothers, and called for women to be given better information about their choices.
The mean age of women giving birth has increased from about 26.5 in 1981 to just over 30 in 2006. Professor MacLennan said this age increase could cause more complications and increase the need for caesarean sections.
He also said a fear of litigation put pressure on obstetricians to give caesarean sections because there was always a "rogue expert witness" who would testify an earlier delivery could have prevented conditions such as cerebral palsy.
Professor MacLennan also warned that women were requesting caesarean sections because of "common myths" that they are easier, less painful and less likely to lead to uterine prolapse and incontinence.
"I encourage people to have a normal delivery where possible but not to criticise their neighbour who has a caesarean."
The Maternity Coalition, a national organisation representing mothers, said obstetricians were "trained in complications instead of trained in natural births", so they have a tendency to intervene and give a caesarean when a natural birth was feasible.
"It's a combination of a fear of litigation, a loss of skills from the way (obstetricians) are trained and a bubble-wrapped population that doesn't want to take risks," coalition state president Lareen Newman said on Monday.
"Some of it is women not knowing how to cope with a natural birth, then there're practitioners who have lost the skills to do natural births."
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