Why are Australian women too posh to push?
Every day, in hospitals all around Australia, women who don't need caesareans are having them.
In the past 15 years our caesarean rate has nearly doubled leaving us with one of the highest rates of C-sections in the world.
Thirty-two per cent of women now have their babies delivered by caesarean in Australia, and that rate soars in private hospitals to 42.5 per cent.
So why this move to not push?
Midwives blame the medicalisation of childbirth.
"We have an obsession with removing pain in Australia," Midwifery Professor Sue Kruske says. "Most women want to have a natural birth, but they rely on the advice of the caregiver, and too often it's to have a caesarean for no medical reason."
Doctors, unsurprisingly, disagree. Obstetrician and current President of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, Professor Michael Permezel, blames the increasing age of first-time mothers for the increase in surgical intervention.
"It's patronising to suggest doctors impose their decision on women," he says, "Women are well educated on their choices now, and increased caesareans are due to older mothers having babies after pursuing their careers first."
International figures don't support his claims. In the country with the lowest caesarean rate The Netherlands the average age of women having their first baby is pretty much the same as Australia.
Research from Australia also contradicts Permezel's claims. Data from the Queensland Centre for Mothers and Babies shows that in that state, it's not just old mothers having babies delivered by caesarean, nor is it sick or fat mothers: it's all women, across the entire spectrum.
Midwifery Professor Hannah Dahlen believes that "there are a whole series of obstacles and realities that prevent normal birth in this country, and the private sector is driving those increases".
That we even have to emphasise that a vaginal delivery is 'normal' is worrying. Women have been delivering babies the old fashioned way for millennia.
While there have been leaps and bounds in improving safety for mums and bubs in the birthing process, Aussie women need to be more aware about their choices more aware that having a caesarean is major invasive surgery, and there are real risks involved.
Academics tell us the number of 'unnecessary' caesareans is 10,000 nationally. Can you imagine the outcry if Doctors were found to have removed 10,000 appendixes without due cause? The anger if they had used 10,000 anesthetics for no good reason?
But there's no outcry, because women accept their doctor's advice, which is often made with convenience, rather than the best outcome, in mind.
Caesareans have their place, but as long as most of us having babies are healthy and fit, more of us should get to experience a natural childbirth.
Yep, it hurts. Yep, bits tear and it's not exactly graceful to have your legs spread asunder while bellowing at the top of your lungs. But it's what our bodies were made for. And when that little life you've been growing for 10 months is finally laid on your chest, the pain of pushing is forgotten.
Zoe Arnold has two daughters, aged 15 months and three years, who were born naturally.
Writer's note: Thanks for all the feedback. This is obviously a polarising issue, and while there is opinion in this article, it is based on fact.
A few points, to clarify:
- The national figures on caesareans quoted in the article are from the 2009 Mothers and Babies report, which can be found here;
- Australian women are NOT too posh to push, but we do have an ever growing rate of caesareans (according to the OECD and our most prominent maternity researchers), which is not necessarily a "good" thing;
- I have NO judgement how you have your baby, but science tells us that the optimal way for a baby to be born is naturally, in most cases. Of course, high-risk pregnancies and labours are a different story: often in those cases a caesarean is the best option;
- This article was based on interviews with 3 eminent maternity experts who all had different opinions, but all agreed that the caesarean rate in Australia was too high, and could be lowered;
- The best thing for all women is to be well-informed before they head into Labour. Caesareans can save lives when used in the right circumstances, but they can also put both mum and bub at risk when performed unnecessarily, particularly when women have multiple caesars. It's important we are getting good information from our care providers about all our options.