Saturday, December 15, 2007

elective caesarean increases breathing difficulties for babies

A recent TV One Health news item speaks of the increased risks of breathing difficulties for babies with elective caesarean sections. Particularly when these are performed early, that is before 39 weeks.
This is information gathered from a large Danish study. They found a nearly fourfold increased risk of breathing difficulties in caesarean babies delivered at 37 weeks, a threefold increase at 38 weeks and a doubled risk at 39 weeks. Babies who have breathing difficulties usually need to be transferred to a special baby unit and are monitored in incubators with oxygen provided. This is another risk which has been identified for women who are choosing or being advised to have an elective caesarean section.

A French study published recently "Postpartum Maternal Mortality and Cesarean Delivery" reported that caesarean section increased the risk of the mother dying after having a baby more than threefold.

This growing evidence of the increased risks to mother and child of having a caesarean section as opposed to a vaginal birth are very concerning as rates of caesarean section continue to rise. Recently published figures from the United States report a 30% national rate of caesarean births. The most recently published national rate in New Zealand was 27% but it is very likely that it too is now 30% or higher.

Can we as a society afford this level of intervention in childbirth.Is this an issue for sustainability? Think of the resources that are involved in this level of intervention/

I am not suggesting that any mother or child be put at risk by withholding necessary medical care and intervention, but where does it stop. Clearly we are not reducing risks for women and children by increasing medical intervention. Instead we are raising risks to the health and wellbeing of the mother and her child.

Can we turn this around? Midwives we need to help and support women to have confidence in their bodies and ability to birth. We need to provide sensitive caring support and information to women. We need to have faith ourselves in the process of birth and to share our faith with women and those who will be supporting them during the birth of the child.

6 comments:

Sarah Stewart said...

Thanks for your post. I think you have raised a wonderful issue for midwives to consider - it takes the whole issue of sustainability right back to the core and puts midwives at the fore of the fight for sustainability.

akissoudaki said...

Hi Carolyne

I am a registered midwife from Greece and I work in a midwifery hospital in the labour ward.Recently I carried out a survey and I presented the results to my colleagues which were dissapointing.Approximately 40% of the greek pregnant women prefer a repeat caesarean section even if a vaginal birth is a safe option.Unfortunately, here in the clinic practice it is common the the DICTUM “ONCE A CESAREAN ALWAYS A CESAREAN”.And the worst is that we (the midwives) can do very little about this since obstetricians have the first word.
I was happy to read your relative article, well done and keep the worthy trial.

Carolyn McIntosh said...

Thanks for your comments Sarah and Akissoudaki.

Good to hear from you Akissoudaki. I wrote another post in September after attending a presentation by Mike Robson from Ireland http://mymidiblog.blogspot.com/2007/09/caeserean-section-rates.html

There is probably not much you can do to change the decision by your obstetricians to do repeat caesarean sections. You can try to present them with evidence that suggests that it is Ok to have a VBAC. Perhaps they do not trust their own surgical technique and only they will know how good their suturing is. Ina May Gaskin from the USA spoke about the problems with some surgeons using a suturing technique which gave problems with future pregnancies. Here is a link to some information about this http://www.collegeofmidwives.org/news01/VBAC%20gaskin01a.htm

What we can all do as midwives, is to protect women from having that first caesarean section. Helping women to understand the process of labour and using all our skill to support women to birth without the use of intervention.

As I asked in this post how can society afford our ever increasing caesarean section rates? Women still do have the ability that they have always had to birth without intervention. What is different now is our increasing reliance on technology and a loss of faith in our own ability. Everything that midwives do should be geared towards helping women to connect with their own bodies and understand that they can do this very important job. In our modern world midwives often seem to fill the role of medical assistants, we need to move away from that nursing image and identify as midwives, protectors of the normal birth process. Nurturing comforting and supporting women through a life changing event. Have look at the videos in my next post by Michel Odent.

My thoughts are with you. Lets hope we as midwives can start to make a difference. Thanks again for your comments. ευχαριστώ πολύ!

mboi said...

what are you talking about here honestly save your Christianity for not such a public post i understand the christian way is natural birth but honestly there is no problem with a repeat cesarean but i think most of all you should point fingers at health care rather than our doctors
i find that if you had a cesarean at first it is more of a risk to you and your child on second hand to deliver naturally just experience i think your statement is a false one and you had a bad moment in which your pointing the finger in the wrong direction no person midwife or not would ever recommend a natural birth after a cesarean was done the first time

Carolyn said...

Some points about your comment Mboi.

The opinions I expressed in this post are based on recent, good quality research findings, not just my personal opinions. My opinions are not founded in a Christian perspective, I am not a Christian, but more on a humanisitic perspective. I think the statistcs do not support your assertion the "the Christian way is natural birth", consider the caesarean section rate in the USA, that most "Christian" of countries.

Anonymous said...

Research is research. Empirical data on the other hand is what really matters and I see none mentioned here.

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