'For the first birth, I felt like no one really
educated me enough. I didn't know a lot and I didn't know where
to find resources to learn moreÉ'
One thing that women need to be aware of, if they are to be involved
in making informed choices, is what this actually means. It is becoming
truly 'involved' in the decisions to be made, in regard to your
pregnancy, labour and the birth of your child. It involves listening
to your childbirth professional's advice, researching the options
available to you in your own specific circumstances, and then following
your own inner guidance in making an informed decision. Basically,
it means accepting responsibility for the decisions that you have
made in regard to your maternity care, and the birth of your child
If you do not feel that the maternity care offered to you by your
initial chosen childbirth professional is what you need, then you
can always research other professionals within your locality to
find someone better suited to your ideals of maternity care. It
is best to be supported by a professional that is as comfortable
with you as you are with them. But if this isn't possible, such
as in rural areas of Australia, then you should try to negotiate
your care with the childbirth professional that is available.
During the process of negotiation your midwife, or doctor, may
need reassurance that you are aware of the possible consequences
of your decision/s. Occasionally it may be a matter of asking for
'a little more time to give labour a chance to unfold' or some space
in which to discuss your alternatives with your support people and
get it all sorted out in your head. It is much better to negotiate
your care, give and take, than to demand the care you want. Your
childbirth professional is as human as you are, with all the same
fears, concerns and issues, and you will achieve more by working
together than you will if you alienate each other by demanding care
that the other can't provide or accept.
Up until the 1970's, the caesarean rate worldwide remained low,
around 5%. The reasons for the dramatic rise in the next decade
to 20-25% in Western countries are complex, but are thought to include
the increasing safety of the operation leading to complacency, defensive
practises resulting from fear of litigation on the part of obstetricians1
and the effects of the increasing use of epidurals, labour induction
and electronic foetal monitoring2.
It's true that the caesarean procedure has become less dangerous,
as anaesthetic and surgical skills improve, but birthing a child
via major surgery, when it is not me
dically necessary, is still not as safe, even by today's standards,
as birthing your child naturally. The caesarean rate for all confinements
in Australia in 1998 was 21.1%. Notably, this rate rose to 47.5%
for twin pregnancies, and to 55.9% for singleton very low birth
weight babies3, 4
It has been noted that these statistics may fluctuate, depending
on many external factors, some of which we have control over. A
clear example of this is how the rates may vary depending on whether
you have private insurance, where you plan to birth your baby (hospital,
Birthcentre, home), your age, your education level and the professional
caregiver you choose (i.e., Ob, GP or Midwife).
The World Health Organization (WHO) recommends a caesarean rate
of 15%, which we are currently exceeding. But this isn't only occurring
in Australia, the caesarean rates worldwide continue to increase
year by year. Australia's caesarean statistics are following this
pattern.
It is hoped that informing women of the pros, cons, risks and
consequences of caesarean birth will enable women to make an informed
decision in regard to birthing their child in this manner. It will
also be a positive step towards achieving a more acceptable caesarean
rate, without risking either Mother or Child in doing so.
What Actually Happens During a Caesarean Section?
Caesarean birth is an operation that enables your
baby to be born through an incision made on your pregnant belly.
You may plan an elective caesarean, for medical or social reasons,
or you may experience an emergency caesarean when labour does not
go as planned. An emergency caesarean usually occurs after labour
has begun.
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