Did you know that birth interventions are a growing problem in most countries? Caesarean births are as high as 50% in many Australian private hospitals and around 30% of births in Australia are now by caesarean. Given that the World Health Organisation state that caesareans should normally only be around 10-12% researchers are looking for reasons why.
Why The Excess Intervention?
Epidurals are now in the spotlight as they have been shown to lead to prolonged second stage labour and women often end up with so-called ’emergency’ caesareans. Approximately 30-50% of Australian women have epidurals during birth – the rates depend on the woman’s age, place of birth and whether a woman has already given birth before. A recent study found that an epidural actually prolongs labour for more than 2 hours – and almost 3 hours for women who have previously given birth. The normal perceived time line for epidurals is only 1 hour, which means that many normally progressing women are misdiagnosed as failure to progress or abnormal labour – which leads to intervention.
The classic ‘cascade of intervention’ often starts with induction of labour, whereby a birth is artificially started with a drug called syntocin. Mimicking the action of the birth hormone oxytocin, syntocin stimulates uterine contractions. Unlike natural release of oxytocin, which is regulated by the body, a syntocin drip may not provide the correct amount. For many women, artificial induction or augmentation increases pain, requiring an epidural which further interferes with the natural birthing environment. Epidurals prolong labour and interfere with the ability for a woman to read her body’s signs and signals of birth. Artificial induction and prolonged labour quite commonly lead to distress in the baby and in turn an emergency caesarean is usually the next step in intervention.
The cost of birth interventions including caesareans in terms of the financial public health burden is massive. The WHO estimate that the cost of the global “excess” in c-sections was estimated to be a massive US$2.32 billion, while the cost of the global “needed” c-sections were around US$ 432 million. (WHO 2010)
Not surprisingly, women giving birth in private hospitals have a higher risk of birth interventions. One study looked at low-risk Australian women having their first birth in either private or public hospitals. For women giving birth in private hospitals only 15 per 100 women had a vaginal birth with no obstetric intervention compared to 35 per 100 women giving birth in a public hospital.
While it is easy to estimate the financial cost of excess c-sections, the emotional and health costs for both the mother and baby are harder to quantify. There have been many studies looking at the immediate and long term impacts of birth intervention. Postnatal depression rates are higher in women who have had birth intervention and there are lower breastfeeding rates also linked to birth intervention. Also for every caesarean a woman has, her likelihood for additional caesareans in subsequent births is markedly elevated. The risk of uterine rupture and hysterectomy following caesareans increases to 1 in 1200 in women who have had 2 or more caesareans. This can be a shock for women who did not anticipate that their fertility would end following what seemed to be a ‘normal’ birth option. This is a stark contrast to 1 in 30,000 risk of hysterectomy during birth for women giving birth vaginally.
For the baby, allergies are more common following a caesarean birth as the baby does not have the benefit of the vaginal flora of the mother which occurs during the normal descent through the birth canal. Breastfeeding initiation and duration is also compromised with birth intervention, which further puts the infant at a disadvantage.
While clearly some births end up in intervention due to unavoidable complications, our birthing culture has become such that for many women interventions have become the norm, rather than the exception. Conversely, the benefits of having a natural birth are many and varied. Preparing for birth well with healthy nutrition and lifestyle choices, having continuity of care with a midwife and having birth support with a known midwife or doula are all factors that have be linked to enhanced outcomes for the mother and baby.
I am pleased to provide comprehensive natural and holistic support for women through pregnancy, birth and the post-natal period. Alongside diet, exercise, relaxation and lifestyle advice I also offer personalised prescriptions of safe and effective natural supplements, herbs and homoeopathic birth kits for labour.
For more information and local resources for preparing for birth naturally please click on the links below: