October 25, 2004

Media reports in the UK

There have been several interesting reports in the British press over this past week concerning midwifery. There was the announcement that starting in January next year, midwives will be required to ask pregnant women is they are being physically abused by their husbands/partners. It is known that many women suffer from domestic violence for the first time when they become pregnant and for many others, the level of abuse increases when they are expecting a baby.

It is not clear what midwives will do with this information, or indeed, if there will be training in how to handle this delicate subject so that useful discussion can take place. This is an area of concern that has been on the agenda here in Britain for some time, with several articles and books being written about it, and a number of studies undertaken. Whether the reporting and documentation of this kind of abuse has any impact on reducing its incidence remains to be seen, but I guess asking the relevant questions is the place to begin.

The Observer newspaper carried a report of a study by Cambridge University researchers of 785 obstetricians in the UK and Ireland (as yet unpublished) that canvassed the reasons behind the increasing caesarean section rate. The main reason given by77% of those surveyed, was “patient’s choice” with “fear of litigation” cited by 67% as a key reason. This is very interesting, especially in light of government figures that reveal that last year there were 60,000 fewer claims for compensation from insurers than the year before, and that the number of claims against the NHS fell by 20% in the last year.

Of those caesareans being undertaken as a result of the “patient’s choice”, only 7% were for non-medical reasons, which suggests that complications (genuine or manufactured?) were the underlying factor for so many women opting for surgical births.

It seems that doctors think they will be sued, even when the chance of this happening are low, and falling. The doctors are clearly frightened, but by whom - the women, or their insurance company? The companies stand to lose a lot if there is a successful claim brought against a doctor, giving them ample reasons to frighten the doctors into doing unnecessary surgery to forestall any later claims. No-one has been sued for performing a caesarean it seems, yet many are perceived to be at risk if they don’t. Surely one day there will be a landmark case where a woman wins damages for an unnecessary caesarean that caused her ongoing pain and suffering. It was a highly publicised court case that changed the way that patients are now informed of their risks for any medical procedure. We need one or two similar high profile stoushes in the courts to stop the doctors, and their insurance companies, in their tracks and force the cessation of unnecessary surgery for birth.

Posted by andrea at October 25, 2004 06:24 PM