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Birth outcomes in NSW

The latest figures on birth outcomes in the State of New South Wales (2003) have just been released. This State is the only one in Australia that makes all the figures, for both public and private hospitals, freely available to the public and it is a goldmine of information.

Once again it underlines what we already know is happening: the caesarean section rate has risen from 19% in 1993 to 27% in 2003 and most of this rise is concentrated in the private sector, where the obstetricians rule the roost and the women have the money to pay them.

At the other end of the scale, this report has the figures on the first midwifery led units, and the Birth Centres, listed separately. Women who choose this kind of care have a 95% normal birth rate, which is impressive, but then this is to be expected as they work with a carefully selected low risk population. If the figures were any worse than this, there would be questions to ask.

The vaginal birth after previous caesarean (VBAC) rates are shocking. Only 20% of women in NSW achieve a normal vaginal birth after a previous surgical birth. The research on VBAC clearly indicates that a normal vaginal birth should be possible for up to 80% of all women and that this option should be encouraged and supported. Some of our births centres will accept women into their programs so they can have a VBAC, which is as it should be, given the research. However, it is clear from the statistics that most women are still being labelled “high risk” and being shunted off to obstetric care, which almost inevitably leads to another caesarean. It is so easy (and convenient) for a doctor to find a “reason” why surgery is to be preferred, and women are very vulnerable to scare stories and have no way of refuting or challenging dubious medical claims, such as a high incidence of uterine rupture if a normal birth is attempted.

There is a lot of work to be done by us childbirth educators, in all spheres, not just with expectant parents.

Posted by andrea at December 16, 2004 06:47 AM