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Educating women about caesarans

This past week has been extraordinarily busy for me and I apologies for the lack of Diary entries - it is not as though there isn’t enough to talk about!

For example, I received this note from a friend in the UK:

“One of our friends from work had her baby last week. She had a 10lb baby boy, and they gave her a Caesarean section, cutting a major artery during the operation. Apparently she nearly died and they have had to give her a hysterectomy as a result.

I just hope the Caesarean section was absolutely necessary - probably the reason given was Preparing for Birth: Mothers the size of the baby. We had given her a some time ago but I don’t think she read it. She didn't want a birth plan, was sure the hospital and midwives would know best and was happy to go along with anything (pretty much like 90% of pregnant women in the UK I think).”

This is a sad comment, but one that I fear is very true. So many women take the their health for granted and put their faith completely in the system, sometimes to their detriment. By way of contrast, there has been a huge kerfuffle in Queensland recently over a woman who wanted a vaginal birth after two previous caesareans,

This woman was receiving care through the largest Women’s hospital in Brisbane. She was advised that another caesarean would be required because of her history, even though she had stated clearly she didn’t want one and was very confident that she could achieve a VBAC (vaginal birth after caesarean). Much pressure was applied by various staff, so she sought a second opinion at another smaller hospital where she was given every support for her decision to have a vaginal birth. The first hospital got wind of this, and demanded a meeting with her. There were five staff to “interrogate” her, including a lawyer, and they asked her to sign a statement that she would undergo the surgery. She declined, saying she would take the document home to read first. When she failed to appear at the next scheduled appointment, the hospital phoned the Department of Community Services, who sent around an officer to check up on her (this is the agency that is charged with protecting children at risk). Her unborn baby had been deemed to be at serious risk, despite our laws that clearly state the unborn baby has no “rights” until it leaves the mother’s body.

In the end, the woman (very sensibly) declined to be “assisted” by this major hospital, and went on to have a perfectly straightforward vaginal birth in the smaller unit, with two lovely midwives who were delighted to be of service.

This case is still reverberating around Queensland. The fact that the Government can intrude on a woman’s rights to this extent, the lack of empathy, caring and support from the major hospital in Brisbane, the pressure from supposed health professionals, all illustrate the sad state of affairs in some areas of the maternity services. There is a Ministerial Review of Maternity Care in progress in Queensland, and it is to be hoped that it recommends sweeping changes so that women’s retain their rights and have better choices available.

There is no evidence that a woman cannot have a vaginal birth after one or more caesareans. Few studies exist, but many anecdotal stories attest to the success of VBAC, when women prepare well and have good midwifery support. This major teaching hospital was more concerned about “risk management” than following the evidence, providing individualised care and offering compassionate support for this woman’s needs. It has been a shameful episode in their history.

Meanwhile, for women who do want to know the risks of Caesarean births, a new publication from the Maternity Center Association in the US has been added it to our range, and you can check it out by clicking here.

Posted by andrea at February 15, 2005 06:26 AM