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Obstetricians - where to next?

Contrasts in obstetric care are in my thoughts this morning, as I head to Heathrow for the long trip home to Sydney today.

First I have been in Ireland, where obstetricians rule the roost and women clamour for private consultant care so they can get their private room in a hospital for three days following the birth. Irish women seem quite happy to accept the high levels of birth intervention they and their babies will suffer during labour, the added costs they must pay, and the potential for long term health problems (of which they have probably been told nothing) just as long as they can be moved into a private room in the crowded maternity hospitals for a few days of “hospital pampering”. Private health insurance is a status symbol and women talk proudly of “their consultant”.

Next, I read in the Sydney Morning Herald (which I access online each day) of the problems facing pregnant women in rural NSW. As a result of the close down of small rural maternity units due to the reluctant of doctors to attend births, women in labour are being forced to drive hundreds of kilometres to the nearest regional centre. A recent report of a baby being born outside a pub with the aid of a publican’s wife (an Irish nurse, as it happens!) during a drive of over 150 kms to get to hospital has raised the issue.

Meanwhile, the Australian Government has decided to try and curb the excessive amounts of money being spent through Medicare on IVF as a way to ease the blow-out in the safety net funding arrangements. This has caused a stir because some women feel they have the right to IVF so they can have a baby, and that this should be funded by the public purse. The fact that the obstetricians charge so much for the procedure, knowing that us taxpayers will pick up the tab is not openly acknowledged, but is the root cause of the high price of IVF.

Here is London, obstetricians are apparently diversifying. Not content with the huge boom in caesareans and IVF, they are now adding colo-rectal surgery to the services they are offering. Using the ploy of encouraging women to get “their private parts tidied up” up after giving birth, some are now offering to re-fashion perineums and vaginas so that the “body beautiful” can be preserved. It won’t be long before the need to preserve the “honeymoon vagina” creeps up the list of reasons for caesarean birth in Britain, as it has in places like Brazil, where obstetricians routinely perform this surgery and are proud of their 100% caesarean rates.

Not that Brazil is alone in having obstetricians who boast of their surgical skills. In Brisbane, Queensland, there are at least two obstetricians who will only perform caesarean sections and they too have 100% surgical birth rates. One of these is a staunch and vocal supporter of private obstetric care and is scathing in his criticism of midwives and normal birth. As a spokesperson for the Australian Medical Association he gets lots of publicity and he is no doubt one reason why people are coming to regard some doctors, and especially some obstetricians, as money hungry self publicists.

I wonder what exploitation of women’s bodies obstetricians will come up with next, to maintain their bank balances?

Posted by andrea at May 02, 2005 06:01 PM