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Caesarean Awareness Day

I had a day trip to Adelaide yesterday (Sunday September 11) for the National Caesarean Awareness Day event organised by CARES SA. Every year, a national campaign is mounted to alert the community to the incidence and implications f caesarean birth, and to encourage women to think about VBAC as an alternative.

CARES (Caesarean Awareness Recovery Education and Support) is an active group in South Australia who also work to co-ordinate a number of activities around the country. The event in Adelaide was a one day seminar, that featured a local obstetrician, Dr Brian Peat and a midwife from the Women’s and Children’s Hospital, Megan Farnhill in the morning and myself doing a three hours active birth program in the afternoon.

Brian Peat spoke about the statistics surrounding Caesarean rates (now 30% in Adelaide), VBAC, and their attendant risks. He produced a graph showing that after 39 weeks, the rates of complications for birth and babies rose in an almost vertical line. The figures had been compiled from reviewing a number of trial and studies and he used it to suggest that perhaps all births should be induced at 39 weeks, if the best outcomes for all were to be obtained. This was an alarming suggestion that had the audience of expectant parents wondering what was going on. On the other hand, he said several times that women should be left to decide for themselves what they wanted and that he was very supportive of VBAC, midwifery care and natural births. His argument was that it was his role, as an obstetrician to give the facts and statistics to those who asked, and in his opinion, these were the figures that he felt obliged to reveal when questioned. Most women, if faced with this information would be more willing to be induced, especially if it was stated that this would result in better outcomes. Of course, the whole argument rests on being able to accurately predict due dates, which in itself is a very inexact science, and may well contribute to the unexpectedly poor outcomes for some babies who might be premature as a result of such a policy of routine induction at 39 weeks.

Fortunately, Megan was able to show that midwifery care gave much better results than care by obstetricians, especially when women were able to have their own midwife, as now happens withing the team program that operates at the Women’s and Children’s Hospital. This program, which has now been going for 18 months has been an outstanding success. One of its biggest advantages is that they will accept women with all levels of risk, overseeing their care and continuing even if medical help is required. The team midwifery service has proven to be enormously popular, and it is hoped that more midwives will join the program so that the many women who are turned away each month can be accommodated. It is certainly a service that women want.

The afternoon was fun, and we explored how women can give themselves the best chance of having a natural birth through taking action in four areas:

1. Trust your ability to give birth and trust your baby.
2. Choose a caregiver wisely - they will have the greatest influence over what happen on the birth day.
3. Stay upright to maximise mobility and enable the body work as it is designed to do.
4. Take no medications - they will affect mobility, impact on the ability to behave instinctively and affect the baby’s well being.

We had some fun exploring these four steps and experimenting with different positions and of course, working out how to use the pelvic to best effect during labour and birth. Armed with a few ideas and the support of CARES, friends and family, I feel sure that the many expectant parents who came along will go away thinking more positively about planning for a natural birth. I am sure that most will achieve this as well. A great day out!

Posted by andrea at September 12, 2005 08:49 AM