Caesareans - who's counting?
- AuthorJudith Thomas-Whittingham
The World Health Organization has dropped its recommendation that fewer births be carried out by Caesarean section, saying there was no evidence for a limit. Ultimately, hospitals will hopefully not pressure women into having vaginal births.
Despite the popular perception of mothers who are "too posh to push", more than half of the C-sections carried out in the UK are done as emergencies. These are carried out when labour has started normally but complications arise. The surgical procedure means that both mothers and babies face slight risks, although often these risks are outweighed by the problems of proceeding with a natural birth.
Experts point to an increased risk of respiratory problems for the baby, higher risk of bleeding for the mother and a longer stay in hospital to recover as reasons why natural births are the preferred option. Plus a major factor in not promoting caesareans is costs. Women who opt for vaginal deliveries spend less time in hospital and use little hospital resources.
However, a vaginal birth also carries risks. I believe that women are not told about these risks prior to birth, therefore giving them an option. During vaginal delivery, a woman could tear badly, the baby could be damaged if forceps or vacuum extraction is used, and there is an increased risk of pelvic organ prolapse after delivery. These are all very serious complications which should be explained to the woman prior to the birth.
Pauline McDonagh Hull of electivecaesarean.com, a website on birthing choices, said women were not being told in ante-natal classes how many vaginal deliveries run into problems. She stated, "Women are made to feel that a normal birth is more important than the baby. We shouldn't be forced to go through a trial of labour if we don't want to. Reducing rates at all costs isn't right," I think women should be given information regarding all forms of birth at ante-natal classes so that they can make the decision for themselves.
Professor James Walker, consultant obstetrician at St James's University Hospital in Leeds and spokesman for the Royal College of Obstetricians and Gynaecologists stated, "Having a Caesarean section is a reasonable option, but it's about the appropriate treatment for the appropriate people," he said.
Yet in the NHS, doctors, hospitals and midwives have been under pressure to persuade women to give birth naturally. So, thinking about it, should there be less pressure on women to avoid surgical intervention?
The National Institute for Health and Clinical Excellence is currently in the process of updating its clinical guidelines on Caesarean section, although it does not expect to publish these until the end of next year. In light of the new changes, I think in time it may be possible for women to be able to consider all types of child birth before making their final decision and hopefully all women will be well informed.
Stephensons deal with cases concerning complications at birth, in both vaginal deliveries and caesareans. If you feel you have suffered from a birth injury please contact us on 01616 966 229.
By clinical negligence solicitor, Helen Shaw