Monday, 20 April 2009

Quick hit: Caesarean numbers up

From the Herald yesterday:

The number of elective caesareans in New Zealand has risen from 7 per cent of total births a decade ago to more than 10 per cent in 2006, the latest Ministry of Health figures reveal.

Of the 14,362 caesareans performed that year, 60 per cent were urgent procedures, where the decision to operate was made during labour. The rest were elective, where the mother made the decision during pregnancy.

But that choice was still likely to be based on clinical reasons, said AUT University's head of midwifery Jackie Gunn. She said medical advances meant more women with conditions that carried a greater risk of complications were able to give birth.

And a policy shift which followed research showing caesareans were safer for breech babies - those born feet or buttocks first - also accounts for some of the increase.

Click through for the whole article, which includes brief interviews with two women, one who gave birth vaginally and the other by caesarean.

I was just relieved to see an article that for once didn't assume elective caesareans were too posh to pushers. Although I'm a little confused that they talk about the record number of C-sections without putting it in the context of a record number of births in general...


Anonymous said...

I'm a little confused that they talk about c-section rates going up due to increased medical necessity and yet the mother they talked to had a totally non-medically indicated ceasar.

Also I'm not entirely keen on using the tern "natural birth" for one that involves an epidural. Maybe vaginal is just too scary a thing to say in the media. (maybe we could talk of a baby being delivered via gentle alpaca?)

Pauline said...

The rate seems low - the hospital in my old DHB had a 30% over all section rate with up to 50% for first time mothers (which is pretty horrific)

10% isn't outrageous. Research indicates soemthing between 3-10% is a "natural" rate (eg when you REALLY need one)

The stats will be skewed though because c/s on request (for non-medical reasons) is not allowed in NZ so a medical indication must be created. This is a small niumber of cases but it happens (the infamous 'too posh' people).

Specialists will recommend a section based on their and the woman's risk tolerance.

I had an emergency section which was sort of elective as well - I was in labour but elected to go to section because of a serious problem rather than "pushing on through". Luckily I have since had 2 quick normal VAGINAL births (Although Hungrymama I like the idea gentle alpaca births :-))

Alison said...

I agree - a pleasant change to see an article that recognises that "elective" caesarians are not restricted to the posh.

I'm confused about the reference to the research about breech births though. Assuming they're talking about the Term Breech Trial, it has been debunked many times over for various reasons. I wonder who told the journalist otherwise? (that doesn't mean there aren't doctors and/or midwives who are nervous about doing vaginal breech births, (as I think you experienced yourself Julie), but still, I hate seeing stuff like that used uncritically in the media when just one quick google would suggest the study was deeply flawed.

Small steps, I guess, and the recognition of what the term "elective c-section" actually means is quite a vital "small step" in terms of supporting women.

Doesn't stop me wishing for some decent science journalism in this country...

Julie said...

I was bemused by the idea that a "natural birth" involved an epidural too, which is why I put vaginally in my post instead. But then I'm not that fussed on the entire "natural birth" term as it tends to be misused in a judgey way by some.

Gentle alpaca sounds all good to me!

Although my own experience with a caesarean was positive my dream birth would still have as little intervention as possible. The most appealing birth story I've heard from my friends who are now mothers was one done without even gas!

I've been thinking about that vagina being too scary a word for the media, in the context of the beaver ads and the "down there" comment. I don't think it's just a problem with vagina (which is probably the word that sees this very blog banned from many computers by Mail Marshall and its kind), because I can't think of an ad where penis is used outloud either...

Azlemed said...

to me natural birth is non intervention, so no drugs no epesiotomy(sp), no nothing, i have had three natural births and they arent easy but I am able to do it. An epidural is intervention and the risks for c section or other intervention increase when it is used. I have heard though that c section rates are over 30%.

on the vagina/penis debate I havent heard either word used on tv/radio or in print, its like they are worse than saying "fuck". Which is on tv quite often after 8:30pm.