I was just listening to the radio news and heard that there is yet  more research showing that Australian women are at more risk of having intervention if they choose to go to private hospitals.

I haven’t been able to read the paper yet but apparently it will be published today in the British Medical Journal‘s online journal, BMJ Open. It is a study of nearly 700,000 women in New South Wales hospitals, and found that those giving birth privately were found to have a 20 per cent lower chance of delivering their first child through normal vaginal birth.

The leader of the study, Professor Hannah Dahlen, said the study looked at the healthiest, wealthiest population possible, a group of women often accused of requesting interventions. In fact the obstetrican interviewed,Rupert Sherwood, from the Royal Australian and New Zealand College of Obstetricians,  said that privately insured women are more “risk adverse group” . Really!

I think this is myth that needs to be dispelled. Obstetricians need to own up to the power they exert over pregnant women and their partners. They must acknowledge that their subtle, and not so subtle, comments can undermine couple’s confidence in their ability to have a normal birth. Too many obstetricians casually comment on how big babies might be.

Women are very vulnerable at this time of their life and they trust their obstetricians, because we are all taught to do what the doctor tells us. This means that the slightest suggestion that  things might not be normal, has a massive impact on the choices a woman will make.

I am not putting all the blame on obstetricians. I think it is also up to women and their partners to be  more informed.

I love the quote “If you don’t know your choices, you don’t have any.”

Obstetricians are highly trained to deal with complications, yet they are caring for more and more low risk pregnancies. Because of their training they have a bias towards seeing all births as risky.  And because they are seeing more and more low risk births they have incredibly high work loads which could not possibly be met without  scheduling in women for induced births and caesarean sections.

Prof Dahlen made a great suggestion and  said that intervention rates of obstetricians should be made public. That would certainly help with informed decision making about which obstetrician to use.

Women and their partners really need to understand this is what  they are buying into when the sign up with a private obstetrician. If they then, still make the informed decision to go with him/her,  because they want the other things that go with a private hospital birth, such as better food, private rooms, fluffy towels, then they need to become the expert in normal birth so they can challenge the obstetricians view of births as inherently risky.

So are  women choosing caesarean sections? Well, if they are choosing private obstetricians, without being their own expert in normal birth, then sadly,  the chances are increasing that they are.


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