Specialists want doctors to reduce c-section rate

For further information, contact Melissa Maimann at Essential Birth Consulting. Link

I was shocked just by the title of this article!

Leaders of Canada's pregnancy specialists are urging doctors not to induce labour unless there are compelling medical reasons.

The call is part of a campaign to "normalize" childbirth and efforts to reduce Canada's soaring cesarean section rate. Some studies suggest inducing labour in a first-time mother significantly increases her risk of a C-section.

... Doctors say several factors are driving induction rates, including the number of older first-time mothers, medical legal concerns and convenience.

"[Women may say], ‘My husband is going somewhere, can't you get my baby out Monday?' " ...

For most expectant mothers, labour begins spontaneously, at about 40 weeks into the pregnancy.

Induction of labour occurs when medications such as prostaglandin and oxytocin are used when a woman is past her due date to ripen the cervix and get the uterus contracting.

"The message ... is, be patient and do not consider inductions before the end of the 41st week," said Lalonde. "If you wait that extra week to 10 days, you will find that most women ... will go into spontaneous labour."

He says "the number one risk" of induction is that it leads to earlier decisions about a C-section ... Nearly 28% of babies were born surgically in Canada in 2007-08 ... That's up from 5% in 1969.

... Induction can lead to longer, more painful labour and continuous electronic monitoring of the baby's heart rate, which itself increases the risk of C-sections, because it generates "a lot of information. In fact, too much information," says Dr. William Ehman ... "So you are trying to sort out the important things versus what's not important."

Research shows that, in healthy pregnancies, checking the baby's heart rate after contractions by listening, or using a hand-held device, reduces the risk of interventions.

But a recently released Canadian survey of more than 6,000 women who have given birth in the last few years found most women (91%) experienced electronic fetal monitoring during labour ...

Ehman worries that women, and their doctors, have lost confidence in the ability to give birth without technological interventions.

... "Nature prepares the uterus better than we can," Ehman said. "There's probably a whole host of things that triggers labour in the first place -- and mainly it's probably the baby. So when the baby is ready it facilitates labour by lots of mechanisms that we can't do.

"We can add these chemicals and get the uterus contracting. But we just know that the numbers say that inductions, if they are done unnecessarily, are going to increase the risk of a C-section."

A very positive article from a doctor. Unfortunately, it's what midwives have been saying for many many years. Australia's CS rate is 31% (well, that was in 2006... I dread to think what it might be now); the CS rate in canada was only 28%. I hope that the changes to the provision of maternity services that are proposed to take place at the end of 2010 will help to bring down our caesarean rate.

Melissa Maimann, Essential Birth Consulting 0400 418 448