Shake-up of NHS 'incentives' in drive to curb caesareans

Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448. Link

Plans to reduce the number of caesarean deliveries and give women greater access to home births are being considered by ministers.

They want to remove incentives that see hospitals paid extra for surgical births, with or without complications.

The payments mean that one in four babies is delivered by caesarean section - almost double the World Health Organisation's recommended rate.

... Ministers say they do not want to 'demonise' C-sections or discourage doctors from performing them when clinically necessary.

But they believe that equalising NHS payments for all kinds of birth, including those at home, could help bring down the number of surgical procedures ...

The Royal College of Midwives has expressed concern over the fact that the proportion of caesarean births is 15 per cent in some parts of the country while hitting 33 per cent in others ...

If only this could happen in Australia The UK College of Midwives and Collegs of Obs and Gynaes has a joint position statement on homebirth, providing support to homebirth in low-risk, midwife-attended births at home. We have no such statement in Australia and the Colleges remain opposed on the issue of homebirth. RANZCOG is outwardly unsupportive of homebirth and the Australian College of Midwives has no public position statement of support for homebirth, however they do support homebirth.

Australia's caesarean rates vary less widely than those quoted in this study. We have a few small obstetric units with "low" caesarean rats of <25%, but it's not until you get to homebirth, midwife-led units and birth centres that you start to find low caesarean rates, under 15%. For the most part, our caesarean rates are shockingly high at ~30%+.

Melissa Maimann, Essential Birth Consulting 0400 418 448