Join the dots - c-sections, placenta accreta, and elective surgery waiting lists
Yesterday I watched an interesting intersection of issues in the media:
Risks increase for babies born by caesarean
EVIDENCE is mounting that elective caesarean sections, once thought to protect the health of the baby, are causing significant harm to newborns, with those born surgically almost twice as likely to be admitted to a neo-natal intensive care unit with serious respiratory problems.
Fatal flaws in steady rise of caesareans
The increasing number of women who opt for surgical deliveries is causing serious problems for them and their health teams, writes Ruth Pollard.
Rare pregnancy problem on the rise with caessareans
AUSTRALIA’S rising caesarean rate is being blamed for an increase in a rare condition that can kill mother and child within minutes.
Ahh don’t we love a hysterical tag line
$43 for 8000 more operations
NSW will receive almost a third of the $150 million in federal government funding to cut elective surgery waiting lists.
And a press release from the Australian College of Midwives to join the dots:
Caesarean rates must be lowered if surgery waiting lists are to be cut
"The Rudd Government and health ministers meeting in Brisbane today must take a lead role in reversing the trend to rising rates of Caesarean section if it is serious about freeing up surgical theatres for much needed elective surgery elsewhere in healthcare" President of the Australian College of Midwives, Professor Pat Brodie said.
More than 75,000 women are now having caesearean sections in Australia each year, around 30% of all births. This is up from 17% of births 10 years ago, without improvements in safety for mothers or babies.
Recent research has confirmed there are increased risks to mothers and babies from caesarean sections, including higher risk of death, higher rates of admission to intensive care, post operative infection, and, for mothers, potentially life threatening complications for subsequent pregnancies.
"The rising rates of caesarean section in Australia are not necessary to achieve safe care" Professor Brodie said. "Indeed for some women and babies we do more harm than good by performing caesarean".
"Caesarean section is not a simple procedure. It involves risk and pain for mothers. It carries risks for babies. It should only be done when there is clear medical indication that the benefits outweigh the risks" Professor Brodie said.
"Caesarean section costs twice as much as a vaginal birth, much more if things go wrong. It ties up scarce surgical resources and thus adds to waiting lists for elective surgery in other areas of health care".
"Rates of unnecessary caesarean can be reduced by giving women access to primary care by a known midwife throughout pregnancy, labour, birth and the newborn period. The midwife works in collaboration with doctors as needed. This model is being introduced in every state and territory but progress is too slow with fewer than 5% of women having access to such services." Professor Brodie said.
The federal government needs to facilitate expansion in access to primary one-to-one care by a known midwife. Access for midwives to professional indemnity insurance, and to Medicare funding for their care, as well as greater support for public maternity services wishing to restructure to provide such care, are essential first steps" Professor Brodie said.
