Food for though for those looking into birth choices.TENS of thousands of Australian women with a low risk of birth complications and delivering in private hospitals are routinely receiving medical interventions once only given as a last resort. A leading midwifery expert has described the practice as ''horrifying''.In a landmark study of nearly 700,000 women in New South Wales hospitals, those giving birth privately were found to have a 20 per cent lower chance of delivering their first child through normal vaginal birth.
''The fact that these procedures, which were initially life-saving, are now so commonplace and do not appear to be associated with improved [baby] death rates demands close review,'' found the study, which is published today in the British Medical Journal's online journal, BMJ Open.
''The findings … suggest a two-tier system exists in Australia without any obvious benefit for women and babies and a level of medical over-servicing which is difficult to defend …''
A professor of midwifery and the leader of the study, Hannah Dahlen, said the women examined in 2000-08 were aged between 20 and 34, were not pre-term or overdue and carried babies of a normal weight.
''We looked at the healthiest, wealthiest population possible, exploding some of the myths out there that women receiving these interventions are sicker,'' Professor Dahlen, of the University of Western Sydney, said.
While 35 per 100 women gave birth with no intervention in public hospitals, this dropped to 15 per 100 in private hospitals.
''These are horrifying figures,'' Dr Dahlen said. She rejected the idea women in private hospitals might also be more risk-averse and therefore requesting the interventions.
''A recent Queensland study surveyed women to see if those in private hospitals were more likely to request a caesarean section, but found there were no differences,'' she said.
''Women need to be informed that intervention in childbirth is no walk in the park, with caesarean sections, for example, potentially causing a scarred uterus, which can increase the risk of complications in future pregnancies.''
Obstetricians highly trained in dealing with complications were overseeing the care of low-risk women, Professor Dahlen said, and had a tendency to see all births as risky until the baby was delivered. ''There is also strong incentive for surgeons to 'schedule in' women for induced births to make their workload and patient flow easier.''
She said the intervention rates of obstetricians should be made public, for example through the federal government's MyHospitals website.
But senior specialist and president of the Royal Australian and New Zealand College of Obstetricians, Rupert Sherwood, said comparisons between public and private hospital births should be done in the context that they were two different groups of women.
''We've always known the intervention rates are different between public and private hospitals,'' Dr Sherwood said. ''We have no idea if the women in this study were choosing interventions … because the researcher did not ask women that
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