I think they are higher cos you have the choice. When dd2 was born the replacement ob (my one was away - early arrival!) offered me gas, TENS, peth, sterile water injections, epi and a pudendal (sp) block. There was an anaes next room over.
Didn't need them (more too late) but I was stunned at my choices. ESP since I knew I wouldn't have to pay for anything.
I think women in the private system are more prone to the cascade of intervention (where one 'simple' intervention leads to another, sort of a snowball effect). Rates of induction in private hospitals are a lot higher than in public, regardless of wether or not it's requested by the woman it still leads to a higher risk of more intervention which the woman may not of wanted in the beginning. Given that more woman suffer PTSD than people who fight in wars something isn't going right.
Some comparisons here http://www.mybirth.com.au/where.html
Now that would be interesting reading. I think it should also extend to hospitals too.She said the intervention rates of obstetricians should be made public, for example through the federal government's MyHospitals website.
Having given birth in a private hospital they were pretty keen to intervene. They pretty much scoffed at my plan for a natural drug-free birth. Am going public this time where I believe I have a much better chance of a natural birth. I was discussing today with my midwife would I need a caesarean for a breech baby. She gave me a very balanced view that I doubt an OB would have.
I really question the author of this study. To make a comment that all OBs "...had a tendency to see all births as risky until the baby was delivered." is such a generalisation and factually unsupported. The study could not have proven this as it's a subjective statement.
Furthermore, some of us choose to see an OB, not because we are "high-risk", but because we feel more comfortable with having continuity of care by one doctor that is a highly trained professional, or even because we just want to go to a private hospital. There could be many reasons.
The author then goes on to suggest ''There is also strong incentive for surgeons to 'schedule in' women for induced births to make their workload and patient flow easier.'' Most OBs accept their job as being 24/7 and cannot possibly "schedule" all their patients to be induced, so therefore what is the incentive really to induce some of your patients, you will still have a large proportion of patients that go into labour spontaneously and naturally. Can hardly see how you could really manipulate your workload that much to make a real difference.
I can only go by my experience and that of many, many of my friends and colleagues that have birthed in private hospitals and the majority of us had vaginal births. My OB for example does not perform elective C-sections (I know because I have asked). In my last pregnancy, when I was over my due date, she said I would have to wait at least 5-10 days before she would induce me. During my labour, when I was finding it really difficult and begged for the vacuum, she wouldn't use it. I really don't think she is unique in this respect. I believe most OBs prefer not to do c-sections unless they have to, due to the higher rate of complications that potentially can occur, there is more risk & liability for them. I guess I just think it is a bit of misnomer to think all OBs prefer intervention. Either way, it's all about choice and personal experience.
So whilst I personally didn't request one, there were definately other women who did.
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