According to a latest study from Queensland, it is doctors, not mothers, who are responsible for the rising rate of babies born by caesarean section in Australia. Queensland has the highest rate of C-sections in Australia and researchers say often women are not properly informed when they make the decision to go ahead with surgery.
The results from the study show that in Queensland 34 per cent of all births now take place via caesarean section, and the figure is even higher in Queensland's private hospitals, at 48 per cent. Researchers from the University of Queensland surveyed more than 20,000 women about their maternity experiences. Researchers say the number of babies born by caesarean has risen by 74 per cent in the past 20 years.
Professor Sue Kruske says only about half of Queensland women who had a planned caesarean section believed they had had all the risks and benefits explained to them. “What we found surprisingly was it was only half the women who received planned caesarean sections, so caesarean sections that occurred before labor - only half of them considered themselves making an informed decision around that,” she said. “Many women who seek care during pregnancy are quite passive, and that they just defer the decision making to their health provider. We'd like to see health providers encourage women to become active participants in their care. And through that they're more likely to be satisfied with their care, and they're more likely to have care that meets their needs,” she said.
Professor Kruske says the study found about 10 per cent of women who had a c-section actually wanted their baby born that way. “I think there's a belief in the health sector that women are actually driving these high rates of caesareans and that they're doing it because they want control or for whatever reason that's socially indicated…But I think that our data actually dispels that myth and actually shows that ... the vast majority of them are doing it because their health provider actually recommends that.” “Notably, only about half of all women (52.4 percent) birthing in public and private facilities reported making an informed decision to have a planned caesarean before labor…And only one-fifth (19.9 percent) of women made an informed decision to have a caesarean section when the procedure was unplanned,” she said.
Professor Kruske suspects the trend for many women to have babies later in life is causing some of the increase, with doctors afraid of litigation being extra cautious. “I know a woman, she's 39 years old, she's due in a few weeks and has been told if she doesn't have the baby by her due date she'll be having a Caesar[ean section] the next day,” she said. “Now there's actually no evidence to say that she is at higher risk the day after her due birth, the term of pregnancy actually extends to 42 weeks not 40 weeks and this woman has had no encouragement to actually be given the risks and benefits of having a Caesar[ean section] or being told the medical reason why she should be having a Caesar[ean section] the day after her due date.”
Queensland based Cas McCullough runs the Caesarean Awareness Network of Australia. She says some women who have caesareans on their doctor's advice often end up being overwhelmed by the experience. “They want to know all the information but sometimes I think with caesarean sections, you know, if they feel like it's being recommended, they just assume that it's going to be straight forward and more often than not, it can be quite a complicated recovery and we don't hear those stories,” she said.
The Centre is an independent centre based at The University of Queensland and is funded by the Queensland Government. The role of the Centre is to work towards consumer-focused maternity care that is integrated, evidence-based and provides optimal choices for women in Queensland.
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