Caesarean births are on the rise in New Zealand, now accounting for about a quarter of all births.
Some of these are emergency procedures, but increasingly women are booking to have elective caesareans prior to their due dates in order to avoid natural labour.
Ministry of Health statistics report an increase in elective caesarean sections in the last decade, while the number of emergency caesareans has remained steady. Elective procedures have been glamorised in the media with celebrities such as Victoria Beckham who famously delivered her children by elective caesarean, sparking the phrase “too posh to push.”
But why are more New Zealand women opting to take the “easy way out?” Obstetrician and gynaecologist Dr Richard Dover from Oxford Women’s Health says increasing maternal age is a factor.
“Some women are in their 30s and only plan to have one or two children, so they want to do everything they can to maximise safety for the baby. If you don’t have a labour, then you can’t have a problem in your labour.”
Other women opt for an elective procedure because of a previous traumatic birth experience.
“We see a number of people who have had such a horrific experience with their first pregnancy – they’ve had awful tears or bleeding, and have found the whole process quite disturbing. I think for those people, to make them go through a further natural delivery is quite inhumane.”
Some first-time mothers are frightened of natural delivery because of horror stories they’ve heard about stitches, tears and “downstairs damage.”
Others enjoy the convenience of being able to plan their baby’s arrival around work and travel commitments, and making arrangements for extra support like a relative coming to stay.
Then there are the women who say they just want one, thank you very much.
“There are genuinely some people who can’t be bothered with the whole thing. I think it is true that there is a group of those people. They’re a small group,” said Dr Dover.
Caesarean sections account for about 20-30% of births in New Zealand, similar to rates in Australia and the UK said Dr Dover. He believes elective caesareans reduce the risk of still birth and are the safest option for delivery.
“You’re going to bypass the whole labour business so that’s got to take some risk out. Some people would argue you might transfer some of that risk from the baby to the mother, because she’s having a surgical procedure. There is some validity in that statement.”
Conversely, proponents of natural labour argue that the body is best equipped to give birth naturally. Women usually feel a sense of accomplishment and empowerment following a natural birth. Hospital stays are shorter and recovery times quicker. Mothers can breastfeed immediately and enjoy skin-to-skin bonding time with their infant. Babies born naturally are less likely to suffer certain respiratory problems following the birth, and are less likely to develop asthma, food allergies, and lactose intolerance later in life. This may be due to being exposed to beneficial bacteria in the birth canal.
Dr Dover said the topic was complex but ultimately he believed in supporting women’s choice.
“There is certainly a perception that caesarean section is the way of the devil. There are an awful lot of people who view natural delivery as the gold standard and if you’ve not had that, you’ve sort of failed,” he said. “I think you should be doing what’s best and safest and there’s certainly a healthy debate about that. The whole thing is about the woman leaving hospital with a smile on her face and a healthy baby in her arms. That’s the big outcome. How you achieve that, I view as a secondary outcome.”
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