Tuesday, January 6, 2009

Fear drives growth in cesareans in Australia

The article, 'Fear drives growth in caesareans' that appeared in Australia's The Age on the 6th January, describes Dr Jennifer Fenwick's opinion that "overblown fears about childbirth are a driver of Australia's rising rate of caesarean sections [and not] a case of women being 'too posh to push'."

She also believes that the country's national cesarean rate is "absolutely too high", and says that "women's fears and a culture of negative talk around vaginal birth - both in the medical profession and broader community - should be addressed." The article continues: "The messages are that birth is dangerous; you're better to have a caesarean section," says Dr Fenwick, who is Associate Professor of Midwifery at the University of Technology Sydney.
"What we haven't done is say (to women) 'let's talk about your fear .. Let's try and help you understand that birth is a really normal, healthy life event and your body is very good at having babies'."

As many readers of my website will know, I carried out research into this area myself, and it is true that women often cite 'fear of birth' and/or 'fear of vaginal delivery pain - during and after the birth' as reasons for choosing cesarean delivery. While I agree with Dr Fenwick that it can be helpful to try and address this fear in the case of some women, it should not be forgotten or dismissed that many women do not wish to go through counselling or therapy for fear, and have made a valid and measured decision to choose the risks and benefits associated with a planned cesarean delivery instead of those associated with a planned vaginal delivery.

Don't assume that fear can or needs to be overcome
Dr Fenwick may describe birth as a "normal, healthy life event and your body is very good at having babies" but the fact is that many planned vaginal deliveries result in adverse outcomes for mother and baby, and it is perfectly reasonable for women to make the decision to avoid these risks.

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