Sunday, July 17, 2011

Dr Miriam Stoppard, you disappoint me

Click on Dr Miriam Stoppard's website and you'll read: "I have always aimed to give people the confidence to follow their instincts - whether planning for a healthy and happy pregnancy..."

Well, choosing to plan my two prophylactic cesarean births was a completely natural and instinctive choice for me. My babies arrived safely and I was satisfied with my choice.

And yet during her article, Victoria Beckham had a caesarean - is it the right choice for you? (Daily Mirror 14 July), Dr Stoppard not only strongly criticizes maternal request cesareans, saying they're not natural, but appears uncharacteristically determined not to even entertain the possibility that this choice is a legitimate one.

To her mind, "the natural way is the way to go", and that's the end of it.

Perhaps she's the type of woman that thinks, 'well, if I had to / managed to go through it all naturally, then so should you', or perhaps she genuinely isn't aware of the emerging research and opinion on the prophylactic nature of c-sections.

I don't know her reasons, but I struggle to respect ideological criticism of an informed birth plan.

Incredibly, she writes, " me ­old-fashioned, I’m in favour of a woman giving birth to her baby naturally, where possible. Even though an eminent obstetrician has said that caesareans are no more dangerous than natural births, to me, that dodges the question."

How does that statement (and similar statements from the likes of a previous President and current exec-vice President of ACOG, and the editor-in-chief of BJOG) 'dodge the question'?

I guess it depends what question is being asked...?

Finally, I'm disappointed that Dr Stoppard wrote this article without making sure that her "old-fashioned" views were being expressed in the context of contenporary clinical guidance.

She writes that for women with a fear childbirth, the National Institute for Clinical Excellence (NICE) "hasn’t recommended they have ­a caesarean".

And yet in its Caesarean Guideline Draft Update (published in May this year), NICE does just that. It states:

"When a woman requests a CS because she has a fear of childbirth, offer referral to a healthcare professional with expertise in providing perinatal mental health support to help her address her fears in a supportive manner. If after providing support, a vaginal birth is still not an acceptable option to the woman, offer a planned CS."

Please, Dr Stoppard, take another look at c-sections with an open mind and perhaps a more 21st century persepctive.

You may still feel you'd never make this choice, but you might begin to understand and respect those of us who do.

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