An article in yesterday's Sunday Star Times discussed the evidence from several studies that both women and babies suffer increased risk of death as a result of cesarean section. In particular, babies are much more likely to suffer with problems with their breathing, especially following elective (planned/booked) cesarean.
The risk of elective cesarean section coupled with the cost ($3000-4000, compared to $1000-1500 for a vaginal birth) has led to a discussion about who pays for elective cesarean sections, especially if it is for a non-medical reason.
The thing is: what do you call a 'non-medical' reason? If elective cesareans go the same way as induction of labor, it will be very easy for women, midwives and doctors to come up with a justifiable reason. Whilst induction of labor is only supposed to be carried out for medical reasons, social inductions are carried out all the time - to suit medical staff as much as women.
I certainly strongly support any move to lower cesarean section rates. I have a sympathy for the view that women who are members of the 'too posh to push' brigade should pay for their operations. However, I believe that it is vital that 'poor' women are not discriminated against because of their financial status. I also have concerns that the reasons for women's particular beliefs about cesarean are not fully explored and dealt with. As midwives and health professionals, we should be asking ourselves what it is we do to influence women into believing cesareans are the preferred mode of birth?
What I believe is vital is to ensure that women are well supported to achieve vaginal birth in the most holistic way available, so that scare tactics around vaginal birth are recognized as such. This requires midwives to be totally committed to normal birth. The question is: how committed are midwives (and women) to normal birth, or do elective procedures like induction of labour and cesarean suit us too much as a means of controlling our working and personal lives?
What do you think? Do you think women should have to pay if they request cesarean sections for no specific medical reason?
If you are a midwife, how often do you see women requesting elective cesarean sections?
Image: 'daffodil' Pawel Loj