News & Current Affairs

August 26, 2008

Mums ‘accept natural birth risks’

Mums ‘accept natural birth risks’

Pregnant woman

About a quarter of UK births are carried out by Caesarean section

First-time mothers-to-be will accept greater risks than clinicians for a natural birth, research suggests.

A Sydney, Australia study also found the women prepared to accept higher pain levels, reports the British Journal of Obstetrics and Gynaecology.

Researchers asked 102 pregnant women and 341 midwives, obstetricians and other doctors what complications would make them choose a Caesarean section.

The journal editor said doctors were “biased”, having seen things go wrong.

This indicates that experiencing labour and attempting a normal birth are two very important priorities in women’s decision-making
Professor Philip Steer
Editor in chief, BJOG

Approximately one in four pregnancies in the UK ends in a Caesarean section, and most are offered in the face of potential complications such as the baby lying in the wrong position for natural birth.

But the Royal Prince Alfred Hospital study suggested that women, given an informed choice, were less likely than the professionals treating them to take a more cautious approach.

A total of 102 women, 84 midwives, 166 obstetricians, 12 urogynaecologists and 79 colorectal surgeons were interviewed to find out whether different complications would prompt them to choose a Caesarean.

Researchers asked them about mild complications such as a prolonged birth and superficial tears to severe problems such as anal and urinary incontinence, vaginal prolapse and severe tearing.

In all categories, the pregnant women were far more likely to be prepared to put up with complications in order to have a natural birth than their midwives or doctors.

Priorities

Study author Catherine Turner said: “Our study found that pregnant women were more likely to aim for a vaginal delivery, and they accept a higher threshold of risks from vaginal delivery when compared with clinicians.”

Professor Philip Steer, the journal’s editor in chief, said: “This indicates that experiencing labor and attempting a normal birth are two very important priorities in women’s decision-making.

“It may also indicate that doctors are biased by their inevitable involvement in complex cases, or labours where things have gone wrong.”

Belinda Phipps, chief executive of the National Childbirth Trust, agreed that health professionals could let their own negative experiences influence the recommendations they gave to women.

“If they’ve seen a traumatic birth, or been involved in a tragedy, there is no debriefing for them.

“It can mean they are more judgemental about the risks involved.”

She added: “I recognise that this is very difficult to avoid, but they need to realise that for most women, this is something that they feel it is important to do for themselves.”

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