Having been involved in the weird and wonderful Childbirth Conversation for 50 years, I have lived through 3 ‘Evidence-based practice’; birthed in two of them; live in another country that implemented a Midwifery Led Maternity System in 1990. And, I’ve been involved in the global Childbirth Conversation that arose in the mid1980s.
What have I learned?
1) When I gave birth in 1970, the Cesarean rate was 4.5%. We all labored whether we coped or suffered; whether we labored for hours or days; whether we had risks or not; whether we had a good outcome or tragedy. A Cesarean was done to save a woman’s life. Risks were normal and natural as were poor outcomes. These were accepted. Cesareans were perceived of a ‘life-saving’. Modern women were grateful.
2) In the US something changed in the 1980s. Women didn’t want to be left with an ugly belly scar because we were wearing bikinis now! So, Obs came up with ‘the bikini cut’ used today. That gave us a realistic option to seek a VBAC, be awake during surgery and have our partner with us. The Cesarean rate increased because we, Women, didn’t want our twins or breeches to be put at risk. We didn’t want to labor for days. In other words, we, Women, began to ‘choose’ a Cesarean (often on our fears of risks) because ‘a Cesarean is safer for the baby’. Safer cesareans were perceived of as reducing risks to our babies. Women will lay down their lives for their babies … right or wrong, good or bad.
3) WHO (World Health Organization) permitted 6% elective Cesarean to be included in their statistics because women in S. America were choosing to have a C/S rather than risk damaging their VJJ.
4) The Natural Birth Movement that ‘advocates’ natural birth began to give a message in the 1980s that ‘interventions’ were imposed on woman and unnecessary. Women should have ‘choices’, make a Birth Plan and say ‘no’ to medical interventions. When you give Women ‘choices’ then more women will ‘choose’ to have a non-laboring Cesarean.
5) Why do Women ‘choose’ a non-laboring Cesarean? Their lives are busy and they want their baby’s birth to fit into life. They don’t want the pain of labor. They have a concern about the wellbeing of themselves or babies. They are being advised by the Ob and accept that advice. They’ve had a previous Caesarean and feel comfortable having another.
In this talk, our New Zealand not-for-profit charitable Educational Trust is going to talk about how to get the most from your non-laboring surgical birth experience. Why? Because we get pregnant to have a baby not a ‘type’ of birth. Every birth is an ‘activity’ that each Woman does with her baby. Every human activity is best done with a good set of skills.