I don't understand...

[BellyBelly]

Yup this is why some people in the birth world call them surgeons instead of using the word Ob. They are skilled at surgery. But where are the skils with vaginal breech? Or anything else that doesn't require tools? If you ask for alternatives you often get a blank face or a few choice words. Obviously to them the risks of surgery are far less when they do not feel confident enough doing other things which they feel will get them sued. They talk risk, we need to talk possibility. Like an Ob may say, 'if we do xxx then there is 2% xxxx might happen.' What about the 98% chance it wont! There is an unspoken language of understanding, a secret code in their world. Would be good to break it.

[fionas]

Well, I reckon lobby for obstetricians to have to disclose their caesar rates in the info you get when you sign up OR we could construct a league table of caesar rates ourselves, effectively naming and shaming the worst offenders. If everyone on bellybelly asked their ob for their caesar rate we'd soon have a little table going. Would make for pretty interesting reading! And if they refused to disclose them, you'd have to get suspicious!

[Rosehip_Fairy]

Our hospital policy is you're "allowed" 2 hours pushing... I remember that because the midwives let me go over 2 hours then asked if the could fudge the times, then got annoyed at the ob for being with another woman in labour when he "should" be with me!

I'm still really upset at how much fighting I had to do for the crap birth I had... why fight for that? Why did I even bother? Sorry, just getting all emothional again!

[doulacara]

In NSW you can look up the NSW Mothers and Babies report on the Health Dept website. It has tables listing c/s rates for all hospitals, public and private as well as inductions, epidural rates and more.

It makes an interesting read......well, for a birth nerd like me it does.

C

[fionas]

Yes doulacara and that's fantastic that people have access to that information. But I think we need to go a couple of steps further. Firstly, we need to educate women that they can and should access this information and secondly we need to be able to access private obstetricians' caesarean rates. I'm kind of guessing here but given that public hospitals have a lower caesar rate than private ones, I imagine that the caesar rates for the obs in the particular public hospital would be similar because presumably they have the same sort of protocols and if one ob was doing vastly more caesars than another it would be noticed by the hospital management.

But, I imagine, variances between private obs are not policed by hospital management. So, for instance, the Freemasons Hospital has from memory a caesar rate of about 30% give or take a couple of per cent. My ob works at that hospital and as he is (sorry to be a broken record) the ob with the lowest caesar rate in Melbourne, I imagine his caesar rate is somewhere around 15%. I also know that Lionel Steinberg works at that hospital and he is notoriously anti-intervention too so I imagine his rate is also around 15%. Now for the Freemasons to have a 30% caesar rate that suggests to me that there are a couple of obs working there whose caesar rates are well over 30%, possibly closer to 45%. But unless you specifically ask your ob you won't know. If you just go on the hospital stats, you'd say OK, well I basically have a 1 in 3 chance whereas depending on your ob, the 'chance' may be much, much higher. Again, I don't know this for a fact but I think that's a pretty logical conclusion to draw.

The easiest way to get women more educated about birth stuff is to encourage them to look at caesar rates. That's a very simple message to put out there and it will prompt them to then start looking at the story behind the figures.

[Bathsheba]

Great post Fiona makes sense to me!

[fionas]

Thanks Bath. I can feel a letter/media release to marie claire coming on. If they can take on campaigns like better maternity leave, I think they would consider taking something like this on. I used to work in PR so once I get a bee in my bonnet, it's very hard to stop it buzzing around. Slightly off topic, I was in a very awkward situation the other day where a woman at Mothers Group was talking to another mum about the fact that she'd had a caesarean cos her pelvis was too small. Now what on earth d'you do? Hardly my place to start saying, oooh but they can't know that until you go into labour, depends on the position of the baby, pelvic scans are unreliable etc. etc. Can hardly tell the poor woman that maybe she didn't need that caesarean with its resulting long recovery. Very tricky.

[doulacara]

To kind of take this thread back to Kelly's original moan...

I agree that women should have access to OBs caesar rates, but knowing that Australia has a national caesar rate of around 30% doesn't seem to deter women from choosing obstetric care over midwifery care during pregnancy. It makes more sense to me to educate women about midwifery care. Most women do not require an obstetrician to monitor their pregnancy and birth, yet many Australian women choose a private OB and cost the commonwealth purse thousands of dollars (in the form of PHI rebates and Medicare Safety Net) for what is, IMHO, better managed by midwives. Obstetricians have put the fear of god into society surrounding birth, when the reality is that for 95% of women it is a normal and safe natural process that is best left uninterrupted.

Midwives are unsupported by this government in its refusal to subsidise insurance and provide Medicare provider status - effectively meaning that anyone who wishes to choose their own midwife must foot the entire bill themselves. Very few PHI reimburse midwifery fees and Medicare does not at all. So when an obstetrician charges a massive 'pregnancy management fee', knowing that the Medicare Safety net will fund most of it and a woman who chooses her own midwife must foot the whole bill (anywhere up to $4000) - it is easy to see why obs get the nod from women, despite those soaring caesarean rates.

The Maternity Coalition actively lobbies for one-to-one midwifery care to be available to all Australian women, not just those who can afford to pay. That's what I would be sticking my weight behind.

Just my thoughts,
C

[BellyBelly]

Yep I agree Cara, they opened up Medicare to midwives in New Zealand and the majority of women choose midwives for their care, I think only 30% choose Obs. So just goes to show you what happens when you have choice.

[BellyBelly]

Just bumping this, Melani told her story last night at the BOBB screening

What did everyone think? Melani did sooooooo well in front of all those people!!! Well done hon! *mwa*

[~Raven~]

Melani I am so sorry I missed it but I bet you did a fantastic job of telling your story!

[Haydies]

I must admit, I didn't think I would be able to do it - but I did. I guess after giving birth you really can do anything. There's no way I would have had the guts before I don't think. And I had to say, everyone made my night when they clapped as I read out my 3:05pm birth time... that just was so awesome!

Hope you're feeling better Sam - you missed out on Savannah cuddles yesterday! Doh!

[SJH]

Melani you did such an awesome job Even having heard (well, read) your birth story before I still felt a huge surge of joy when you read out your birth time! And Savannah did so well to stay up right til the end (actually, maybe that wasn't such a good thing for you!! )

[Haydies]

Haha, Savannah was SUCH a gem yesterday. Only one crying session when I was still opening up the milk bar. She was quiet the whole way home and we both fell asleep with in moments of crawling into bed after walking in the door. She is 100% what makes that horrible day worth it.

[ren]

Melani I thought you were amazing- you're a born natural public speaker. I was hooked on every word you said and your birth story was a very powerful part of the evening for me. Thank you for sharing.

[Bathsheba]

I agree completely ren

You spoke so well Melanie! I had read your story before and thoroughly enjoyed hearing it again as it was so similar to my own last birth. I was rushed in a similar way and (I think I may have mentioned it in this thread) they also told me "we could tell you that we need this delivery room for other women as we are incredibly busy today but we'll tell you that you are putting your baby at risk... he could DIE". Anyhow bubs and I made it in the end but not without emotional scars like you share. So thankyou Melanie for articulating your thoughts and experience so well last night. It's hearing stories like yours that will contribute to making a difference and bringing about change for the better!