Maternity ward crisis? Media crisis more like…

This blog has been swirling around in my head like a mini-cyclone for over a week. My instinct was to lash out when I first watched the Weekend Sunrise clip that I’ve included below, but common sense prevailed and I have given myself some time to rewatch it several times, analyse it and do my research. Before I continue, I invite you to first watch the following clip that aired on Channel 7 on March 20th, 2016:

Okay. So where do I start?

I love co-host Angela Cox’s opening line; “They are the war stories no one talks about — giving birth.”

Really? Who HASN’T heard a birth horror story? In fact, I would strongly argue that women are bombarded by horror stories of birth, which in turn has led to an absolute crisis of confidence for many women who approach labour with high levels of anxiety and fear. We know that fear will cause a woman to produce high levels of adrenaline (triggering the ‘fight or flight’ hormone), and conversely her Oxytocin levels will plummet, which absolutely contribute to slower, less effective uterine contractions and increased perception of pain during labour (talk about a self-fulfilling prophesy!).

Let’s also look at their banner headline; “Maternity Ward Crisis: Women are sustaining major injuries from forceps during birth.”

Let’s get a bit of statistical perspective here. According to Australia’s Mothers and Babies 2012 report (which was released in 2014), forceps delivery occurred for 4.3% of births.  When looking at instrumental deliveries, far more common are deliveries by vacuum extraction which occurred for 8.1% of women who gave birth.

In stark contrast – at 32%, Australia has one of the highest Caesarean rates in the world (although in our private hospital system that rate increases to approximately 40%) and we are only just trailing behind the United States who have a 33% Caesarean rate. This is not a statistic we should be proud of.

Sunrise in-house GP, Dr Ginni Mansberg glibly comments; “look, rates probably were a bit too high.” A BIT? Seriously? I’d hate to know what she would consider is TOO high a Caesarean rate. She goes on to say that “[Caesareans] are not completely safe, so they’re saying we should just be bringing the rates down and so we have!” she ends triumphantly.

Dr Mansberg must have access to data no one else does, because last time I checked, Australia’s Caesarean rate has not decreased at all.

Then we meet ‘expert’, Dr Karen Philip who tells viewers; “If you could have the birth as easy as possible, then go for it. We don’t have to suffer excruciating agony to be a mother.” A bit of simple Googling revealed that “Dr” Karen Phillip is not a MEDICAL doctor, let alone an obstetrician. In fact, Dr Karen Phillip doesn’t have a day of training as a birth professional whatsoever. The “Dr” comes from having a PhD in Sociology. Last time I checked, sociologists were not generally in the business of giving obstetric advice.

So what Dr Philip is really saying is; go on – have the Caesarean. Vaginal birth equals excruciating agony, so why on earth would anyone in their right mind choose that option?

And to me, THIS is the crux of the issue and why this television segment has upset me so much. Women DO have options. Many options! And believe me, they are way, way better than having major abdominal surgery or sustaining severe pelvic floor injuries.

For a start, can we please start to normalise birth? Let’s stop turning it into a pathological ticking time-bomb. Let’s inform women that they have the ability to make choices about their model of care, their choice of health care provider, choice about where they birth and most importantly, choices about HOW they birth.

Our modern hospital obstetric system is not geared to supporting normal, physiological labour and birth. It is not woman-centred and in many hospitals, not baby-centred either (currently, only two of Melbourne’s hospitals have met the criteria required to be accredited by the Baby Friendly Health Initiative).

By DocP – Own work, CC BY-SA 2.0 de,

Women need to understand how easy it is to be swept along by a cascade of interventions, that starts with an induction of labour for reasons that are often not supported by evidence-based research. That induction will likely lead to labour augmentation (artificially speeding up the labour) with the use of synthetic Oxytocin, which will increase her pain, require her to be continuously monitored which then has a massive impact on her ability to move around, change her position or use the shower or bath for natural pain relief. The end result? A woman will often end up requesting an epidural.

What do we know about epidurals?

  • Epidural use necessitates an IV, continuous fetal monitoring, and restricted mobility, and it relaxes vaginal muscles. All of these factors can prolong labour.
  • Epidural use increases the risk of instrumental delivery and may increase the risk of Caesarean.
  • Epidural use raises the risk of fever and postpartum separation to rule out infection.
  • Epidural drugs do reach your baby. Both of these factors can make breastfeeding initiation harder.

According to an article in the British Medical Journal (BMJ), “Obstetricians are increasingly choosing caesarean section when complications arise in the second stage of labour. Injury to the pelvic floor and trauma to the baby are more common after forceps delivery, but major maternal haemorrhage and separation from the baby are more common after caesarean section. Women are more likely to achieve a spontaneous vaginal delivery in a subsequent pregnancy after forceps delivery than after caesarean section.

Mamas – you don’t have to take this lying down – literally! Educate yourselves. Empower yourselves. Avoid induction unless it is absolutely necessary. Avoid having your labour sped up artificially (unless there is a damn good reason to do so).  Move around in labour, change your position frequently, use things like the shower or the bath, heat packs, a TENS machine and birth balls for comfort and pain relief. Try and avoid pharmacological forms of pain relief if you can.

When it comes to the second stage of labour (the pushing stage), don’t lie flat on your back (or worse, with your feet up in stirrups). Adopt upright or forward-leaning positions. Lean over the back of your bed, stand up, squat, use your bed or a mat to be on all-fours, or lie in a side-lying position. All of these positions will either encourage gravity to do its thing, or encourage the pelvis to open as widely as possible, thus facilitating an easier – and often faster – delivery of your baby.

And let’s not forget about the critical role of partners in labour. At the end of the segment, the co-host recalls the birth of his two children. “[Partners] feel dreadfully inadequate” he says. I only wish he had come along to my Lamaze course when he and his wife were expecting! Partners need to feel informed and empowered too.

Channel 7, you should be ashamed of yourself for broadcasting such a piece of sensationalist rubbish, lacking in any journalistic integrity whatsoever. The mass media has done so much damage by perpetuating the myth the labour is a life-threatening emergency waiting to happen. Why not use your power for good for a change and feature some positive birth stories? At the very least, please call on experts who are actually qualified to comment.