Hail Caesar - Why elective caesareansare on the rise

Pindara Private Hospital Magazine - Issue One

chaaeilsar Why the incidence of elective caesarean deliveries is on the rise. With so many women’s magazines and online forums pushing the fact that natural delivery should be the only way to go, caesareans have been getting a bad rap of late. Often accused of being ‘too posh to push’, women who elect to deliver their babies via caesarean have to contend with criticism from everyone from their own family to playgroup mums who feel it’s necessary to give their uninvited opinion on childbirth. But have you ever given thought as to why so many women are delivering via caesarean these days? Well, for some women, a caesarean delivery offers control over the birth of her baby, right down to the date and time of delivery. For others, it’s about avoiding the real or perceived risk of damage to their pelvic fl oor. Some simply have a family history of prolonged or diffi cult labour or have had previous surgery making a caesarean their safest birthing option. Pindara Private Hospital Obstetrician and Gynaecologist, Dr Andrew Cary, has been in private practice at Pindara for more than a decade, and in that time he has cared for and delivered the babies of more than 5,000 mothers. “While childbirth is incredibly safe nowadays, changing hormones and risks of blood pressure, thromboembolism and haemorrhage still make pregnancy and childbirth the highest risk period of a woman’s life,” Dr Cary says. “If everything goes well with a vaginal birth – it is great – but it is an unknown journey and for many women, the latent stage of labour can be quite a lengthy and prolonged episode. Even when the labour is progressing well, anything can happen, which is why it is so important to have good quality antenatal and intrapartum care,” he reinforces. Dr Cary understands a woman’s concerns about her pelvic fl oor following a vaginal birth. “There is no doubt the pelvic fl oor will be different after a vaginal delivery and any change will frequently be irreversible. Muscles are stretched and tearing or nerve damage can occur. In some instances, there is a risk this can cause urinary or faecal incontinence later in life. From a medical perspective a caesarean offers us control over all these unknowns,” he explains. At this point, Dr Cary emphasises, it is important not to overlook the benefi ts of vaginal delivery or to discourage a woman from choosing this as her fi rst birthing option. He goes on to point out there are several serious medical scenarios when a caesarean is the only safe option for the mother and baby - placenta praevia and breech presentations being the most common. Placenta praevia occurs when the placenta lies partially across the cervix blocking or obstructing the birth canal. The condition occurs in fi ve to ten percent of the population and the incidence seems to be higher in women who have had assisted reproduction treatment. Both the mother and baby are at high risk if labour is allowed to progress; therefore the only safe option is for a caesarean birth. A breech birth occurs in approximately four perent of all pregnancies and also exposes the woman and her baby to a high risk. The baby’s head can become impacted or caught WOMEN’S HEALTH 42 Pindara Magazine Summer - Autumn | 2014


Pindara Private Hospital Magazine - Issue One
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