Birth

 

Less natural births in private hospitals

Amelia Bloomfield
Thursday, September 13, 2012
Image: Getty

Australian women giving birth in private hospitals are 20 percent more likely to undergo medical interventions than mums who go to public hospitals.

A newly released study of nearly 700,000 NSW women with low-risk pregnancies has found that while 35 percent in public hospitals had natural vaginal births with no medical intervention, this figure dropped to 15 percent for women choosing a private hospital.

And this is a phenomenon that has increased dramatically in the past decade, according to study leader Dr Hannah Dahlen, a professor of midwifery at the University of Western Sydney.

To challenge the popular belief that women receiving interventions such as caesareans and induced labour are older or less healthy, Dr Dahlen said they specifically sought out women aged 20 to 34 with a low risk of birth complications.

With one in three babies now delivered by caesarean section in Australia, rising public health concerns over the associated risks to mother and child has led the New South Wales government to implement policy aiming to increase vaginal birth rates.

Related: Caesareans not always best for baby

Researchers noted that the cost to the taxpayer of rising interventions is also significant, with birth costs increasing by up to 50 percent once interventions were introduced among first-time low-risk mothers.

“The fact that these procedures, which were initially life saving, are now so commonplace and do not appear to be associated with improved [baby] death rates demands close review,” found the study, published this week in the British Medical Journal’s BJM Open online journal.

The marked difference in birthing experiences of women in public and private care is “potentially due to variations in the practitioners’ behaviour rather than the health of women,” concludes the study.

“The findings suggest that a two-tier system exists in Australia, without any obvious benefit for women and babies, and a level of medical over servicing which is difficult to defend.”

But the Royal Australian and New Zealand College of Obstetricians has expressed concern over the study’s findings. In a statement posted on the College’s website, president Dr Rupert Sherwood denied the notion that “low-risk women were routinely being given unnecessary obstetric care.”

Dr Sherwood called the study “an open criticism of those women who make the choice to access…one-on-one continuity of care with a specialist medical practitioner.”

He asserted that women receiving obstetric interventions were well informed about the implications. “In particular, the private hospital patient is more likely than most to have carefully researched her options prior to making choices about care,” said Dr Sherwood

“It is important that we respect the choices women make and continue our strong advocacy for the best care to be available to all women, whatever their choice of birth provider or location.”

What was your birthing experience in public or private care? Did you have any medical interventions? Share your thoughts below.

User comments
As a midwife who has worked both public and private I can say that in the public system you are given all the options and the information and allowed to make an informed choice. I am now working in the private system and am horrified how many women are having interventions "because the Dr said it was the only safe option". I am horrified by the number of women who put their trust in so called professionals who makes choices based on their preferences not that of the women, medical indication!!! One such Dr openly states the only safe way to birth a baby is via caesar!!!! It is truly horrifying at times.
I went private only because I knew I had a high chance for complications so I saved my money and went private. Not once did my doctor push for an c-cection until 10 hours later I needed emergency c-cection. Does this study take into account people like me who only went private cause we have a high chance for complication. I know of other mothers who have gone private for the some reason.
I've had children under both private and public systems. The only difference I found was that you have more choice and are way more likely to get things like pain relief and epidurals upon request in the private system where you are paying for it. If you are a public patient in the public system good luck getting anything other than gas. Apparently epidurals are only for those who can pay.
I would lime to share my experience as a first time mother..I gave birth to my son on the 20th of August,.2011..The excitement leading up to these was so overwhelming,and to mention the midwifes who were there to help me through during the birthing process..being admitted at 1am and frequently experiencing needle pain is something i still can explain up until today..My husband was there with me,the midwifes keeps on tellingme to whatever that is comfortable for me to do..so everytime I'm in pain i stand on the shower with the hot water running on my back..to me that helps alot especially with the backache..I dont even care about the doctors entering and leaving the room coming to check to me..about 10.15am on Saturday morning i told them that iam tired and could no longer standing..the midwife gently told me.."you gotta push that baby out"..and i did it at 10.48 am..all those pains and backaches was all worth it when i saw my lil angel for the first time..
Re Cristy from Sydney.. You seriously have no idea what you are talking about. C section 4 weeks early to avoid pregnancy weight?? Oh get over yourself. If you have any idea elected c sections are done in the last week leading up to the due date. Giving birth by Ceaser 4 weeks early (by choice) would be highly unlikely as baby's lungs would be too prone to problems with fluids (versus being born naturally and having the fluid 'squeezed out') I'm still unsure if I can have a natural birth in 8 weeks due to low placenta but regardless I'm choosing an elected C section at 39 weeks due to my own personal reasons which happen to be nobody's business but mine and my husbands. As for you and every other mum out there, I couldn't care less how you birth your child because it is YOUR business and no one else's. Yes my PRIVATE OB has asked me to consider natural birth and is by no means pushing me to have the Ceaser, he is simply there to inform me of MY choice. HAPPY MUM = HAPPY BABY
This topic is so contentious as it's such a deeply personal experience and preference. But I do think that giving birth, no matter which way your beautiful little person arrives into this world, if they come out healthy, then that's hopefully where the focus is during this amazing time in your life.
I gave birth to my children through the midwife-supported program at the birth centre of our local public hospital. What I liked most about this program, which includes regular pre-natal visits with a small team of midwives (one of whom will be present at the birth) is that it has been developed in recognition that it is WE - the mothers - who are giving birth, not the doctors, not the midwives, not the surgeons. My first labour was long, over 22 hours with more than half of that in the active second stage. I felt entirely supported by the midwives who, without taking over, helped me to keep moving, try different positions, breathe, etc, all the while ensuring the health of baby and me. I am so thankful to have had this experience where I was given all the time I needed, rather than being induced or whisked off. I believe there should be more rigorous questioning of the rise of intervention and a greater promotion of natural birth where there is no apparent health risk to mum or bub.
I had my boy 10 weeks ago at the Mater Mother's Private Hospital in Brisbane. It was the best experience a new Mother could have hoped for. My waters spontaneously broke before arriving at the hospital, so the only invasive thing that was done was an internal clip which was attached to my sons head so I could move around freely. I was left to my own with my husband, the Midwife would ask if I was O.K. every 30 mins and if I needed water. But that was it. She helped massage my back and directed my husband to help where he could. I birthed naturally and drug free for 4 hours and 26 mins. Because my experience was nothing short of beautiful, we will be going back to the Mater in Brisbane!
I gave birth to my children through the midwife-supported program at the birth centre of our local public hospital. What I liked most about this program, which includes regular pre-natal visits with a small team of midwives (one of whom will be present at the birth) is that it has been developed in recognition that it is WE - the mothers - who are giving birth, not the doctors, not the midwives, not the surgeons. My first labour was long, over 22 hours with more than half of that in the active second stage. I felt entirely supported by the midwives who, without taking over, helped me to keep moving, try different positions, breathe, etc, all the while ensuring the health of baby and me. I am so thankful to have had this experience where I was given all the time I needed, rather than being induced or whisked off. I believe there should be more rigorous questioning of the rise of intervention and a greater promotion of natural birth where there is no apparent health risk to mum or bub.
The study should not be touted as some smoking gun for _unwanted_ intervention because the women were never asked whether their interventions were _requested_ or not. Without this information, the stats collected on intervention is basically meaningless. It's trying to say "private hospitals will do things you don't want them to do" because there's more intervention (requested or otherwise) in them. That's simply a ridiculous claim to make. It's only half a study without that information.

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