What you need to know. Birth interventions and how they can affect your baby.

You may have seen some news stories over the past 48 hours regarding a scientific study that was conducted and found there was an increased risk of health implications of babies born instrumentally or by caesarean. I've thought long and hard about posting anything about it as we, as Mothers, tend to get a little emotional and defensive when we hear things that imply our mode of birth could potentially have long term issues for our children.

Now taking away the sensationalist journalism surrounding this emotive topic, the fact is that around half of all caesareans in Australia are unnecessary and surely any evidence that supports the push to minimise interventions is good?

What did the study find?

* Babies who were born via an instrumental birth (forceps or ventouse) following an induction or augmentation had the highest risk of jaundice and feeding problems in the first month.

* Babies born by caesarean had higher rates of being born with lower body temperatures and needed treatment in hospital

* Children born by emergency caesarean had the highest rates of metabolic disorders such as diabetes and obesity by the age of 5

* Rates of respiratory infections, metabolic disorders and eczema were higher among children who experienced any form of birth intervention

How can a study like this help us in the future?

Firstly, we're aware of it! How many of us go through pregnancy and birth and don't know the risks involved? This gives us the knowledge to ask further questions or refuse unnecessary interventions. And secondly, it starts the conversation again for the powers that be to have a think about our current obstetric guidelines. Professor Hannah Dahlen expanded on the study here yesterday and mentioned the "recently released guidelines from the World Health Organisation (WHO) recommend ways to reduce unnecessary intervention by encouraging evidence-based clinical care. Among the recommendations are three that can be applied in Australia:

* Women should have continuity of care, where they see the same health practitioner throughout pregnancy, during the birth, and in the postnatal period. This reduces the risk of unnecessary interventions.

* Don’t intervene too early. Women progress much slower in labour than we previously thought. For 70 years, clinicians believed the cervix should dilate by 1 cm per hour. If the cervix was slower to dilate, intervention was initiated because labour was thought to have slowed. We now know labour progresses more slowly.

* Don’t use continuous electronic monitoring (CTG) to monitor the baby, unless there are significant risk factors. Instead, listen in regularly with a small, hand-held monitor. Continuous monitoring increases intervention rates for low-risk women and healthy babies without improving outcomes for babies."

Now, this is not to say intervention or caesareans should be avoided at all costs. There are times when they are absolutely necessary for the safety of Mum and/or baby. The WHO recommends the caesarean rate should be no more than 15% and with Australia's average well over 30% (and some Private hospitals around 70%) its now more important than ever for us to get informed so we can make supported and educated decisions.

You can read the full study here

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Renee Bradfield, Perth WA

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