Western Australian birth statistics.

Western Australian birthing statistics

These are stats for 2005. In other words, there’s a good chance things are actually worse right now in terms of overuse of interventions.

C section rate 33.9%. This is rising dramatically. In 1991, it was 18.5%. In 2004, it was 32.4%. At the 2005 rate of increase, it may hit 40% by around 2008.

The rise in C section rate since 1991 has seen no corresponding increase in the proportion of livebirths. Perinatal mortality has barely improved, from 11 per 1000 perinatal death rate to 10.1 per 1000. (The biggest change occurred in 1997, with a drop to 9.3 per 1000, though the statistical significance of these changes is likely to be questionable at best.)

In births occurring in private hospitals, the C section rate skyrockets to 45.7%, though they deal with a wealthier, healthier population, and typically turf very preterm or complicated births to tertiary hospitals. In a hospital with a teaching department, which often deals with disadvantaged populations but is perhaps a little more likely to provide evidence-based care, the rate drops to 27.9%.

65% of women who had a C section never experienced labour.

17.8% of birthing women had their vagina cut open.

49.4% of women went into labour spontaneously. 28.6% of pregnant women had their labours induced.

Only 22.7% of women laboured without augmentation and had a spontaneous vaginal birth.

In other words, more than THREE IN EVERY FOUR births was profoundly interfered with. Over 50% of women had their bodies cut open with a scalpel or scissors at the time of birthing.

Can anyone seriously look at these statistics and pretend we don’t have a problem?

Who here thinks that fewer than a quarter of women can birth safely?

Categories: gender & feminism, health, violence

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20 replies

  1. In industries where paid parental leave is available, it’s generally for the “primary care giver”. My information is purely anecdotal, but: in some industries there seems to be an increasing trend for C sections with the result that the mother is certified to be unable to care for the new-born, allowing the (usually higher-paid) father to access the paid parental leave.

  2. No, it’s utterly screwed. Utterly utterly screwed. Of course there is a problem. And of course it’s not that fewer of a quarter of women can birth properly.
    And it’s nice to see the issue getting some feminist attention.

  3. That the rate of C-section has nearly doubled since 1991 particularly stands out. It’s not possible that women’s physical birthing needs could have changed so much in such a short time: there are obviously social pressures.
    I hadn’t considered the possibility that draco offers, but obviously if people are desparate enough to go for major abdominal surgery in order to have both parents on leave for the newborn period there’s a strong need for a more comprehensive parental leave system.

  4. Birthing is such an interesting topic and not as popular in feminist forums as I think it should be. Although birthing trends have changed drastically throughout the past couple hundred years, there is one glaring consistency: to remove the mother’s efforts and awareness from the process. Starting in Victorian culture, and I’m sure well before that, women have been visually shielded, anesthetized, drugged in many ways and cut open here and there. In the 1950’s and 60’s the trend was to have a “twilight birth” – I think that’s the term – wherein women were anesthetized to the point of unconsciousness during labor. We cringe at the thought of this now, but is it much different than having a nerve-block and your baby cut out of you when it is not medically necessary? The myriad of psychological and physiological stages that occur during labor are all critical for the health and well-being of both the mother and baby.
    Of course I realize that C-sections are medically necessary sometimes and it is a wonderful thing that women don’t routinely die from childbirth (in Industrialized cultures anyway), but women in general need to put themselves back into the birth process.

  5. Becky, I agree with the general thrust of your post. I’m struck by your use of the passive voice, and I think it would be interesting to try to re-cast it in the active voice and put back the agents.

  6. Maybe I used the passive voice because I’ve never given birth and feel slightly guilty passing judgment on those who have, but have done it in a way I don’t necessarily approve of. How’s this: We women need to take back our labor. We need to scream and push and experience all the horrible and wonderful things associated with giving birth to a new life! And we certainly shouldn’t let anyone, especially men or our insurance company, tell us how and under what circumstances to push our babies out! – wow, you’re right, that’s much better!
    A sidenote on the insurance company bit. I have been told by my fiancee, whose mother is a general practitioner who occasionally delivers babies, that hospitals and and insurance companies sometimes prefer that women have C-sections because there is less risk of something “going wrong” – plus it can be scheduled for normal business hours. Isn’t it nicer to have a baby between 8-5 rather than in the middle of the night?

  7. Ah, that wasn’t what I meant, Becky! You said “women have been visually shielded, anesthetized, drugged in many ways and cut open here and there.” – Women weren’t the ones doing that to themselves.
    Saying that the primary problem is that women have been “letting other people tell us what to do” places the blame squarely on women instead of where it belongs. (Have you read this? It explains a bit more clearly where I’m coming from.)

  8. In industries where paid parental leave is available, it’s generally for the “primary care giver”. My information is purely anecdotal, but: in some industries there seems to be an increasing trend for C sections with the result that the mother is certified to be unable to care for the new-born, allowing the (usually higher-paid) father to access the paid parental leave.

    This is why I specify “maternity leave” and not “parental leave” when I’m talking about birthing & breastfeeding. Parental leave is for a child to have an adult carer. Maternity leave is for rest and preparation for birth; birthing; recovery from birth; and the establishment of a breastfeeding relationship. They’re not interchangeable.

  9. Lauredhel- You’ll have to excuse me, I’m a scientist, definitely not an English major! That was definitely my point that women have NOT been in control of their own births and this has been largely the decision of men. I certainly didn’t mean to imply that women were passively going along with those things. Although, I know a LOT of women who are scheduling their own C-sections for ease, convenience, lots of reasons. Although this is their decision, obviously they are influenced by the prevelence and preceived “ease” of C-sections. Unfortunately, I don’t think enough doctors discourage this practice, they probably encourage actually.
    On the topic of parental vs. maternity leave, I have noticed this recently. I have been looking for jobs, and employers usually list benefits and health packages for potential employees. I was shocked a couple times to see a category for “health-related leave” for up to 2 weeks for illness or parental leave including either birth of children or adoption. There was NO different category for maternity leave specifically. That implied to me that a man can have just as much time for leave as his wife/girlfriend when they have a child. It is also shocking that they provided only 2 weeks. I couldn’t believe it. I actually got into a discussion on another blog about this topic and someone pointed out that some law passed requires employers to provide “up to 12 weeks” for maternity or sick leave. I think the phrasing UP To is very important. Its a sad state of things.

  10. “That implied to me that a man can have just as much time for leave as his wife/girlfriend when they have a child.”
    Um, why shouldn’t both parents be entitled to leave?

  11. Um, because a woman needs to take time off before and more time off after due to physical recovery and nursing. More and more, I have seen that women aren’t able to take any time off before, unless they are required to because of doctor’s orders. When they are in their most exhausted and uncomfortable, women work through until the day they deliver. I agree that both men and women need to bond with the child, but women need more time to recover, especially if the birth didn’t go perfectly or if they had a C-section. Also, women who make the good decision to breast feed need to be there to feed their child every few hours, which makes going to work quite inconvenient.
    I think both parents should be entitled to leave, but due to the biology of it, women just require more time, and it shouldn’t be seen as “sexist” to give it to them.

  12. Yes, there should be more of a distinction made between birth leave and parental leave. Both parents need parental leave, only mothers need birth leave.

  13. To nitpick, I’d go with “maternity leave” over (or as well as) “birth leave”. Breastfeeding gets ignored quite enough as it is. There is definitely a need for a decently long period for mother and infant to establish a breastfeeding relationship. Not all babies can or will feed from artificial devices and still take the breast, not all mothers can pump readily even with decent workplace accommodations, and not all workplaces can accommodate babies (though many more could than currently do).
    There are also special needs that involve no births, like adoptive mothers establishing breastfeeding. If we’re going to shift the focus away from breastfeeding for a short few months and toward breastfeeding to WHO recommendations, the leave situation has got to change.
    Whether this should be limited to one partner could be a point that detractors will seize on, though I doubt it; it’s going to be an issues only in a miniscule minority of families (where a lesbian/poly partner also feeds the baby), and maternity leave could readily be required to be divided between the partners in that case.

  14. Holy Cow! I wonder if I can get the stats for NSW. Makes homebirth look more and more attractive.

  15. Why do you think this is a problem?
    Yes surely not all these interventions were necessary. But perhaps some of them were desired. By women who made an active choice.
    Women choose to have (some) elective caesarians (elective may mean planned but medically recommended, eg, Triplets, breech). Women can choose to have home births or go to a birth centre, or to go to a labour ward in a hospital and have drugs. We can during labour decline an epidural (you have to sign a consent form to get one). We can decline augmentation and choose to continue to labour for longer.
    It’s not fair to judge women who make these choices because they don’t want to experience pain or because they are concerned about the outcomes for their baby (these aren’t just feminist issues, discomfort with pain is a broader social issue as is changing perception and tolerance of risk esp. medical risk)
    Today (not the 1950’s!) women *are* in control of their own births. We can choose to homebirth after all. And if a woman decides to pass responsibility for decision making during birth or beforehand onto a member of the medical profession, that is also a choice, and a valid one.
    What is a feminist issue is that way that “mothers” become social property. What we eat and drink in pregnancy is depicted as a moral issue (smoke, drink in pregnancy = social condemnation). How we choose to give birth is viewed through a moral lens (it is better or higher somehow to have laboured in pain and naturally? Why? Why are you outraged by these statistics?). And social pressure faced in child-rearing reinforces that, as mothers, women are socially constructed beings with a more limited range of freedoms, because of our social role in raising the next generation.
    My body, my labour, my choice. My epidural, my oxytocin drip, my caesarian.

  16. Miriam, clearly I have not explained myself well, or perhaps you’ve not read anything I’ve written before on birthing.
    I work in this field. I have worked in obstetrics, in general practice, with mothers, for a long long time. I KNOW that huge numbers of women are not given the opportunity to make informed choices around birthing. Perhaps you were – if so, you are speaking from a position of extreme privilege in this respect, and recognising that would go a long way toward understanding where I am coming from.
    It is a fundamental feminist principle that patriarchal control over women’s bodies is a major problem for women, and that the pathologisation of normal physiological processes has been a tool used over the centuries to exert power over women.
    Women are coerced and deprived of informed choice at every step of the way along a birthing journey. Escaping the coercion generally takes either a fairly rare stroke of luck, or a tooth-and-nail fight for basic human rights. Women are instructed that C section, even for no medical indication is the way to “escape” pain (this is an astonishing and bald-faced lie), that it is safer (again an outright lie), that it is easier and more convenient, that it reduces the risk of urinary incontinence. Women are told they MUST have a C section purely because the obstetrician thinks they have a ‘big baby’, or because they have a breech presentation or twins. They are offered (pushed) C sections for “indications” like maternal diabetes or failed non-medically-indicated induction of labour or (insert long list here). They are told that they must have a C section if they’ve had one before, and they are often flatly denied the choice to have a vaginal birth after C section.
    Once in labour, it all gets worse – women are strapped down with monitors, positioned on their backs, subjected to frequent vaginal examinations, all for no medical reason and all with a host of possible adverse events about which they are almost never informed. If you’re informed about birthing, you know about the cascade of interventions and “failure to wait” C sections in which the “dead baby card” is played over and over and over.
    Going to the extreme, there are obstetricians with a near 100% C section rate. There are obstetricians who insist a woman sign a “consent form” for vaginal birth, because it is so “dangerous”. There are obstetricians who say “nothing good happens after 38 weeks”, and induce or section all their patients at that time.
    Then there is birthrape, which is experienced by a large number of women and almost never recognised or picked up on by healthcare providers; talking about it is taboo. By “rape”, I mean coerced or even forced vaginal penetration by fingers or an instrument in labour; not the same as PIV rape, but still literally rape, and experienced as such by women. I have, I am sorry to say, seen this happen more than once, and never stepped in to do anything about it. I am glad I know better now, though the guilt is strong. Read this by Navelgazing Midwife, please. This very accurately reflects my personal experiences, things I have witnessed occurring with my own eyes.
    You also seem to think that women have ready access to homebirthing and birth centres. This is not the case for many, many women in Australia. If you are agitating for better access to homebirths and birth centres, I salute you.
    If you made a completely informed and decision to birth in the way you did, from a position of social power – great, whatever. That’s none of my business, and I have no interest in legislating away your right to do that. Please recognise your own privilege in this respect and spare a moment to think about the enormous number of women who are denied this choice, and the reasons why.

  17. I totally agree that the cases of intervention and c-section are alarming and disturbing. Some women may feel they have made an informed decicion based on the hospitals often one sided information, that they present to suit their own policies. If more women knew the risks they are taking and stress they are putting their babies under I’m sure the intervention rates would be lower.
    I did heaps of research and found that homebirth was the best option for me, I had a wonderful first birth and can’t imagine going to a hospital or having anyone interferring with my future births.
    I am horrified at the number of c-sections I hear about, I know of 8 people who have had babies in the last month. 6 were c-sections, one was vacume delivery, and the other was a completly normal planned homebirth…clearly that says something about the hospital system, I really wonder why women are being told they can’t birth their babies normally when that is what our bodies are designed to do!
    I’m really hoping the government wakes up to this with the Maternity health services review they are doing at the moment…it would really help us out if we didn’t have to use most of the baby bonus to fund our birth choice.


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