Back in 2007, I wrote about Western Australian birthing statistics, based on the 2005 statistics that had just been released at the time.
Quite the contrary, in fact! I’m pleased to report that my worries that a skyrocketing intervention rate could continue have failed to come to pass. Instead, with a lot of hard work from mother-baby advocates, the maternity care conversation in Western Australia in the past couple of years has become more focused on how intervention rates can be reined in, though there are plenty of dissenters. Public hospitals are edging toward encouraging or at least ‘allowing’ vaginal birth after C section, which has the potential for a huge impact on C section rates, with nearly half of C sections done simply because te woman had a previous C section.
There are lots of ifs and buts and caveats on this, but it seems that our healthcare system seems to be inching toward a better understanding that More Isn’t Better, and that we haven’t yet reached the mooted runaway point with obstetric interventions.
Let’s have a look at what’s happening to some of those key intervention and mortality figures in Western Australia.
Here are the data on Caesarean section rates in Western Australia for the past three years. The increase has stopped, and C sections in fact slightly down across the board, even in private hospitals. “Elective”* C sections before labour onset have reduced particularly.
Cesarean section rate:
Private hospital C section rate:
Public/Departmental hospital C section rate:
Teaching hospital C section rate:
Percentage of women having C section who never experienced labour:
Perinatal mortality trends may disappoint the hardcore Vaginal Bypass and Dead Baby Card fans, as this decrease in C sections has coincided with a decrease in perinatal deaths:
2005: 10.1 per 1000
2006: 9.5 per 1000
2007: 8.3 per 1000
Episiotomy stats are still absurdly high. There is no evidence-based reason for this many episiotomies.
Spontaneous labour is up, and induced labours and augmentations are down:
Percent of women who went into labour spontaneously:
Augmented labours (of spontaneous labours):
Lest my enthusiasm for the arrest of runaway interventions be overwhelmingly, let’s still remember that there’s a long, long way to go yet. Fully half of women birth surgically, with episiotomy or C section, and the number of women who experience major birthing intervention is still above 75%.
Women birthing with a surgical incision (abdominal or vaginal)
Labour without augmentation and with spontaneous vaginal birth:
* In quotes because many people (mis)understand “elective” to mean “too posh to push”. Elective C sections are simply C sections planned in advance, and very, very few are due to maternal choice.