Throwing out the baby with the spa water?

Abstract

Australia is now one of the safest countries in the world in which to be born. This is largely a result of the many advances in obstetric and neonatal medicine of the past 50 years. However, the “medicalisation” of birth has tended to diminish women's satisfaction with their experience of childbirth. It has been shown that women are most satisfied by care from a single practitioner, and when they themselves have input into decision‐making. Although maternal satisfaction is important, it should not be promoted at the expense of the health of mothers and babies. More realistic antenatal education and preparation should be available for all pregnant women so that both maternal satisfaction and good perinatal outcomes can be achieved.

Attendance of paediatricians at elective Caesarean sections performed under regional anaesthesia: Is it warranted?

“…a paediatric registrar or consultant paediatrician) is theoretically the ‘gold standard’ of care for the newborn. However, as well as being costly, it is a logistically impossible goal and increases the ‘medicalisation’ of the birth detracting from the maternal satisfaction of their experience 1,2 . Guidelines published by the American College of Obstetrics and Gynaecology, the American Academy of Pediatrics and the American Heart Association advocate that personnel capable of initiating resuscitation should attend all deliveries 3,4 .…”

“…Australia is one of the safest countries in the world in which to be born. In recent years the perinatal mortality rate has fallen such that perinatal deaths are now a third of what they were in the early 1970s 1,17 This is largely due to the improvements in obstetric, anaesthetic and neonatal care in recent years. At the same time the incidence of CS in Australia has increased from 9.6% of deliveries in 1980–1984 to 27% of deliveries in 2002 6,17 .…”

Throwing the baby out with the spa water?

“…To the Editor: In a recent article, de Costa and Robson 1 suggest that Australia's high rates of caesarean surgery — currently among the highest in the Western world — may be beneficial, and causally related to our low perinatal mortality rate.…”

Throwing the baby out with the spa water?

“…To the Editor: The article by de Costa and Robson 1 is a timely reminder that the ideology and politics surrounding maternity services could have an adverse impact on Australia's excellent record as one of the safest countries in the world in which to be born 2 . de Costa and Robson highlighted continuity of care as the attribute of antenatal supervision and birthing that women value most highly, and they quote evidence of the safe care provided by a midwife or general practitioner in a “low‐tech” environment.…”