A new kind of birth control, if it's convenient

SOME doctors are likely to be performing caesareans for convenience, despite the increased risks they pose for women, specialists say.

As new government figures showed only 55 per cent of Victorian women were having ''normal'' unassisted vaginal births, several obstetricians said they believed the convenience of caesareans might be contributing to rising intervention rates.

Professor Euan Wallace, Southern Health's director of obstetrics, said although the increasing age of mothers and higher levels of obesity were likely to be driving more interventions during birth, convenience for doctors could be playing a small role.

''Some commentators would say it's much easier for the doctor to do a caesarean section so he can get on the golf course, which is rubbish. But underlying that is probably some element of truth,'' he said.

''There's no question that scheduling elective caesareans makes for a more structured working week than waiting for women to go into labour on their own, but I don't think convenience for women and doctors is the major driver.''

Professor Jeremy Oats, an obstetrician who advises the state government on maternity care, also acknowledged the potential for doctors to intervene out of convenience, particularly in private practice where they juggled day and night-time work.

But other senior specialists, including Dr Rupert Sherwood, the president of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, dismissed the suggestion, saying there was no evidence doctors were doing that. ''It's not a factor,'' he said.

Dr Len Kliman, chairman of obstetrics at Epworth Freemasons Hospital, said it was insulting to suggest doctors were prioritising their schedules over patient care.

''I've spent the last 30 years of my life getting out of bed in the middle of the night … I've never ever done a caesar for convenience and I think that would apply to all of my colleagues as well,'' he said.

The debate follows a state government report showing the caesarean rate continued to rise to 31.3 per cent in 2009, up from 30.6 per cent in 2008 and 23.4 per cent in 2000. In private hospitals, only 43 per cent of women had an unassisted vaginal birth, with 39 per cent caesareans and 18 per cent involving vacuums and forceps.

In public hospitals, the caesarean rate was 28 per cent, with 60 per cent of women having an unassisted vaginal birth. Overall, 55 per cent of Victorian women had unassisted vaginal births in 2009.

Some doctors are concerned about caesareans done without good medical reasons because they increase the risk of complications, including bleeding and infection.

Mother of three Jane McIntyre, 36, said she was thrilled to have delivered twins vaginally on Monday because twins had increased her chances of a caesarean. She was not against caesareans, but believed a vaginal delivery was better for her and her babies.

From: The Age

The story A new kind of birth control, if it's convenient first appeared on The Sydney Morning Herald.

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