It was a tense scene on Offspring. Midway through a delivery Nina Proudman discovered the baby’s shoulder was stuck. ‘Quick, we’ve only got a few minutes,’ said Nina, played by Asher Keddie. Intensive care was on standby, another doctor was counting the passing minutes and viewers were left in no doubt that this was life-threatening.
Obviously Offspring is fictional but real-life situations like these are prompting medics to ask whether vaginal births are the best option for mothers, with risks including tearing, incontinence and damage to the baby.
For thousands of years vaginal births have been regarded as the most natural and safest option. But now experts are predicting that view could change.
‘Why is it that the vast majority of pregnant women are only being warned about the risks of Caesarean sections?’ asks Dr Mairead Black, a clinical lecturer from the University of Aberdeen.
She says while both Caesarean and vaginal births are relatively safe in high-income countries, both come with risks. She adds that Caesarean sections are becoming safer but with more women having children later, the risk of problems during labour and birth are higher.
The UK’s Royal College of Obstetricians and Gynaecologists is to discuss the current view that vaginal birth is still regarded as the default option for childbirth. They will consider whether there’s merit in discussing the risks of both delivery methods with pregnant women, prompting speculation that the same could happen in Australia. Currently we have one of the highest rates of caesarean births in the world at around 32 per cent compared with 20 per cent in New Zealand and 22 per cent in the UK.
Dr Black says just over half of first-time mothers in the UK experience an uncomplicated spontaneous vaginal birth. She points out that 21 per cent have an emergency Caesarean which is not as safe as a planned one. She also says among those who have vaginal births, eight per cent suffer a postpartum haemorrhage, one per cent have a blood transfusion and five to six per cent have a third-degree tear (40 per cent suffer some degree of tearing).
Further, a study in Sweden found that 20 years after giving birth, 40 per cent of women who had had a vaginal delivery had some form of urinary incontinence, compared with 29 per cent who’d had a C-section. Ian Milsom of the University of Gothenburg, who did the Swedish study, also believes women need to be better informed, particularly about future incontinence.
As he says: ‘There are advantages and disadvantages of both C-sections and vaginal deliveries. My aim is to do the best for the women and baby in question.
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