3 March 2011

Canberra's Baby Boom forges ahead

| johnboy
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Katy Gallagher is celebrating another big bump in the number of babies being produced in Canberra.

Well, being produced up until 2008, because if the stats were too up to date it could be a dangerous thing.

The Maternal and Perinatal Health in the ACT 1999 – 2008 report is the source of the excitement.

A headline increase of 22% more births a year over the period is a substantial cause for celebration (and building more schools), but Katy also has other news from the report:

— While the majority of women who gave birth in the ACT from 1997 to 2008 had a normal birth, the proportion has decreased significantly over time (1997: 66%, 2008: 57%)

— Over the same time period, the percentage of women having a caesarean section increased significantly (1997: 20%, 2008: 30%)

— ACT women overall were significantly less likely to smoke during pregnancy than the rest of Australia
Younger women (less than 25 years) were significantly more likely to smoke than older women who gave birth.

— The smoking rate for teenage women who gave birth was nearly 50%

— The fertility rate for teenage Aboriginal and Torres Strait Islander women who gave birth in the ACT was four times higher than the rate for non-Aboriginal women

— The percentage of Aboriginal and Torres Strait Islander women who reported smoking during pregnancy increased from 41% to 49% between 2000 and 2008.

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I’m sure these loving mothers would never opt for a caesarian to avoid the pain and nastiness of labour. Same as they would never try to delay the birth to take advantage of higher baby bonus amounts kicking in on a certain date, or paid mat leave starting on a certain date. Oh wait…

an increase in maternal anxiety about potential for their bodies to be able to do what they are designed to do

I think it has more to do with the increasing general obesity/overweight factors leading to higher birthweight – it’s not as if the female pelvis is getting any bigger to compensate for the bigger heads that need to get through. And sorry, but I don’t believe women are anxious about what their bodies are capable of. The caesareans I’ve spoken to were deeply disappointed they couldn’t have a “normal” birth.

On page 21, Figure 12 clearly states “Normal birth and caesarean section trends, ACT, 1997 – 2008? with a line indicating “normal birth” and another line indicating “caesarean”.

Yes, but the totals don’t add up to 100%. If you look at Table 44 on page 53, you will see that there is an additional 12 (ish) per cent of assisted deliveries.

Anyway there is a Glossary and the term is defined on page 86:

Normal birth refers to a spontaneous cephalic vaginal birth. The term only relates to the birth method and excludes other methods of birth such as forceps, vacuum extraction or Caesarean section.

Technically, since the notes under Table 44 say that breech presentation is no longer considered in birth method, a spontanous breech vaginal birth is also a normal birth (however finding an attendant who will let you even try to have one could prove difficult). The definition should not contain the word “cephalic”.

I believe that the fact that the percentage of ‘normal’ births dropped and the caesarian rate increased (no explanation supplied) could be attributed to the increasing age of mothers in Canberra, increased rates of artificial conception in Canberra and increased levels of interstate transfers to Canberra of high risk pregnancies.

Increasing age of mothers? The report actually says “the decrease in the percentage of women having a normal birth is seen across all age groups”

Increased rates of artifical conception? Only in that there is a higher (but still low) rate of multiple births from assisted conception. Having an embryo implanted in an operating theatre doesn’t necessarily mean you have to have the baby extracted.

Increased levels of interstate transfers to Canberra of high risk pregnancies? Most of these go to TCH, not to the private hospitals where intervention and caesarean rates are highest.

I think the decrease in normal births and increase in caesarean rates reflect an increase in maternal anxiety about potential for their bodies to be able to do what they are designed to do. This is compounded when private obstetric care is dictated by the medical insurers – a classic case of the tail wagging the dog!! There is also an element of the female childbearing population who sees neither pain nor hard work as appealing or necessary parts of their life… the “too posh to push” factor which is not IME as prevalent as “oooh but I am scared something might go wrong” or “oh but the doctor thought the baby might be a bit big so suggested I think about a caesarean”.

Why on earth do they classify it as a “normal birth”?! What a vague term to be used in a report. Why not use vaginal? Are we then to assume that a caesarean is “abnormal”?

It’s not because they are sqeamish about using VAGINAL in a media release. It’s because “normal birth” includes caesareans AND assisted deliveries (ie vac extraction and/or forceps).

On page 21, Figure 12 clearly states “Normal birth and caesarean section trends, ACT, 1997 – 2008” with a line indicating “normal birth” and another line indicating “caesarean”.

Why on earth do they classify it as a “normal birth”?! What a vague term to be used in a report. Why not use vaginal? Are we then to assume that a caesarean is “abnormal”?

It’s not because they are sqeamish about using VAGINAL in a media release. It’s because “normal birth” includes caesareans AND assisted deliveries (ie vac extraction and/or forceps). Given that bureaucrats love acronyms, I would have thought they could use SVD (spontaneous vaginal delivery) which is widely used medically.

Although “spontaneous” makes it sound a lot quicker than it actually is…

Even though 57% of actual births are SVD, only 36% of births (40% public and 26% private) have spontaneous labours, ie no induction or augmentation.

Lazy I said :

Next time you’re watching the discovery channel, take note of how many animals give birth through the sunroof.

This is something i would watch. I think i need to get Foxtel back again.

smilesr said :

had a normal birth
Why on earth do they classify it as a “normal birth”?! What a vague term to be used in a report. Why not use vaginal? Are we then to assume that a caesarean is “abnormal”?

Hyper-sensitive much?

Next time you’re watching the discovery channel, take note of how many animals give birth through the sunroof.

Hospital coverage for North Canberra (Considering the population “Boom” and where it is located) is dimishing very quickly in real terms.

had a normal birth
Why on earth do they classify it as a “normal birth”?! What a vague term to be used in a report. Why not use vaginal? Are we then to assume that a caesarean is “abnormal”?

All this and no extra maternity beds created during this period, and no extra staffing levels !
Here’s to the midwives who just worked harder and longer to meet this increased demand.

I believe that the fact that the percentage of ‘normal’ births dropped and the caesarian rate increased ( no explanation supplied) could be attributed to the increasing age of mothers in Canberra, increased rates of artificial conception in Canberra and increased levels of interstate transfers to Canberra of high risk pregnancies.

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