Are we “medicalising” pregnancy?

New research casts a light on “unnecessary interventions” in pregnancy and claims they can be detrimental to women’s health.

Health experts writing for one of the world’s leading medical journals have claimed that there is global concern about the “over-use” of treatments for managing birth-related complications.

In a series arguing the case for midwife-led care published in The Lancet, researchers wrote that the consequence of this over-use is that many healthy women and newborns in high-income, middle-income and low-income countries become exposed to the adverse effects of unnecessary interventions.

The interventions mentioned by the authors included caesarian sections, episiotomy (vaginal cutting) and limited mobility (movement) during labour.

The research also suggested that in high-income countries like Australia, midwife-led units in or next to hospitals were better at generating natural births and lower levels of hormone treatment, assisted birth, caesarian birth and episiotomy than conventional labour wards.

What’s so bad about unnecessary intervention?

Lead researcher, Professor Caroline Homer, from the University of Technology, Sydney, said that under and over-use of medical interventions in pregnancy contribute to short and long-term illness for an estimated 20 million child-bearing women around the world.

“This not only affects their health and wellbeing, but may also result in their needing to pay for ongoing health-care costs, and on the ability of their families to escape poverty,” she said.

Check out these answers to common pregnancy questions >>

A woman’s right to choose intervention is the subject of much controversy. In 2011, researcher and ethicist, Dr. Leslie Cannold, author of The Abortion Myth and What, No Baby?, famously argued that there was no shame in being “too posh to push”.

“There is no hard evidence on the relative risks and benefits of caesarean delivery for non-medical reasons compared with vaginal delivery. This makes emphatic assertions by health experts that vaginal birth is safer than elective caesarean for low-risk pregnant women worth less than a hill of beans,” she wrote in the Sydney Morning Herald.

Dr. Cannold believes that women are entitled to choose their preferred birth option — just as they can choose to drink a glass of wine at dinner or choose to bottle-feed instead of breastfeed. “As long as women are making the decision freely, and on the basis of a substantial understanding of the issues, the choice belongs to them,” she wrote.

Around 30 per cent of Australian women give birth via caesarian section, and according to the World Health Organization (WHO), caesarean rates should be 10-15 per cent.

More on birth

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What is a caesarean like?
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