Coping with complications

Press, 23 September 1980, Page 12

Coping with complications

We asked MRS RACHEL WALKER, of Christchurch, to consider both “Unnecessary Cesareans” and “Bonding” from a consumer s point of view. Mrs Walker is national president of the La Leche League. Copies of both books, which have been highly praised in North America, will be held by the Christchurch Parents 9 Centre.

If you are planning to have, a baby in the next few years you should be aware that five; out , of every 100 New. Zealand babies arrive this way by .caesarean '-p/ or about 2500 every year. These are the figures from 19701975. Strangely since then statistics have not been kept. In some areas it may be as. high as 40 per

The aim of this booklet is to help parents safely avoid, unnecessary caesareans. ■ Although written in the United States, where the rate of caesareans has tripled in 10 years to 14 per cent — and apparently not accompanied by evidence of healthier newborn babies • — the authors’ list of possible reasons for this rapid increase could well apply in New Zealand. , One of the commonest

reasons given is “pelvis too >. small — baby too big,” so it is unsettling to read of the difficulty- of estimating these sizes, and that doctors have -different, opinions. Therefore, the authors suggest, you seek a second opinion. ,: An alarming trend highlighted is the greater use of technology, such as foetal monitoring; contributing to more caesareans. It would probably come as a surprise to many that, though a previous caesa-

rian is the most common indication, many can have a normal vaginal birth after a caesareans. In the how “to avoid a caesarian” section— there are extensive check lists for different situations — when pregnant, when in labour,- breech. . . These . lists include investigating available maternity care; seeking family-centred childbirth; discussing with your doctor points such as labour positions, ' birth drugs, caesarean indica-

i tions; and making your 3 choices known. i The advice to seek those > hospitals with low caesaa .rian rates could prove too difficult here, but it could s be advisable. Stress is given to adopti ing now unconventional e labour positions such as ; standing, hands and knees ; position, and squatting, in 1 second stage, which could i encourage a normal birth, s If a caesarean is unavoii dable, useful advice on the type of incision, anaes-

thesia, achieving early bonding, and establishment of breastfeeding is include ed. This book is appropriate for the already informed and motivated, who would also value the glossary of medical terms, many references and suggestions for further reading. But it could also be used to provide the basis of a local information mutual honesty, trust, and shared decision making.” sheet made , available by the Department of Health as part of the general health education. It is certainly ideal material for those guiding antenatal programmes.