First-time mothers-to-be will accept greater
risks than clinicians for a natural birth, research suggests.
A Sydney, Australia study also found the women prepared to
accept higher pain levels, reports the British Journal of
Obstetrics and Gynaecology.
Researchers asked 102 pregnant women and 341 midwives, obstetricians
and other doctors what complications would make them choose
a Caesarean section.
The journal editor said doctors were "biased", having seen
things go wrong.
Approximately one in four pregnancies in the UK ends in a
Caesarean section, and most are offered in the face of potential
complications such as the baby lying in the wrong position
for natural birth.
But the Royal Prince Alfred Hospital study suggested that
women, given an informed choice, were less likely than the
professionals treating them to take a more cautious approach.
A total of 102 women, 84 midwives, 166 obstetricians, 12
urogynaecologists and 79 colorectal surgeons were interviewed
to find out whether different complications would prompt them
to choose a Caesarean.
Researchers asked them about mild complications such as a
prolonged birth and superficial tears to severe problems such
as anal and urinary incontinence, vaginal prolapse and severe
tearing.
In all categories, the pregnant women were far more likely
to be prepared to put up with complications in order to have
a natural birth than their midwives or doctors.
Priorities
Study author Catherine Turner said: "Our study found that
pregnant women were more likely to aim for a vaginal delivery,
and they accept a higher threshold of risks from vaginal delivery
when compared with clinicians."
Professor Philip Steer, the journal's editor in chief, said:
"This indicates that experiencing labour and attempting a
normal birth are two very important priorities in women's
decision-making.
"It may also indicate that doctors are biased by their inevitable
involvement in complex cases, or labours where things have
gone wrong."
Belinda Phipps, chief executive of the National Childbirth
Trust, agreed that health professionals could let their own
negative experiences influence the recommendations they gave
to women.
"If they've seen a traumatic birth, or been involved in a
tragedy, there is no debriefing for them.
"It can mean they are more judgemental about the risks involved."
She added: "I recognise that this is very difficult to avoid,
but they need to realise that for most women, this is something
that they feel it is important to do for themselves."
