Midwives support legal opinion against elective caesareans

11.45am

The College of Midwives said today it supports a legal opinion urging doctors to avoid offering pregnant women Caesarean births unless there was a good medical reason to do so.

A legal opinion by Auckland law firm Meredith Connell, released today, advises doctors not to perform elective caesareans unless there is a medical reason to do so.

"The college of midwives basically supports that view," college president Sue Bree told NZPA.

"The midwifery perspective is that birth is a normal life event and caesareans -- because they are a major abdominal operation and because they carry risk -- should be reserved for absolute medical indications (of need)."

More education was needed about birth and research should be done on why more women, about 20 per cent, were opting for caesareans.

"Pregnant women have anxieties about birth because it's such an unknown journey for them, especially their first babies.

"I don't know that we are absolutely clear about why women are electing to have caesareans.

"I don't think that fear is the only reason. I think there are many reasons that need to be explored."

She said it was normal for women to be afraid of birth but with the right support this could be managed.

Concerns could include fear of pain, ability to give birth, and damage.

"Our world is changing and we like to be a bit more in control in what is happening in our lives.

"Perhaps birth is one of those situations where we needed to surrender to the process rather than try and control it."

Medical Council chairman Tony Baird said the legal opinion needed to be discussed and risked impinging on women's rights.

He said there was no evidence that women were being coerced into the operation by doctors and before operations were done women were involved in a consent process where they were told all risks.

The council had not received any complaints from women who had caesareans they did not want.

However, Dr Baird said one legal opinion was unlikely to change the availability of the operation unless district health boards limited funding.

"The issue is much more complex than one legal opinion ...

"Women are intelligent and capable of making decisions. They don't need other people to make them for them."

The legal opinion claimed caesareans were riskier than natural births but Dr Baird said it did not contain professional research to show that natural birth could sometimes be dangerous too.

Medical Association chairman John Adams said doctors already had the power to refuse to do elective caesareans.

However, the opinion told doctors that legally the risk of saying no was less than the perceived risk of complaint or action as a result of refusing.

"It does appear to support the doctors' clinical judgment."

The council was not ready to say whether it agreed or supported the opinion.

- NZPA

Further reading
nzherald.co.nz/health