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Women Willing to Take Risks for Natural Birth

by Gopalan on Sep 1 2008 10:14 AM

Women, especially first-time mothers-to-be, tend to opt for natural birth in preference to Caesarean section, even if it means facing some risks.

That is in remarkable contrast to doctors and midwives who said Caesarean should be looked at first in times of complications.

Approximately one in four pregnancies in the UK ends in a Caesarean section, and most are offered in the face of potential problems 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 to opt for such a course.

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.

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The findings have been published in the British Journal of Obstetrics and Gynaecology.

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."

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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."

A Sydney, Australia study also found the women prepared to accept higher pain levels.

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