In the last 10 years the Australian caesarean section rate has increased by 5 percent, from 28% in 2003 to 33% in 2013.*

According to the latest statistics, 29% of women in a public hospital give birth by caesarean and 43% of women in a private hospital have a caesarean section. Compare this to 1991 when the caesarean rate was 18%. A caesarean can be a life-saving operation for mother and baby, however, there are many risk factors that go with having one.

In 2015 The World Health Organisation (WHO) published a recommendation that the caesarean rate across the world should be between 10% - 15%. According to its research, the WHO found no evidence of improved outcomes for mothers and babies if the rate surpasses 15%. In fact, the procedure exposes them to increased risks of complications and injuries.

So we have to ask the question: if increasing rates of caesareans aren’t improving birth outcomes, how come 1 in 3 women will have one to give birth?

According to some of those who work in the birth industry the increasing rate of unnecessary caesareans is driven by Australia’s medically-focused maternity system. In countries where midwifery-led models of care are the norm, caesarean section rates are low or within the recommendations of the WHO. Professor Hannah Dahlen, spokesperson for the Australian College of Midwives, believes Australia could learn from these countries where c-section rates are low:

“When we look at the countries in the world that have both low caesarean section rates and excellent outcomes for mothers and babies we find three things in place: firstly, midwives are the cornerstone of care, and obstetricians are only involved where there are complications; secondly, evidence-based care is actually taken seriously; and thirdly, there are strong social policies supporting parenting in place. We could improve in all three areas in Australia”. 

While some midwives and obstetricians believe that we are treating low-risk women with high-risk care, other obstetricians argue that the rising age and greater weight of birthing women are the causes of increasing rates of caesareans. Women who are older (over 40) or obese (i.e. having a body mass index of 30+) are more likely to be treated as high-risk simply because they are in a higher risk category for pregnancy complications. These factors in turn predispose them to a caesarean. This does partially account for the increasing trend of caesarean section rates, but studies show it does not explain the remaining majority of the statistics.

While it could be the model of care, the place you choose to give birth, or age and/or lifestyle factors that increase your chances of a caesarean section, one thing is for sure: it is more important than ever to do your research and ask questions during pregnancy. If a caesarean is not what you want, take action to put in place all you can to minimise the chance of this happening. Sometimes caesareans are a medical necessity, but sometimes they may lead to unexpected outcomes and risks. Knowledge is power!

*Source: Australian Institute of Health and Welfare 2015, 'Australia’s mothers and babies 2013—in brief. Perinatal statistics series no. 31'. Cat no. PER 72. Canberra: AIHW