Monday, May 28, 2012

The world's news gorged on obesity hypothesis

For the record, recent research suggesting (not proving) a link between cesarean-born children and obesity in pre-school children concluded that those "delivered by caesarean section may be at increased risk of childhood obesity". 

Yet not only has this study (which found no causal link with ANY c-section type, much less maternal request in healthy pregnancies - despite the authors' statements in reports that the findings might "provide an important rationale to avoid non-medically indicated caesarean section") been reported by virtually every major news service, a large number have failed to include the words "may be".

Even TIME magazine for example wrote, "babies born by c-section are twice as likely to be obese by age 3", which is not strictly true.

Yes, women need to be fully informed of planned c-section risks, but they should be relevant and proven, not just a hypothesis born of mixed cesarean data. Please...

Thursday, May 24, 2012

BBC London interview on c-section obesity study

This evening I was interviewed by Eddie Nestor on his BBC London Drivetime programme. You can listen again here until May 31, 2012.

We were discussing the reports today about an American study citing a possible link between cesarean birth and obesity in pre-school children.

Monday, May 14, 2012

Letter published today in the British Medical Journal, titled, 'Elective caesarean has also been shown to reduce stillbirth risk'', in response to Scottish research published last week, which provided information about reducing the risk of stillbirth.

This coincides with other important news about new research about to get underway in Cambridge, led by Professor Smith. The Pregnancy Outcome Prediction Study (POPS), which aims to involve 4,500 women who, as "well as their routine ultrasound scans at 12 and 20 weeks, [they will] have blood tests, and additional research scans at 28 and 36 weeks, and when they give birth a sample of the placenta is kept and stored. Combining all this information will, Professor Smith believes, provide a clearer picture of how best to identify women at increased risk of stillbirth."

Saturday, May 12, 2012

If you don’t reach targets, collect your P45

I've just read this article in The Scotsman this morning, and while I have no evidence that this has happened with cesarean rate targets in Scotland, I do think that it's an important article to read in order to see how medical professionals can end up swayed by "an aggressively target-driven culture", and give advice that is not necessarily in the best interests of mothers and babies.

In our book, we highlight the example of a British doctor who apologises for trying to force a woman to have a natural birth, solely because of target rates (a midwife and GP intervened and he allowed a cesarean).

One member of NHS staff here says,

Another c-section refused, another baby dies

Lynn News reported the loss of Zoe and Robert Rust's son Lincoln, stillborn on July 22, 2010, and the fact that managers at Queen Elizabeth Hospital "have apologised and paid compensation... following a catalogue of errors during his birth."

The couple had wanted and requested a cesarean for Lincoln's birth because Zoe "had endured difficult births with her two older sons", but the hospital wanted Zoe to deliver him naturally. They've now been told that Lincoln’s death "was avoidable [with an] elective caesarean", but instead he was delivered stillborn by emergency caesarean section. Zoe recalls, "It seemed unbelievable to me that all this time we had been begging for a caesarean section and that request had been refused by all sorts of people and now Lincoln was dead.

I took a look at the hospital's website, and intend to contact its staff about their policy on maternal request cesareans, but interestingly, in a leaflet titled, Working with us, I found this

Friday, May 11, 2012

My interview for Toronto Star article

Journalist Andrea Gordon told me when she interviewed me a couple of weeks ago that she found our chapter, "The Day of Surgery: What Happens, Step by Step", particularly helpful when researching for her article, Caesarean section: The Star goes inside the operating room for this look at why C-section rates matter, which was published today. Here's what she says about our book:
"Pauline McDonagh Hull says while it’s a small number, women should have the right to request a planned C-section covered by health insurance. The British journalist, who opted for caesarean birth for her two children, makes the case in a new book she co-authored with Alberta obstetrician Dr. Magnus Murphy.

Wednesday, May 9, 2012

No financial incentive behind Michigan's CS rate

Researchers in the U.S. asking the question, Does medical insurance type (private vs public) influence the physician's decision to perform Caesarean delivery? concluded that "No significant disparity was found in the odds of Caesarean delivery between privately insured and Medicaid patients in Michigan after adjusting for other Caesarean risk factors. A positive disparity would have provided de facto evidence that financial incentives play a role in physician decision-making regarding Caesarean delivery."

Monday, May 7, 2012

Cost-effectiveness of saving lives with c-sections

It's a shame that it's so very often 'money talks' above all else, but if this new research on the cost-effectiveness of MORE CESAREANS in the developing world means that fewer women and babies die or are injured, then I'll certainly accept it.
Obstructed Labor and Caesarean Delivery: The Cost and Benefit of Surgical Intervention is summarized well in this article, in which lead author Blake Alkire says,

FIPO condemns Bupa over its caesarean policy

A day after my blog post about Bupa's decision to only pay for cesareans in private hospitals if the mother's life is at risk (not the baby's), the Federation of Independent Practitioner Organisations (FIPO) strongly condemned Bupa’s policy changes in this press release: "In a letter sent to obstetricians and hospitals Bupa has advised that it will no longer pay for caesarean sections unless “there is a risk to maternal life”. This contradicts the NICE guidelines, which clearly state that emergency Caesareans should be carried out not only if the life of the mother, but also if the life of the baby is in danger, or

If birth is a marathon, not everyone wants to run

Last week, I came across this article: Midwife uses marathon running principles to coach women through childbirth, and the birth-marathon comparison is something I've discussed in the past to demonstrate that while marathons can be an amazing experience for people who want to take on that challenge, it's perfectly understandable to us as a society that others would rather opt out of the challenge - and not spend a single day of their lives feeling as though they've missed out on anything.

Similarly, most women who choose to have a cesarean simply never have any desire to experience natural birth and shouldn't be criticized for this.

Tuesday, May 1, 2012

Bupa refusing to pay for life-saving emergency c-sections?

In a letter titled "Caesarian conflict", published in The Scotsman yesterday, Dr John Cameron claims that Bupa will only pay for an emergency cesarean that saves the mother's life, but not the baby's.

I'm genuinely shocked. Can this really be true? I hope not.

Here's the letter in full: