I was at a private maternity hospital last week and asked what
their caesar rate was.  Response: "Quite low, about 60%, it goes
up to 80% in some other clinics.  It is what the moms want."

I was appalled.  Amongst other things, surely this must impact on
the initiation and subsequent success of breastfeeding?  Would
Deena Zimmerman please keep Lactnet posted re. the epidural study
- will you be making a distinction between epidurals for caesar
and "normal" deliveries?  Please share your response to Chris
Lundberg.

What are the caesar rates in other countries?  Any studies re.
the impact on breastfeeding?  We have huge discrepancies between
what happens in public sector facilities and private clinics.

Would anyone who subscribes to the midwifery list be willing to
post this there as well?  Perhaps it has already been discussed
there.

The comment re. "It is what the moms want" made me wonder if this
is informed consent.  Does anyone have a good working definition
for "informed consent" so that health workers realise their
responsibility to fully inform?  Surely if the caesar is elective
(the mom is fully informed and chooses to have a caesar), the mom
should pay for herself and not contribute to escalation of
medical aid rates.  Am I being unreasonable?

Lynn in overserviced Johannesburg (I don't think the rest of the
country is as bad).
--
Lynn Enraght-Moony                                 [log in to unmask]
Phone: +27 11 782-4100                         Fax: +27 11 888-1086
Snail: P O Box 222, Auckland Park, Johannesburg, 2006, SOUTH AFRICA