Pregnant women to be educated on the dangers of natural birth

Doctors are considering issuing women with advice on the pros and cons of giving birth naturally, in the same way as they do for C-sections and other operations. The move follows a landmark Supreme Court case in which a woman won £5.2million after her son Sam was severely brain damaged during childbirth. Nadine Montgomery’s labour was expected to be more complicated than usual and she said that if she had been advised of the risks, she would have chosen a Caesarean section and her son, Sam, would be healthy. Her doctors said that pointing women towards C-sections was not in the ‘maternal interest’. The court ruled that Mrs Montgomery, of Lanarkshire in Scotland, should have been informed and called for an end to such ‘medical paternalism’.
The ruling is expected to apply to all births and the Royal College of Obstetricians and Gynaecologists is considering how best to provide the information. College president, Dr David Richmond, said: ‘It’s terribly sensitive and different.’
Options range from producing a leaflet to asking women to sign consent forms, although they are unlikely to be mandatory. Currently, women considering C-sections are warned of infections, blood loss and other potential problems. But they aren’t told of the risks associated with natural births, including tearing and incontinence. Some nine in ten women will either suffer a tear or need a surgical incision during labour. And one large Swedish study found that 20 years after giving birth, 40 per cent of women who had a vaginal delivery had some form of urinary incontinence, compared with 29 per cent who’d had a C-section.
Dr Bryan Beattie, an obstetrician at the University Hospital of Wales, told New Scientist magazine: ‘They have got leaflets about C-sections, yet most people opt for a vaginal birth and there are no risk leaflets for them.’
Dr Hans Peter Dietz, an Australian obstetrician who has researched how the risks of a natural birth increase with age, said that women deserve to be ‘treated like adults’ and given unbiased and accurate information. Louise Silverton, of the Royal College of Midwives, said that the risk of natural births need to be balanced against any potential harms from C-sections. These include the baby being born with breathing problems and riskier future pregnancies. A New Scientist editorial argues for the risks of all forms of childbirth to be made clear.
It states: ‘Vaginal birth is, of course, the natural end point of a pregnancy, but natural does not mean good.’
But Deborah Chippington Derrick, of the Association for Improvements in Maternity Services, said: ‘A vaginal birth is not a treatment, it’s a natural consequence of being pregnant.’
Dr Beattie said that ultimately it is up to the woman to decide which risks to take.
He said: ‘You might say to me: ‘I could cope with a wound infection if I had a C-section but I could not cope with faecal incontinence from a bad vaginal delivery.
‘You should be allowed to make that choice and you can’t if you don’t have the information.’