CARES Inc. aims to support women to make informed birthing choices. Because every woman’s birth journey is unique, we encourage all women to make evidence-based choices and to critically consider research in terms of its validity, credibility and relevance to one’s own personal context.
Researching your birth choices, past and present, can help you make better sense of your journey. As you explore the resources available to you, it is important to keep in mind that not everything you encounter online will be evidence-based, and that not all evidence is created equal.
While it is important to consider medical and scientific evidence when you make your decisions, it is sometimes helpful to balance this information with the more anecdotal evidence which can be obtained from other birthing women and consumer-generated, woman-centred sites.
Hearing the birth stories of others can be just as valid ‘research’ as reading studies, stats and facts. All are welcome to attend a CARES coffee morning or event to hear the experiences of other women.
If in the course of your research you come across any information about which you are unsure (whether in terms of content or voracity), we recommend you discuss this with your care provider or a trained health professional. While CARES cannot provide medical or legal advice, we can offer you ‘woman-to-woman’ advice, so please remember you are welcome to email us if you would like our support as you undertake your research.
Lastly, it is important to know when to stop researching, when to stop thinking and planning, and when to stop reading. Know that birth has its own flow and at some point you will need to surrender and trust the process.
SOME TOPICS TO GET YOU STARTED
- Benefits and risks of elective Caesarean
- Benefits and risks of elective repeat Caesarean and VBAC
- Uterine rupture and relative risks
- The use of CTG and intermittent auscultation
- The accuracy of ultrasound predictions of baby weight, foetal abnormalities and amniotic fluid index
- Breech birth
- Vaginal twin delivery
- Induction risks for planned VBAC
- Premature rupture of membranes/premature labour
- Shoulder dystocia
- Cephalopelvic disproportion (CPD)
- Placenta praevia and placental abruption
- Active birth and ‘stalled labour’
- The Sphincter Law and childbirth
- Woman-centred or ‘natural’ Caesareans
- The ‘cascade of intervention’
- The ‘estimated due date’ concept
- Delayed cord clamping
- Lotus Birth
- Unassisted birth/’freebirth’
- Guidelines, practice standards and policies relating to the birth setting and state in which you plan birth for all delivery modes
- The history of the medicalisation of childbirth
- The qualities of obstetric and continuity of midwifery care
- National benchmarks for Caesarean and VBAC
- Stats and facts about pregnancy and birth outcomes for the birth setting and state in which you plan to birth
SOME SITES TO GET YOU STARTED
- PubMed is a search engine comprising more than 21 million citations for biomedical literature from MEDLINE, life science journals, and online books. It is an excellent place to start searching for the latest research. In many cases you will be able to read a study abstract – you may need to subscribe in order to access studies in full.
- The Cochrane search engine allows access to independent, high-quality evidence for health care decision making.
- The Pregnancy Outcome Statistics Unit undertakes a state-wide monitoring of pregnancy characteristics and outcomes, obstetric problems and characteristics of perinatal care, to identify those population groups most at risk so that preventive interventions can be directed accordingly.
It is recommended that you read the most recent documents available on this page from both the Maternal, Perinatal and Infant Mortality Committee and the Pregnancy Outcome Unit. These PDFs provide up-to-date stats and facts about birth in South Australia, including information about Caesarean rates (elective, emergency, elective repeat Caesarean and more), VBAC rates, how frequently certain procedures are used and why (for example induction, CTG, assisted delivery), and much more about the recorded outcomes for women and babies across the state.
- The following is a set of statewide guidelines put out by the South Australian government – this provides information on what to expect from your care provider.
Caesarean section: antenatal preparation and postnatal care
- An SA Health publication about ‘Birth Options after Caesarean section’.
- These SA Health ‘Standards for Maternal and Neonatal Services in SA 2010’ were reviewed by the local Maternal and Neonatal Clinical Network. These include information about different models of care, levels of perinatal services in various hospitals and more. Read this document to better understand the system in which you are birthing and your place within it.
- These ‘Standards for the Management of Category One Caesarean Section in South Australia’ were developed by the SA Maternal and Neonatal Clinical Network. This document explains how different hospitals are ranked in relation to the emergency services they provide and how Category One Caesareans are managed, among other things.
- The Western Australian government website contains well-balanced information about ‘Vaginal Birth After Caesarean (VBAC)’.
- The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) college statement on ‘Planned Vaginal Birth after Caesarean Section (Trial of Labour)’ was first endorsed in and current as of July 2010 and is due for review in July 2013. C-Obs 38 ‘Planned Vaginal Birth after Caesarean Section (Trial of Labour)’ can be downloaded from here.
- The World Health Organization’s ‘Monitoring Emergency Obstetric Care’ handbook includes WHO recommendations about Caesarean section rates and obstetric practices.
‘Monitoring Emergency Obstetric Care’
- Childbirth Connection has an excellent booklet called ‘What Every Pregnant Woman Needs to Know About Cesarean Section‘ as well as many other resources on Caesarean and VBAC birth choices.
- The following booklet is about the care and treatment of women who plan or need to have a Caesarean section in the NHS in England and Wales. It explains guidance (advice) from the National Institute for Health and Clinical Excellence (NICE). While it is written for women who need to have a Caesarean section, it may also be useful for their families or carers or for anyone with an interest in Caesarean section.
This booklet provides an interesting point of comparison when read in combination with equivalent Australian documents.
The guidelines can be viewed in full here.
NICE Caesarean section guidance
- The National Perinatal Epidemiology and Statistics Unit (NPESU) is a collaborating unit of the Australian Institute of Health and Welfare (AIHW). It aims to provide information and statistics in reproductive and perinatal health. Australian Perinatal Statistics can be downloaded as PDFs from this page.
- The Women’s and Children’s Health Network has comprehensive information about ‘Next Birth After Caesarean Section’.
- Health Direct Australia has a range of resources on ‘having your baby by Caesarean section’.
- The South Australian Health and Community Services Complaints Commissioner’s site helps people – service users, carers and service providers – resolve complaints about health and community services in South Australia when a direct approach to the service provider is either unreasonable or has not succeeded.