How Did the Pandemic Influence Birth Methods in Scotland?

I've been delving into the data on childbirth methods in Scotland for 2020/21, a period marked by the challenges of Covid lockdowns. Despite the pandemic's significant impact on many aspects of maternity care, the overall methods of delivering babies remained relatively consistent. However, there was a notable shift in the statistics.

During 2020-March 2021, Scotland recorded its lowest rate of 'normal vaginal deliveries' since 1975/76, with only 51.6% of babies born through spontaneous vaginal birth. Conversely, the proportion of births by caesarean section rose to its highest ever, reaching 36.1%.

Why the Rise in Caesarean Rates?

There are many theories behind the rising caesarean rate: increased maternal age, higher maternal BMI, maternal request, previous caesarean births, and the threat of litigation. Additionally, there's a suggestion that the rise in labour inductions contributes to this trend. I found an insightful statement in a recent report:

"The view of obstetricians and midwives, and the role they play in influencing decision-making around caesarean sections, is important in understanding the variance in caesarean section rates. Studies show that clinicians' personal beliefs, perceptions of risk and safety, and clinician characteristics significantly influence these decisions."

https://www.gov.scot/publications/best-start-review-caesarean-section-rates-scotland/pages/6/

https://publichealthscotland.scot/publications/births-in-scottish-hospitals/births-in-scottish-hospitals-year-ending-31-march-2021/

Navigating Hospital Guidelines and Personal Experiences

When entering the hospital, you encounter a world of guidelines, procedures, and protocols that can vary significantly between hospitals and health boards. This variability indicates that there isn't a standardised approach to care. Midwives and doctors are human too, with unique life experiences that inevitably influence their medical practice and perception of risk.

I've worked with anesthetists who admit their view of labour and birth is skewed because they typically only see births when medical intervention is needed. They rarely witness the calm, peaceful births that occur without complications.

Parents often report receiving differing opinions on birth and baby care from various medical professionals. One doctor might say something can't be done, while another says it can. Similarly, one midwife might praise a baby's latch, while another criticises it.

I recently experienced this variability firsthand when I had a mole checked. The doctor, 98% sure it wasn't sinister, decided to remove it due to a previous patient with a similar history whose mole turned out to be problematic. His past experience influenced his decision, and his honesty allowed me to make an informed choice. Thankfully, the mole was benign.

Supporting Parents in Making Informed Choices

For parents-to-be, navigating this complex world during antenatal appointments and labour can be confusing, especially when they feel vulnerable and scared.

During a recent antenatal class, we discussed the value of birth plans. The consensus was that knowing their options and having honest conversations with hospital staff about preferences and expectations were crucial. They also acknowledged the importance of understanding how hospital protocols and medical opinions can differ.

Promoting informed choice and decision-making is at the heart of my antenatal teaching. Join The Complete Birth Prep Package

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