Cesarian rate in Switzerland 30 percent


Last week’s Migros Magazine featured an article entitled Boom des césariennes: attention danger? (C-section Boom: Danger Ahead?) and stated that the c-section/caesarian rate in Switzerland was 30% (some cantons higher some lower). Whoa, 30% I thought! That’s high! C-sections are an essential tool for obstetricians, yes, and to quote promient Obstetrician Dr. Michel Odent, caesareans are “a magnificent rescue operation” (The Caesarean, 2004), but 30% is almost every third pregnancy! Think of that, every THIRD pregnancy. Every. Third. Pregnancy. Whoa, indeed!

According to the World Health Organization, a more reasonable c-section rate is between 10-15%, 1/3 to 1/2 of the overall rate in Switzerland. That’s a big difference. WHO research has also proven that “caesarian section without medical indication increases risks of short-term adverse outcomes for mothers”. So, knowing this, clearly I started reading the Migros article with a bit of pause and wondered why they put a question mark after “attention danger” when 30% is a lot higher than what is recommended…

In any event, other than the question mark, the facts were well presented and the views of the government and the midwife responsible were clearly set out (it’s too high!). Great. Here’s the but (why is there often a ‘but’ with Migros articles?): to close, the authors chose three personal stories from three families who had had c-sections. Also a good idea, but here’s where it went awry, the three stories were all stories where the women were satisfied with their c-sections. What about those women who weren’t satisfied? Don’t they get a say? Nevermind that, were the women really happy and had good results or did they just say what they thought the author wanted them to say? And were the c-sections medically indicated? Also, what about postpartum problems? None of this was mentioned nor was whether (or not) the women profiled went on to breastfeed (or for how long).

Not only this one-sided story-telling, but also, one story stated that a THIRD c-section was performed because the mother had HAD TO, as she had had two previous c-sections (so a third was inevitable). This is a c-section MYTH. Once a c-section, always a c-section no longer holds true (The Caesarean, 2004, The Birth Book, 1998) . The incision and stitches that our talented OB/GYN surgeons perform are perfectly capable of withstanding spontaneous labour and birth (augmented or induced labour, however, is another story and in fact is contraindicated). But, now this decade-old debunked myth is in print, again, in a widely read FREE publication, so the myth once a c-section always a c-section is perpetuated. Sigh. I’m not saying that in this mother’s case a c-section was not necessary, and once again I repeat that c-sections are a surgery that I am grateful exist, what I am saying though is that the reason was likely NOT because she had had two prior c-sections, to know the real reason, we need her obstetrician/gynaecologist to say why one was performed.

Are you pregnant and your doctor thinks you will be a c-section candidate? Did you have a c-section and want to avoid one in the future? If you end up having to have a c-section, do you want to be more in control and have a better experience? All I can suggest is that you enlist an independent midwife and/or birth doula to help you learn what you need to know about YOUR personal situation. Read voraciously about labour and birth (especially relief in labour and positions for labour), about VBAC and about “family-centred caesareans”. Books that have been approved by La Leche League or are on the reading lists of Doula-certifying bodies such as ChildBirth International, DONA, CAPPA, or Childbirth Educators such as Lamaze International or Bradley Birth, are great places to start (click on the links above to get to their reading lists). Women wishing to attempt a Vaginal Birth After Caesarean (VBAC) or Home-Birth After Caesarean (HBAC) can also consult the International Cesarean Awareness Network – ICAN or VBAC.com – a women-centered, evidence-based resource .

Finally, do you want to share YOUR c-section story in our “giving birth in Switzerland guest blog series”? Think back about your birth, reflect upon it and then write up your story and submit to michellewalz[at]expatdoula.ch with MIV BLOG CONTRIBUTION in the subject line.

NOTE:
For questions about pregnancy, labour, birth and the postpartum period, contact one of the professionals listed on www,expatdoula.ch.

 

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