Tens of thousands of Australian women with low risk of birth complications are undergoing unnecessary medical interventions in private hospitals in a trend a leading midwifery expert has described as ''horrifying''.
In a landmark study of nearly 700,000 women in NSW hospitals, those giving birth privately were found to have a 20 per cent lower chance of delivering their first child through normal vaginal birth.
''The fact that these procedures which were initially life-saving are now so commonplace and do not appear to be associated with improved [baby] death rates demands close review,'' the study found. It is published today in the British Medical Journal's Open journal.
''The findings … suggest a two-tier system exists in Australia without any obvious benefit for women and babies and a level of medical over-servicing which is difficult to defend.''
A professor of midwifery and the leader of the study, Hannah Dahlen, said the women examined between 2000 and 2008 were aged between 20 and 34, were not pre-term or overdue and carried babies of a normal weight.
''We looked at the healthiest, wealthiest population possible, exploding some of the myths out there that women receiving these interventions are sicker,'' Professor Dahlen, from the University of Western Sydney, said.
While 35 per cent of women gave birth with no intervention in public hospitals, this dropped to 15 per cent in private hospitals. ''These are horrifying figures,'' Dr Dahlen said.
She rejected the idea women in private hospitals may also be more risk-averse and therefore requesting the interventions.
''A recent Queensland study surveyed women to see if those in private hospitals were more likely to request a caesarean section, but found there was no difference,'' she said.
Obstetricians highly trained in dealing with complications were overseeing the care of low-risk women, Professor Dahlen said, and they had a tendency to see all births as being risky until the baby was delivered.
''There is also strong incentive for surgeons to 'schedule in' women for induced births to make their workload and patient flow easier to manage.''
She said the intervention rates of obstetricians should be made public, for example through the government's MyHospitals website.
But senior specialist and Royal Australian and New Zealand College of Obstetricians president Rupert Sherwood said comparisons between public and private hospital births should be done in the context that they were two different groups of women with varying medical needs.
''We've always known the intervention rates are different between public and private hospitals,'' Dr Sherwood said.
''We have no idea if the women in this study were choosing interventions like caesarean sections or not because the researcher did not ask women that.''
