Midwives have labelled a study that raises questions about the impacts of obstetric intervention measures as ''a big concern''.
A study into births in Australian public and private hospitals has found newborn babies have more than two times greater the odds of dying in a public hospital compared with a private one.
A major difference between public and private hospital maternity services is that private hospitals are more likely to carry out obstetric intervention measures such as inducing labour and caesareans.
Report lead author, Associate Professor Stephen Robson, said the findings raised questions about the long-held orthodoxy that increased rates of obstetric intervention such as caesareans were ''bad'' for women and their babies.
He said he hoped the study would result in people ''taking their blinkers off'' and being open to starting new research on the issue.
But Associate Professor of Midwifery and Australian College of Midwives national spokeswoman Hannah Dahlen said many other studies had shown the negative outcomes of obstetric intervention measures.
''There are at least 20 papers I can count now in the last two years that are saying the more caesareans you have, the more bleeding you have, the more times women lose their uteruses, the more babies that die in the next pregnancy,'' Professor Dahlen said.
She said the latest study did not take into account many important factors, such as obesity and low birth rate. ''Low birth weight is well known to be double in the public system,'' she said. ''You control for it when you look at adverse outcomes, because the strongest predictor of a baby dying or having adverse outcomes is a low birth rate and that should have been controlled for.''
The study examined the outcomes of almost 790,000 births over four years, using data from the National Perinatal Data Collection.
The study has been published online by the Medical Journal of Australia before the release of the Federal Government maternity services review, which may be issued as early as this week.
Professor Robson, of the Australian National University Medical School, said he hoped people did not read too much into the study.
''What we really want to say is this is an unexpected finding and I think it needs further study,'' he said.
''Using a giant database like the Australian perinatal database is in many ways a blunt instrument it has certain information, but it doesn't have detailed information about everything.
''This should prove to be a starting point. I think up to now it's been assumed higher rates of intervention are bad and when you look at the data from the real world, the opposite seems to be the case.''
Terilee Malone, of Gilmore, gave birth to 4.17kg daughter Roshonda just after noon yesterday.
Miss Malone said she chose to have her baby at a public hospital, because ''it's just as good as private''.
After a delivery lasting only 112 hours, she was happy to have had a natural birth.
''I reckon they should be all natural,'' she said.
ANU professor of obstetrics and gynaecology and senior specialist in maternal-fetal medicine at the Canberra Hospital, David Ellwood, said he believed the number of caesarean sections carried out was ''inappropriately high'', particularly in the private sector. He said the study did not take into account all of the relevant information about the differences in patients at public and private hospitals.
In the ACT, women with high-risk pregnancies and in need of specialist newborn care are referred to the high-level care centres at the Canberra Hospital.
Professor Ellwood said the fact that women transferred from the private sector as a result of pregnancy problems was not taken into account in the study.
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