A leading midwifery expert said a promising new trial that led to fewer caesarean and epidural-assisted births would be examined in an ACT review of antenatal education.
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University of Canberra professor of midwifery Deborah Davis said caesarean rates were too high across Australia and education preparing women for births in "interventionist" acute-care settings was inadequate.
"There are many ways to help reduce intervention in childbirth, including arming women with information so that they can make informed choices, pain relief choices, place of birth choices," she said.
Professor Davis said the Australian maternity system had not supported midwives to be as autonomous as they should be, meaning they did not have enough one-on-one time with pregnant women.
"That's bread and butter for midwives, getting mothers through to normal birth," she said.
Women enrolled in a two-day childcare birth course which focused on pain relief techniques had a 65 per cent lower epidural rate and a 44 per cent lower caesarean rate than women offered a standard course, a Western Sydney University study recently found.
The "complementary therapies" course taught women evidence-based pain management skills, including meditation, breathing techniques, yoga and acupressure to use during labour. The trial was based on the She Births and acupressure for labour and birth courses.
While 29 per cent of Canberra women gave birth via caesarean section in 2014-15, lower than the 33 per cent national average, Professor Davis said that was still double the rate recommended by the World Health Organisation.
More than 90 per cent of those who had a caesarean at an ACT public hospital last year had an epidural, but only 417 of the total 5195 women who went into labour had an epidural with no caesarean.
Professor Davis, who holds a joint appointment as clinical chair in midwifery with the University of Canberra and ACT Health, said epidural was a valuable tool for women and no one would suggest access to it should be discouraged.
"I do think, however, that given the right support in labour and with the right sort of preparation, many women would surprise themselves and find that other alternatives for pain management work really well (including immersion in a nice deep bath)," she said.
She cautioned about the study's sample of 176 "fairly well-off women".
The review of childbirth courses at the Centenary Hospital for Women and Children received funding approval early last month and will shape a new model.
The hospital's childbirth education manager, Christine Fowler, said women had a wide range of public pregnancy courses on offer, including one with a physiotherapist, and pain relief options and "unexpected outcomes including caesarean births" were all covered.
"During labour in the hospital setting, with midwifery care and support, women have access to and are encouraged to use exercise balls, floor mats, water immersion, mobilisation and other resources, such as Transcutaneous electrical nerve stimulation (TENs) machines," she said.
"Many women booked at the hospital also may attend 'Calm Birth' classes, pregnancy yoga and/or Pilates, or pregnancy aqua-aerobics."
QUICK FACTS
- 29 per cent of Canberra women gave birth via caesarean section in 2014-15, four percentage points less than the national average.
- Of the 5195 women who gave birth, 417 had an epidural without a C-section.
