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ACM applauds health insurers call for Medicare ban on 'harmful' early caesareans

8 April 2019

“Health insurers call for Medicare ban on 'harmful' early caesareans”, Published in Sydney Morning Herald April 1st 2019.

The Australian College of Midwives applauds Private Health Australia in drawing the federal government’s attention to early elective caesareans. The article reports that elective caesareans before 39 weeks gestation cost over $80 million a year and can potentially be harmful.

This year alone there have been three studies addressing the impact of timing of caesareans:

  • An American study involving 15,602 women was published in the Journal of Maternal-Fetal and Neonatal Medicine Journal. They concluded there was less morbidity for infants who had been born via an elective caesarean after 39 weeks then those before 39 weeks. In fact, there research said that the closer the birth was to 40 weeks, the less harm to babies.
  • A study in China published in BMC Psychiatry found that children born via an elective caesarean before 39 weeks had an increased risk of emotional and behavioural problems compared to those born via elective caesarean from 39 - 41 weeks.
  • A study from London published in the Journal of Obstetrics and Gynaecology Canada, identified the risk of respiratory morbidity for infants was significantly higher following elective caesareans before 39 weeks. This resulted in increased length of stay in hospital (and consequent cost). All these studies suggested that every day matters. “About 39 weeks” was not what they recommended. They (and numerous other studies) recommend from 39 weeks onwards.

It is due to evidence like this that the National Institute for Health and Care Excellence (NICE) state that “Pregnant women having a planned caesarean section have the procedure carried out at or after 39 weeks 0 days, unless an earlier delivery is necessary because of maternal or fetal indications.” They also state that Service Providers should ensure that systems are in place for pregnant women having a planned caesarean section to have the procedure at 39 weeks or after. “Hospital scheduling” as Dr Robson refers to in your article, should not determine the safest time for a woman to birth. Evidence should.


Additional information The Australian College of Midwives (ACM) is the peak professional body for midwives in Australia who are registered with, and regulated by, the Nursing and Midwifery Board of Australia (NMBA). The ACM’s position is that women be attended during pregnancy, birth and postnatally by a midwife who is registered with the NMBA

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