Sir, – Laura Kennedy raises an important issue with regard to the promotion of natural childbirth ("The natural childbirth movement has a lot to answer for" Life, April 17th), and scepticism that medical care "has made it safe" demands close scrutiny (Letters, April 29th). The use of Caesarean section, as the name implies, dates back thousands of years, but the first known case of maternal survival was recorded late in the 16th century. The surgery was effectively a way to rescue a viable infant in the case of maternal death, which was common.
Numerous advances saw birth, and Caesarean section, become extremely safe. While data from developing countries vividly illustrate the global need for expert care during birth, perhaps it is best to focus on developed ones to assess risk in Ireland. Recently presented data from Israel presented at a meeting of the Society for Maternal-Fetal Medicine (in February) may be worth considering. Looking at about a quarter of a million births, Sheiner and colleagues found a three-fold increase in perinatal mortality in cases where birth took place outside a hospital, including scheduled home births. Maternal complications were also much more frequent. The authors note that “this study matches the findings of larger studies conducted in the United States”.
While individuals may disagree about whether stoicism in the face of pain is laudable, presumably we all agree that choices threatening children’s survival should be strongly discouraged. And whether such life-saving interventions are sought, it surely behoves a compassionate society to advocate them. – Yours, etc,
BRIAN O’BRIEN,
Kinsale, Co Cork.