Watch this if you're planning on having a baby soonish...

http://news.sbs.com.au/insight/

Insight last night had a discussion about birthing and the system as is is here in Australia. A few women talked about how they were shoe-horned into a certain approach or procedure here in Asutralia, just because of the public/private system dichotomy, or the midwife vs obstetrician choice you may have to make. Well worth a look, and also features Claire Bowditch, who tried to have a home birth twice, but was thwarted, at first by the high cost (insurance), and second by having twins and feeling more comfortable in a hospital on her second delivery.

Also a lot of discussion about elective caesarians vs required ones, and the grey area in between where women are being told they need one, but aren't really sure they want to, and aren't really being given all the info they need to make an informed choice. Many first time mums go with whatever they're told has to happen, while it takes a more assertive mum-to-be to demand more information, question what they have been told, and actually seek second opinions - this is not how it should be.

Also, there isn't much flexibility to change tack part way down the process - ie to start off a preganancy with one approach (ie seeing a midwife) then switching to an Obstetrician down the track if you have a complication arise, whilst keeping your midwife on board. And there is a lack of continued care - ie obstetricians don't really know much about breastfeeding and routine neonatal issues, and you're "handed over" to local area midwives who are fantastic, but have no prior relationship to you.

I've only had 2 appointments with my Obst this pregnancy, and I chose to see an Obstetrician because of the complication I had last time, and the fact that a caesarian was flagged as a good idea by specialists after the injury I suffered giving birth. So far I haven't been given a lot of information about the complications around caesars, and much of what I know is from having talked to others who have had one, and reading Mermaidgrrrls blog.

So far our strategy is to pencil in a caesar, but have a scan at 36 weeks, see how the baby is going for size, and make a decision then. But I'm finding the idea of delivering vaginally is scarier for me still at the moment. I'm not sure if there is data on pelvis size to baby head size ratios and what the the likelihood is of another nerve injury, and there are other matters - every baby is different, mother's pelvises are more elastic second time around, girls tend to be smaller than boys, and second babies tend to be bigger etc.

But the risk to me of suffering a permanent leg injury that affects my ability to walk is getting more stressful rather than less stressful with time. And I haven't even begun to discuss the issues around the scarring I have from my last delivery either - info on this is non-existant in birthing books. I know caesars bring many complications, but perhaps it is the better option for me. After all, it will be a decision that could affect the rest of my life.... but it's not something I really want either - it's just the best option for me, I think.