For years, women have been labelled ''too posh to push'' for choosing caesarean births without medical reasons, but a controversial new study suggests they may be picking a better path for themselves and their babies.
Dr Stephen Robson, an associate professor of obstetrics at Australian National University, is recruiting 1000 pregnant women to test the long-held view that vaginal deliveries are better than caesareans for healthy women with uncomplicated pregnancies.
The study, which requires 500 women choosing a caesarean and 500 planning a vaginal birth, will look at psychological and physical outcomes for the women and their babies, including depression and breastfeeding rates.
Dr Robson said that although an estimated 10,000 Australian women chose to have caesareans each year without medical reasons, no one had ever comprehensively studied their outcomes because research tended to focus on women with problems. ''From a medical point of view, it's difficult to counsel people because no one can give a reasonable comparison of what the risks are for women who are otherwise healthy,'' he said.
Dr Robson said a study published in The Lancet in 2000, which compared caesareans with vaginal deliveries for babies in the breech position unexpectedly found that women in the caesarean group did slightly better overall than women in the vaginal group. The results left doctors around the world wondering if surgical deliveries could be better for healthy women.
''It dawned on people, what if it turns out to be safer to have a caesarean birth if you're a healthy mother? … What would that mean? How would that affect society? The topic led to great discussion at a meeting I was at recently where one cheeky guy said, 'Maybe we could do away with labour wards forever and save hundreds of millions of dollars,' '' he said.
''Depending on what we find, there is a profound sense that maybe this will lead to an unanticipated and staggering finding.''
Current research cited by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists says caesareans in healthy women may reduce the chance of injuries that lead to incontinence and difficulty with sex while also reducing the risk of their baby dying or getting cerebral palsy.
On the other hand, the college says it may slightly increase the risk of death for mothers while also increasing their risk of placenta accreta in future pregnancies - a serious complication that can cause significant blood loss. The recovery time is also longer compared with a vaginal delivery.
President of the college, Dr Rupert Sherwood, encouraged women to take part in the study.