To view the original news clip and article, click here.
The following is my response to this news story:
Dear CBC News,
My name is Samantha Alphonso and I am a CBC news viewer/reader. I’m writing to you because I was concerned by your news story about the rate of caesarean section births in Canada, titled “Ontario Hospitals Strive to Cut C-Section Rates: C-section delivery rates under the microscope”, and which was posted online on April 20th, 2015. First of all, I would like to commend you for deciding to post a story on this topic, because I believe this topic is very important for Canadians to learn more about. However, I believe this topic could have been covered in a less biased and misogynistic manner and that is what has motivated me to write to you.
First of all, this news story did not address the most important reason why the very high rate of caesarean birth ought to be of concern to Canadian birthing families. The health costs to women and babies who are undergoing unnecessary surgical births at a historically unprecedented rate were not covered. Surgical births increase the risk of the following complications: infection, paralyzed bowel, pulmonary embolism, blood clots in mother’s legs, hemorrhage, injury to bladder/uterus/blood vessels, hysterectomy, maternal death, complications in subsequent pregnancies, the baby being cut, lower APGAR scores for baby, admittance of baby to intensive care, and persistent pulmonary hypertension in the baby. Instead, this news story focussed primarily on the financial costs of the currently high caesarean birth rate. In choosing to portray the increase financial costs of surgical births as the main reason why we as Canadians (and CBC viewers) should be concerned about the c-section rate, you have hidden the pain, suffering and increased risk of death of the Canadian women and their babies who undergo this major abdominal surgery. While financial issues are also important to consider to me and other Canadian taxpayers, I believe the health, lives and experiences of birthing women and newborn babies are more important than money. This side of the story is what deserves to be told and heard above all else.
This news story was medically biased. You selected two prominent obstetricians as “experts” to interview. Why would you assume that obstetricians, the people who are performing too many caesareans, are the people who know the most about why there are too many surgical births and how to reduce the rate of caesarean births? This is like asking Al Capone how to make Prohibition laws more effective. He may know, but why would he tell you? Furthermore, you interviewed Dr. George Arnold, as an example of a doctor who is attempting to reduce the rate of caesarean birth. Yes, he has brought the rate of surgery down from 29% to 23% in his hospital, but that still means that 23% of women are receiving caesareans in the hospital where he works. The fact that he is not a person who is motivated to institute major change, which will ultimately benefit the health and well-being of the birthing women and newborns who are cared for at Markham Stouffville Hospital, is demonstrated by your summary of his statement: “Until the budget crunch, Arnold said caregivers had no reason to question C-section rates since they were providing excellent care with good outcomes for mothers and infants.” This statement reveals that he does not even think that a 29% c-section rate is problematic. If the care was so great, why were at least 14% of birthing women receiving unnecessary surgery at Markham Stouffville Hospital? The World Health Organization recommends a c-section rate of no more than 15%. The fact that his efforts have reduced the caesarean rate, but have been ineffective at reducing the c-section rate to below the standards set by WHO, demonstrates the problem with the way that Canadian obstetricians and hospitals manage childbirth. The medical approach to birth, while it is the hegemonic model, is not the only approach. Why were there no midwives interviewed in this news story? They often have c-section rates for their clients which are much lower than those of obstetricians. Midwives are ideally suited to comment on the causes of high caesarean section rates because they are not performing c-sections themselves, do not profit from an increased c-section rate and are, in fact, working to prevent c-sections and succeeding at it.
Lastly, I wanted to point out to you the ways in which the language used in this story was deeply misogynistic and offensive to me. Throughout the entire news clip and most of the article, the bodies and choices of birthing mothers are implicated as being responsible for the increase in the rate of surgical births. The following quotations from the news clip demonstrate my argument very well: “Women who have had multiple c-sections are mostly responsible for the high [c-section] rate.” And “C-section rates are on the rise for a variety of reasons, including women having children later in life.” In fact, women are not responsible for the rise in c-section rates, nor are their “old” bodies to blame for it. The average age of Canadian mothers giving birth to their first babies in 2010 was 29.6 years old. In 1997, the average age of a first-time mother was 28.5 years old. To put this in perspective, in 1944, the average first-time mother was 29.3 years old and the lowest post-World War II average maternal age for first time mother was achieved in 1975 (26.7 years old). It is quite ignorant to say that maternal age is a major contributor to the rise in rates of surgical births! That is saying that because Canadian women are giving birth an average of one year later, it warrants an 8.5% in the c-section rate. No, the most important factor in determining how many surgeries are being performed on Canadian women is how many surgeons (in this case obstetricians) there are per capita. This is, yet another reason, why obstetricians implementing new hospital / obstetric policies should not be portrayed as the solution to the problem of there being too many c-sections being performed in Canada.
Thank you for taking the time to read and consider my concerns. It is my hope that you will consider what I have said and more thoroughly as well as sensitively explore issues relating to maternal health and caesarean births in any future news stories you choose to share with your audience.
Sincerely,
Samantha Alphonso.