published letters

Published in The West Australian on Wednesday, October 10, 2012

The rate of caesarian sections in the private sector is a difficult issue and causality is complex. It is, however, very obvious to me as a GP that most patients who use private obstetricians end up with a section, and that the minority who do have a vaginal birth almost invariably have some sort of intervention. It is a concerning fact that obstetricians earn more when they intervene, and that they have to earn enough to pay astronomical indemnity (insurance) fees.

Obstetrics is a very difficult tightrope between watchful cautious waiting and jumping in – one I don’t choose to walk and I admire those who do. Knowing when to have the guts to hold back and wait, only intervening when really necessary, is the most admirable skill of all. Perhaps Medicare and the private funds should recognise this skill and pay the most when a labour is managed totally without intervention?

Dr Jane Ralls