By Tracy G. Cassels

I bring you another installment (sadly we’re nearing the end of what I have) of the Choices in Childbirth newspaper from Ontario in the 1980s.  The current volume has some interesting discussions surrounding the then-impending legalization of midwifery, the role of the labour supporter (which makes me wonder – was Doula not a term back then?), an article raising the question of nipple shields and how they may have affected the cessation of breastfeeding too early (of which I figure they were found to be useless as I’ve never even heard of them), and one article I want to briefly discuss.  The article by Chris Sternberg on the Canadian Consensus Conference on Caesarian Section meeting that took place at that time to discuss the worrisome quadrupling of the c-section rates from 4.8% in 1968 to the then-whopping 17.9% in 1984.  The summary of the information presented at the conference should have had an impact on birthing practices.

That data?  That VBACs are not only possible but should be recommended.  That not all breech positions require a c-section and in fact most breech babies would be best birthed vaginally.  That not all cases of dystocia require a c-section and that slow progress of labour is not necessarily abnormal.  And it goes on.  One quote by a doctor sums it up perfectly when asked why it is so difficult for women in 1985 to give birth to their first baby: “We’re not as skilled in vaginal deliveries as before, and patients won’t put up with damage.”

I can’t help but wonder what happened to this information to see the c-section rate has nearly double again, putting it near 30% of births in Canada today.  Women today still struggle to find caregivers willing to allow a VBAC.  Breech vaginal births are so rare you almost never hear of them.  And over 25 years ago we had the information needed to change this path.  So tell me – what happened?