Australian Babies More Likely to Die in Public Hospitals
Posted by Amber Robinson at 8:00 AM on February 16, 2009
Wait… what? In news that flies in the face of conventional beliefs about public vs private hospitals and childbirth, a new study claims that the death rate for newborn babies is threefold in the public system.
In addition, women who give birth in public hospitals are also more than twice as likely to suffer tearing, or that their babies will need resuscitation.
Researchers looked at data on 790,000 births which took place over four years, and about a third were in the nation’s private hospitals.
Associate Professor Steve Robson, one of the authors of the study, said “There is often a lot of criticism in the medical press of rates of caesarean birth and rates of the induction of labour – everybody says ‘Wow they’re so much higher in private hospitals.’”
“And if you take the literature at face value … all of those things ought to up the complication rate, (but) it was lower.”
He added that says the study raises questions about the view that some in the medical fraternity hold that “increased rates of obstetric intervention are bad for women and their babies”.
The study, is to be published in the Medical Journal of Australia, and I hope it answers a few questions of mine. Such as,
1. Did the study take in to account the higher risk pregnancies and births the public system copes with? Most private hospitals will either not book in a high-risk pregnant woman or will transfer a sick or premature baby as soon as possible after birth.
2. What is the episiotomy rate as compared to the tear rate in the different hospital systems? Current wisdom seems to say that tears heal better than episiotomies, and thus epis are rarely given in public hospitals.
3. Was there any screening for socio-economic background and general health status of the participants?
I can’t wait to get my hands on it.
Amber, I’m afraid your concerns are not addressed by the article.
I read it this morning (available here: http://www.mja.com.au/public/rop/robson/rob10880_fm.html) and…
1. No. The study excluded private patients birthing in public facilities (many of whom were likely the transfers you refer to) but didn’t similarly exclude high risk women/babies who were in public facilities to begin with.
2. Apart from mentioning previous Australian evidence that rates of episiotomy are higher in private facilities in the introduction, the authors do not mention that episiotomy could entirely account for the effect observed in tears.
3.In a word, no.
Sorry state of affairs really…
Rachel