Caesarean section

A quarter of New Zealand women have caesarean sections (Ministry of Health, 2015). While the proportion of elective caesarean sections has increased in the last decade, the number of women having an emergency caesarean section has showed little variation over the same period (Ministry of Health, 2015). Caesarean section is more common among women aged 35 years or over and of Asian, European or ‘Other’ ethnicities (Ministry of Health, 2015).

When a caesarean section needs to be considered, the associated risks and benefits should be clearly explained and a female interpreter should always be offered when required. Health practitioners should understand that some CALD women may not want to consider a caesarean section despite explanation of the likely outcomes. This may be because of their cultural or religious beliefs. For example, Japanese women tend to view a caesarean section as posing a great burden to a postpartum woman and may prefer to avoid this intervention. In most developing countries, caesarean section is performed only as an emergency surgical procedure. Caesarean section for maternal choice alone is not funded in the New Zealand health system and is not available in District Health Boards.

Some issues regarding caesarean sections may arise for women with female genital mutilation. It should be explained that a caesarean section is not routinely performed on women with female genital mutilation. However, an elective caesarean section could be considered if it is the woman’s informed choice and her preferred way of giving birth (refer to Female Genital Mutilation section for details).

Modes of birth: practical advice
(Adapted from Queensland Health Multicultural Services, 2009)

• Provide the woman with a qualified female interpreter if needed.
• Inform the woman about the different modes of birth. Provide sufficient information about elective caesarean section, and explain the difference between elective and emergency caesarean section.
• Discuss the woman’s eligibility for these modes of birth, according to her levels of risk.
• Refer to specialists for advice regarding other issues (eg female genital mutilation).
• Discuss complications of surgical procedures.

Complications in neonatal health
(Adapted from Queensland Health Multicultural Services, 2009)

Discuss with the woman:

• Health conditions and treatments required.
• Any concerns related to her cultural or religious background (eg severe jaundice).
• If a baby needs to be admitted to intensive or special care discuss the purpose of the admission, and how the baby might benefit from the admission.
• Any questions and concerns regarding the admission.
• Care that will be provided to the baby while in the neonatal unit.
• How the woman and her partner can visit her baby.
• How the woman can help care for her baby.