THE number of childbirths by cesarean section could significantly drop if more midwives lead pregnancy care, a new study says.
The Deakin University study says a midwifery-led model - where a midwife provides continuity of care through pregnancy and childbirth - had a positive effect on reducing the number of C-sections.
About 330 babies were at Horsham's Wimmera Base Hospital in 2017 - about 31.4 per cent were birth by C-section with spontaneous labour and 29.7 per cent with induced labour.
Deakin University lead researcher Professor Alison Hutchinson said caesarean rates in Australia had grown from 31 per cent in 2006 to 34 per cent in 2016.
Professor Hutchinson said this was worrying, because C-sections without a medical reason put women and babies at a greater risk of harm.
"It's a major operation for the mother. There's the risk of infection, a lot of pain, a slower recovery and they're more likely to have challenges with breastfeeding," she said.
"Midwives use a lot of effective strategies to assist women through labour. They can really help coach and support women to birth their baby naturally using movement, positional changes and massage."
Wimmera Health Care Group obstetrician and gynecologist Dr Yakep Angue said the benefits of midwifery services were long known.
"The research is just confirmation," he said.
Dr Angue said although the midwifery services did help to reduce the number of C-section deliveries, midwives' cases were often low risk.
"Doctors tend to deal with high-risk cases - those who are unlikely to deliver naturally," he said.
He said high-risk cases included women with diabetes, obesity or high blood pressure.
Dr Angue said contrary to the belief that a natural birth was more favourable, C-sections were often safer and had benefits for the mother and baby.
"When you look overall, it is known that those who have a natural delivery might have continence issues (or) prolapse issues in later years of life," he said.
He said these risks were 10 times lower in C-section deliveries.
Dr Angue said there had been a long debate about C-section deliveries in the medical industry.
"Obstetricians are split in half and everyone has evidence," he said.
Dr Angue said despite the difference in opinions, the midwife services were indeed beneficial and the main centre of care.
"They connect very well with the patients. They tend to get a good outcome," he said.
"They see them on a much regular basis. With specialists, they get referred to us only for a short time."
Dr Angue said using midwifery services in smaller hospitals could be challenging.
"Some women have labour for 24 hours or 32 hours. A midwife can't stay through for that long. We can't meet that demand," he said. "In bigger hospitals they can meet that demand because several midwives will look after one patient and they can change over."
Dr Angue said in complicated cases, patients were often referred to bigger hospitals.
"For instance, if we have someone with diabetes, that will require a endocrinologist. The first 24 hours will be intensive care for them. There will be nurses and intensive physicians looking after them. That's when they need to go to Ballarat or Melbourne where they can be cared for," he said.
"Even in cases of placenta previa, where the placenta of the baby is in the front, deliveries can be done here - but what if they require 20 units of blood? If that happens, terrible things can occur."