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When birth becomes business: what we’re not saying about high caesarean rates
News broke this week about the retirement of Dr John Love, a well-known Perth obstetrician who has “delivered” over 10,000 babies during his long career. The tone of the reporting, particularly in this Channel 9 News segment, was overwhelmingly celebratory — portraying Dr Love as a beloved figure in maternity care, with tearful goodbyes and glowing words from staff and patients alike.
And while I absolutely acknowledge the gratitude of women who felt their lives or their babies’ lives were saved under his care, it’s vital that we don’t let heartwarming farewells overshadow some uncomfortable truths about our maternity system, particularly those of the private sector.
Dr Love has long been associated with one of the highest caesarean rate private hospitals in Western Australia. That’s not just about statistics. It can’t simply be explained by a high percentage of women having true emergency births, or by women choosing elective caesareans, as is commonly claimed. It’s a reflection of how maternity care is being managed, particularly in private hospitals, and it begs the question: how many of those caesareans were truly necessary? How many women were funnelled down a path of intervention from the start — inductions, strict timelines, “failure to progress” labels (also known as “failure to wait”), or “big baby” “small pelvis” or “too fat” warnings that ultimately led them to the operating theatre?
The high number of caesareans could also be driven by repeat caesareans, often following an initial one that may have been avoided with better support, education, and a more physiologically focused approach to birth. While some obstetricians claim that most women want a repeat caesarean, the reality is that many are never told that a VBAC is a safe and available option — nor are they fully informed of the risks associated with multiple surgical births.
While we are unable to validate exactly how many caesareans versus physiological births Dr Love has performed, what we do know is that private hospitals are not required to publicly report practitioner specific statistics, making it difficult to assess patterns or trends in individual practice. However, it was only up to a few years ago that statistics for private hospitals were available and included in the WA Mothers and Babies Report, but in more recent years, the reporting of private hospital data was discontinued. Whether due to privacy policies or pressure from increased public scrutiny, the change has raised concerns about transparency in private maternity care.
The absence of detailed, publicly available data on individual obstetricians’ caesarean rates and specific hospital statistics limits the ability to assess and compare practices comprehensively. This gap underscores the need for greater transparency and reporting in maternity care to inform expectant mothers and healthcare stakeholders effectively.
Caesareans save lives. But overuse causes harm.
We are incredibly fortunate to live in a country where medical technology can step in when birth veers into dangerous territory. A well-timed caesarean can be lifesaving. No one disputes that.
But what we do need to question — with nuance, with evidence, and with respect for both women and their care providers — is the routine use of surgical birth. When a practitioner’s caesarean rate sits well above both national and World Health Organisation (WHO) recommendations, we must ask whether this is truly about what’s safest for women and babies — or what’s easier to manage within a scheduled, medicalised model of care — which may also align with the financial structures of private healthcare.
For context, the World Health Organisation suggests that caesarean rates higher than 10–15% are not associated with reductions in maternal or newborn mortality. Yet in many private hospitals in WA (and indeed across Australia), rates hover between 40–60%, and sometimes higher. That’s not reflective of a sudden surge in complications — it’s reflective of a system that sees birth as something to control, contain and “deliver.”
Birth is not the happy side of medicine
In the Channel 9-piece, Dr Love is quoted saying that obstetrics is “the happy side of medicine.”
But birth is not — and should not be — viewed as a subset of medicine.
Pregnancy is not a pathology. Labour is not an emergency waiting to happen. Birth is a physiological process, and for the vast majority of women, it unfolds safely and powerfully when undisturbed and supported.
Of course, there are times when intervention is needed. But when that intervention becomes standard, rather than exceptional, we disempower women. We disconnect them from the process. We replace trust in the body with fear and deadlines.
We often hear women say, “My baby and I were saved by my obstetrician,” and for some, that may be absolutely true. But we must also ask how many of those situations were the result of a cascade of interventions that could have been avoided. How many of those women were unnecessarily induced or had their labour artificially augmented? How many were routinely strapped to continuous CTG monitoring, confined to the bed, on their backs, unable to move freely or instinctively in response to their labour? How many were given drugs that had an adverse effect on them and / or their baby? How many were given timelines to perform or progress? When we intervene too soon or without clear medical need, we may inadvertently create the very emergencies we claim to have saved them from. It’s time to ask not just whether women and babies were saved, but whether they truly needed rescuing in the first place.
When we “think” we are “helping” women in labour and birth, but we are “preventing” the normal hormonal process and the physiology of birth, then that is “harming” both mother and baby.
The imagery tells a deeper story
What’s also telling is what we see — and don’t see — in the news story itself. The footage shows women in operating theatres, surgical gowns, machines, cannulas and babies wrapped up like little packages. There is no footage of an undisturbed birth, women birthing in their position of choice, skin-to-skin, no mother-baby bonding and breastfeeding in those early moments that are critical for postpartum recovery and attachment. The father interviewed states how important it was to have a “happy, healthy baby” — which, of course, is a valid and shared goal.
But what about a “happy, healthy mother?”
No one mentions how essential it is for mothers to recover well physically and emotionally, to feel connected, respected, and supported — not just for their own wellbeing, but so they can care for their baby and thrive during the postpartum period. When caesarean birth becomes the norm, we must be willing to ask at what cost — physically, mentally, emotionally, and culturally.
We need a cultural shift
This is not about villainising individual obstetricians, as they are doing exactly what they are highly trained to do – surgical births. It’s about holding a mirror up to the systems and practices that shape modern birth culture. Dr Love’s career is a reflection of how we have medicalised and managed birth in ways that don’t always serve women — especially in private care models where time is money and birth is scheduled.
If a woman walks away from her birth experience feeling informed, respected, and truly part of the decision-making process — that matters. But too many women walk away with scars — physical and emotional — from births that felt rushed, coerced, or hijacked by unnecessary interventions. Others say they didn’t know any different and handed over their trust — and their power — to their care providers, and afterwards they just fell through the cracks and were left to fend for themselves.
A commonly discussed experience is the “bait and switch” — where women are given reassurance and promises of support for physiological birth during pregnancy, only to have the plan change dramatically once labour begins. This is reflected time and again in birthing groups, where women share their stories of caesareans and describe feeling traumatised — not always because of the surgery itself, but due to how they were treated, pressured, or led into the procedure without feeling fully informed or supported
And for those working within hospitals or maternity systems where coercion, manipulation, or bullying of women is happening — staying silent is not neutral. If you witness these behaviours and do nothing, you become part of the problem. Failing to speak up or intervene enables this culture to persist, leaving more women vulnerable to trauma. Whether you’re a midwife, nurse, doctor, student, or support worker, every person in the room has a responsibility to protect a woman’s autonomy, dignity, and right to informed consent. Saying “that’s just how the system is” is no longer good enough.
We can do better
So, while we can acknowledge Dr Love’s retirement from obstetrics and the thousands of babies born under his watch, let’s also acknowledge the bigger picture.
Let’s ask the hard questions:
If you adore your obstetrician, by all means take them out for coffee or send them a Christmas card — but don’t let their charm or confident reassurance be the deciding factor in your birth choices. Birth deserves more than good bedside manner; it deserves informed decision-making, evidence-based care, and respect for physiological processes.
And let’s work toward a maternity system where birth is supported, not controlled. Where interventions are used wisely, not routinely. And where women are the centre of their own birthing stories — active participants and not passive bystanders or spectators.
It’s clear from the many heartfelt comments on social media that Dr Love is well-liked and loved by many of his patients, and he appears to genuinely care about those he supports. He has continued the legacy of his father and grandfather in the field of obstetrics and gynaecology, marking three generations of service in women’s health. And while his dedication is evident, how amazing it would have been to also see more support for physiological birth throughout his career — a shift away from a predominantly medical and risk-averse obstetric mindset, and toward a more balanced model that trusts the natural process of birth. We wish Dr Love all the best as he continues his work in fertility and gynaecology, and hope that this next chapter offers opportunities to support women in a way that promotes long-term health, wellbeing and autonomy.
Additional Resources:
Stop taking offence to every little thing – it is so exhausting! | Back to Basics Birthing
https://www.facebook.com/watch/?v=994678556178615&rdid=Z8EoD6qOrD0hEAM4
https://www.health.wa.gov.au/Reports-and-publications/Western-Australias-Mothers-and-Babies
https://vickihobbs.com/choosing-a-care-provider-for-your-birth-can-be-a-daunting-task/
If you have any questions or would just like more information please don't hesitate to get in touch by clicking the button below and filling out the contact form.
Contact Vicki