Monday, September 12, 2005

Bless Their Hearts

A group of English midwives have designed a two-year study to see if the baby's in utero position at the time of labor has anything to do with labor length and outcomes. A few things from the article that caught my eye:

  • One of the study's organizers is quoted as saying, "One of the most common reasons why women have [a Cesarean delivery] is when they fail to progress in natural delivery, ie their cervix is not dilated enough. As midwives we believe that's due to the baby's position in the womb, but that diagnosis has never been formally made."

I did not realize that the failure-to-dilate/malposition relationship is hypothetical. I have always heard it talked about in more certain terms. When a woman doesn't dilate, it's either because the baby isn't low enough to press on the cervix and make it dilate or the baby's head isn't making complete contact with the cervix. Perhaps the midwives will find this is not so (but I doubt it!).

  • Another midwife working on the study said, "I think we've come to the point where if there are problems during labour we think 'Well we can always do a C-section'." The article reports these midwives have a Cesarean rate over 20 percent.
I find it interesting that even the midwives take the Cesarean option for granted. She talks about it not as a life-saving option of last resort but as a familiar and recognized solution to labor problems. I am again reminded of Sage Femme's client who pushed for seven hours. Name one hospital where that woman would not have had a surgical delivery.

  • Finally, the article reported that "the team - which also includes midwife Bernadette Early and the University of Central England's senior midwifery lecturer Susan Dover - urgently need extra research staff to assist them. Ms Webb added: 'We're doing this in our own time, on top of our full-time work, and we need a research midwife and a statistician to help us collate all this information and analyse it.'"
If there are medical researchers out there that can educate me on this last point, I would appreciate it. The article makes it sound like the midwives have organized and launched this study without any funding. From my time in academic institutions, I would be shocked to learn of a major research project that does not have funding. Isn't that how things work? Perhaps only in the U.S.; or not even here. This is why I'm asking for help here.

Still, it is impressive that these women took it upon themselves to learn something that might help reduce the Cesarean rate. If they have organized it without any funding, then it's all the more inspirational.

What can you do to bring down the Cesarean rate?


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