I find this trend concerning and I have a question. What was the total operative delivery rate in England 30 yrs ago? I mean the rate of high forceps, mid forceps and low forceps delivery? Or can we assume that the 96% of deliveries that did not have a c/s had a NSVD? Also, what were the mortality and morbidity stats especially on the high and mid forceps births? I am asking these questions because I was at a lecture/presentation in the last year (in the USA) where an OB defended part (and only part!!) of the higher c/s rate as being because high and mid forceps deliveries where no longer done as frequently (if at all) as they were 20-30 years ago mainly because of the poor outcomes associated with and attributed to these methods. I was also at a birth recently where the mom had progressed rapidly to complete and then stalled. We waited 3 hours at home trying various position changes and methods to stimulate labor, when there was no change in descent (-3 with caput forming) we transferred to hospital. With another 2 hrs of pitocin augmentation and no change the OB gave the mom a choice of c/s or a mid forceps with possible damage to the baby (she (OB) said skull fracture) and to the mom's coccyx (OB said it was rigid): mom chose a c/s. Baby was 6#4oz persistent OP. I only mention this because I think (but don't know) that 30 years ago this would have been a forceps delivery. So, I guess my question is: is there a corresponding decline in # of operative vaginal deliveries with rising # of cesarean deliveries or are these apples and oranges? Comments please.
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