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The following are all critiques of the TBT , first 2 are freely
available on the web .I can email a copy of the third one off list if
required.
Cheers,
David
Banks M
(2001) Breech Birth Beyond the ‘Term Breech Trial’ ,sighted at
http://www.birthspirit.co.nz
Somerset,
D (2002) Managing term breech deliveries : Term breech trial does not provide
unequivocal evidence [Letters]
BMJ ,5
January 2002 , Volume
324(7328) p 50
Keirse M (2002) Evidence-Based Childbirth Only For Breech
Babies?
Birth ,Volume 29 Issue 1 Page 55 - March
2002
----- Original Message -----
Sent: Saturday, September 13, 2003 6:52
PM
Subject: Re: [ozmidwifery] Term Breech
Trial
I do not have the paper in front of me, but from memory
there were many concerning issues. It was a multi centered trial (121)
in a number of countries(?) with obstetricians who were said to be
experienced in breech birth. I believe that those who weren't experienced,
attended workshops to bring them "up to speed". There were many
variables eg IUGR which were not excluded and which would have had an
impact on the outcome. I believe that the "normal" hospital position for
breech delivery was used. It would be really good if someone who has
read a critique of this paper, could post the reference. Thanks,
MM
----- Original Message -----
Sent: Saturday, September 13, 2003 6:23
AM
Subject: RE: [ozmidwifery] Term Breech
Trial
From memory,
there was about a 64% induction rate alone in the TBT and I'm fairly sure
all in Western hospitals had epidurals. There were no Birth Centre,
hands-free or homebirths to compare with. All of the women were delivered in
lithomy and all had intervention. Leilah McCraken from the Birthlove website
has done a comprehensive analysis of the TBT which is worth
reading.
cheers,
Cas
I imagine that the women were in the
lithotomy position. I haven't read it for a while - can anyone tell me the
rate of epidurals the women had? Whether they were all hooked up to CTGs?
The experience of the 'accoucheurs', whether the women were able to be
upright and active? Whether they had amniotomies? How often they were
disturbed in labour? How many people (not chosen by the woman to be
there) were present for the birth? Whether there were time limits
imposed on the women? I could go on and on.....There are so many
confounding factors in any study that involves humans, thus
encoaching on human rights. Time to evolve new research paradigms
methinks, to become evidence based for humanity's sake!
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