----- Original Message -----
Sent: Sunday, September 14, 2003 12:15
AM
Subject: Re: [ozmidwifery] Term Breech
Trial
Prof Marc Keirse (editor of Effective Care) has
done quite allot of very critical critiquing of the TBT. He has
written a number of things about the failures of the TBT. I don't know
when they have been published but know that they have been published in the
Birth Perinatal Issues Journal (Blackwell science). He sent me them "for
some light reading over xmas" a few years ago....I would have to ask his
permission to send them to anyone directly, but sure you will find them in
Birth. Prof has been one of the most outspoken critics of the
TBT.
yeah, I know I was going off list, but haven't
had time yet!!
----- Original Message -----
Sent: Saturday, September 13, 2003 6:22
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!
