Hi All, Thanks Lynne whereas I agree with the main theme of the inappropriateness of such a trial it is the randomisation that appears to be the major sticking point.
I would welcome a comparative trial as it would show, in my opinion without a shadow of a doubt the benefits of vaginal birth over an over employed obstetric intervention. The trial would instantly be flawed but I fear like the breech trial would become a singular point of reference to all wishing to simply advise women rather than empower women through information. We know the flaws in the touted breech trial were the location and quality of staff chosen to assist in womens pursuence of vaginal breech. The lack of familiarity or experience itself was somewhat prohibitive. Not much is made of this in the official critiques of this now perceived benchmark study and as a result women are misinformed and disempowered through a lack of information. In the case for elective caesareans this would be the same, a unit where the randomisation of women to that extent could occur is not very likely to be an actively birthing women centered unit? Now if we can only remove the messy hit or miss act of conception by a controlled trial....but then there is sometimes a lack of experience in this department too for many...LOL Love and Peace Nigel -----Original Message----- From: Lynne Staff [mailto:[EMAIL PROTECTED] Sent: Sunday, 19 October 2003 09:45 To: [EMAIL PROTECTED] Subject: Re: [ozmidwifery] C/S in Sydney Morning Herald "there is this trial which gives you a 50-50 chance of totally avoiding all this pain........" A father-to-be I saw the other day, whose wife has had 2 caesareans (and is having the devil of a time finding anyone to support her for a planned vaginal birth), made the very pertinent point that 'natural' (read vaginal) birth is ALWAYS portrayed as the worst pain a woman can ever have - too terrible to contemplate, unbearable and totally avoidable, while the portrayal of caesarean birth is ALWAYS pain-free, peaceful, smiles all round.....etc Should publish some photos/stories of infected wounds, blood loss, how women vomit when their uterus is pulled outside their abdominal cavity, because it is easier to suture, the trouble they have accessing their babies because of the physical limitation of spinals and post-op pain (although that is becoming such an art that it is very 'manageable' nowadays), babies with lacerations on their face or buttocks, babies on oxygen, sometimes for a week, and the separation that goes with that....as you can see this is a sore point with me. This trial disturbs me greatly for many reasons - but it's not just the trial (although if the findings are that women like it better, that it is as safe), then God help us! The wholehearted embracing of the findings of the term breech trial (which scares the living daylights out of me) will pale into significance compared to this (and the findings from the term breech trial will be no doubt used to substantiate the rationale of this trial in the first place........) As I see it, one of the biggest probblems is the way information is provided to the women in any 'obstetric' situation. I can imagine the way the information will be provided for this. Major heebeejeebies. ----- Original Message ----- From: "Neretlis, Bethany" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Saturday, October 18, 2003 6:38 PM Subject: RE: [ozmidwifery] C/S in Sydney Morning Herald > we have been discussing this article too, or an offshoot from perth. it seems to me to be a further automatic kneejerk reaction to litigation from those experts at strange who are from the usa. i can just see some insurance company paying for this research, and unfortunately i can even see some women being manovoured into it. can't you see some ob. finding a scared pregnant woman who is vasilating over whether she wants to suffer pain in labour and saying "there is this trial which gives you a 50-50 chance of totally avoiding all this pain........" it just makes you cry. i have run into this attitude towards vaginal birth amoung surgeons and anaethatists when i worked in theatre so its not too far a stretch of the imagination to see where this came from. just the idea of someone being serious aout this research gives me the heeijeebies. it would be sooooo immoral to do this to women. i'm sure that the researchers could somehow write it to pass an ethics board, how i don't know, but they'd get some ethics lawyer involved and before you know it , white isn't white at all, its black. > > love Bethany > > -----Original Message----- > From: Justine Caines [mailto:[EMAIL PROTECTED] > Sent: Friday, 17 October 2003 16:00 > To: OzMid List > Subject: [ozmidwifery] C/S in Sydney Morning Herald > > > Hi All > > The SMH have confirmed the following letter will appear in tomorrow's paper. > > Justine > > > As soon as safety is mentioned in obstetrics by Obstetricians there's a mad rush. > > What they neglect to inform us is that many of their practices are not based on evidence and that despite huge medical intervention, safety has not improved in Australia. In fact the latest data on maternal deaths saw an increase. This study represents a very sad fringe of the medical profession. > > A woman is 4-5 times more likely to die from a caesarean section than from a normal vaginal birth. A figure quoted in the last Senate Committee report into childbirth procedures. It is also well noted that surgical intervention in birth increases post-natal depression. With a C/S rate 2.5 times higher than the World Health Organisation recommends, high incidences of post-natal depression and no report into what seems to be a high incidence of maternal morbidity, this study would be highly unethical and a denial of a woman's most basic human right. > -- > This mailing list is sponsored by ACE Graphics. > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. 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