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'How childbirth went industrial'From: Jane Helwig, MD (jane@helwig.net)Fri Oct 13 07:45:23 2006
There is a fascinating article in the current issue (Oct. 9, cover art shows airplanes tinting Vermont's leaves autumn colors) of The New Yorker magazine by Atul Gawande, MD, on the subject of rising c/s rates and why obstetric skills such as forceps are rapidly slipping away. The gist is that it's hard to teach forceps skills and it's easy to teach c/s skills. Thus some finish residency without knowing how to do forceps safely. The remedy: concentrate on teaching residents how to do a c/s and presto! safer childbirth. As with most stories from Dr. Gawande (a general surgeon), it is an entertaining and well researched piece. He quotes extensively from Watson "Watty" Bowes, MD, professor emeritus of obstetrics at UNC, who was my adviser in medical school. One exception I noticed was Gawande's description of how a c/s is done, about delivering the baby from the uterus: "If the head is deep in the birth canal, you have to grasp the baby's waist, stand up straight, and *pull*." I haven't ever grasped a baby's waist at c/s. Is this a standard maneuver?
-- Jane Helwig, MD, FACOG Private practice, 2 MDs Lancaster, SC
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