Thursday, February 26, 2009

Where cesareans are too few

Amidst talk about the increasing cesarean rates in the developed world, it is all too easy to forget the plight of women in other countries where access to cesarean surgery is dangerously low.

An article this week in the International Herald Tribune, 'Project works to improve lives scarred by childbirth injury', describes the devastating injury fistula that occurs as a result of obstructed labor during vaginal delivery.

Denise Grady writes: "If prolonged, obstructed labor often kills the baby, which may then soften enough to fit through the pelvis, so that the mother delivers a corpse. Obstructed labor can kill the mother, too, or crush her bladder, uterus and vagina between her pelvic bones and the baby's skull. The injured tissue dies, leaving a fistula: a hole that lets urine stream out constantly through the vagina. In some cases, the rectum is damaged and stool leaks out. Some women also have nerve damage in the legs."

She continues: "Fistulas are a scourge of the poor, affecting two million women and girls, mostly in sub-Saharan Africa and Asia - those who cannot get a Caesarean section or other medical help in time."

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