Fixed ideas, even if later discredited, are hard to dislodge. This is why urban legends and Internet rumors must repeatedly be quashed. Either we like what we "know" and don't care enough to be concerned about its veracity, or a new generation comes upon the outdated information and unwittingly embraces it. Or both.

This, I'm afraid is what will happen in the case of obstetrical practice. Several years ago a study (the "Term Breech Trial") led to the conclusion that it was safer for breech presentations to be delivered by Caesarean section, rather than vaginally. Consequently, this has become standard, established practice.

However, an article in the January 2006 issue of the American Journal of Obstetrics and Gynecology reports serious flaws in the Term Breech Trial, and concludes that the recommendations from that study should be withdrawn.

Most cases of neonatal death and morbidity in the term breech trial cannot be attributed to the mode of delivery. Moreover, analysis of outcome after 2 years has shown no difference between vaginal and abdominal deliveries of breech babies.

Because Caesarean sections are considered to be more convenient than vaginal deliveries (nature is so messy!), and because people seem less inclined to sue doctors for interventions than for not intervening, I don't expect to see a rise in the number of women allowed to attempt vaginal deliveries of breech babies. Nonetheless, it is important to note yet another instance of major life decisions being made on the basis of erroneous data.
Posted by sursumcorda on Wednesday, February 8, 2006 at 1:53 pm | Edit
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