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Review
. 2017 Jun;67(3):157-161.
doi: 10.1007/s13224-017-0981-8. Epub 2017 Mar 18.

Can We Deliver Better?

Ajay Rane  1   2 , Jay Iyer  1   2 , Harsha Ananthram  1   2 , Thomas Currie  1
Affiliations
Review

Can We Deliver Better?

Ajay Rane et al. J Obstet Gynaecol India. 2017 Jun.

Abstract

Human childbirth has been described as an "obstetrical dilemma". Evolution favours enlargement of the foetal brain, whilst bipedal locomotion demands a reduction in pelvic breadth for improvements in biomechanical efficiency. The result of this conflict is a human pelvis incongruous with the dynamics of childbirth. Acute genital distortion at delivery can inflict lasting damage to female pelvic function. Pelvic organ prolapse, urinary, faecal incontinence and sexual dysfunction are long-term sequelae rarely discussed at antenatal care, impacting upon the expectant mother's ability to make an informed decision. The alternative option is the elective caesarean section, an abdominal incision bypassing the maladies of a vaginal delivery, although not without complications of its own. Childbirth remains an emotive event where evidence-based medicine can be disempowered, and the rising trend to "normalise" birth can disrupt care of the woman. This needs to be maintained in a healthy balance to best provide competent and safe care for women.

Keywords: Anal sphincter; Childbirth; Obstetrics; Pelvic floor; Trauma.

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Conflict of interest statement

Conflict of interest

Ajay Rane, Jay Iyer, Harsha Ananthram and Thomas Currie declare that they have no conflict of interest.

Human and Animals Rights

Ajay Rane, Jay Iyer, Harsha Ananthram and Thomas Currie declare that no human research participants were involved in composing this invited review article. Ajay Rane, Jay Iyer, Harsha Ananthram and Thomas Currie declare that no animals were involved in composing this invited review article.

Informed Consent

Ajay Rane, Jay Iyer, Harsha Ananthram and Thomas Currie declare that informed consent was not required for this invited review article as no human research participants were involved.

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