Friday, January 26, 2018

Risk-benefit calculus for breech presentation

Making a decision about how to birth a breech baby involves a complex risk calculus. Women have to weigh the short- and long-term benefits to themselves, their babies, and their future pregnancies. This graphic (created for me by Lauren McClain of Better Birth Graphics) shows how planned CS for breech has affected women and their babies in the Netherlands. Verhoveen et al (2005) discuss the effects of the increase in planned CS since the Term Breech Trial, and the results show a risk trade-off.

Between 2001-2005, 8,500 women in the Netherlands had a planned CS for breech. This increase in pCS saved an estimated 19 babies, but it also led to 4 direct maternal deaths, 9 additional babies dying in future pregnancies due to the uterine scar, and 140 additional life-threatening maternal complications in future pregnancies.

Alternative version of the graphic with text embedded in the image:

1 comment:

  1. This is a very important question to examine. Why is it okay to perform a procedure that results in the deaths of three to four times the number of mothers in order to cut the number of newborn deaths in half? What are the ethical, medico-legal, and importantly cultural influences that elevate the value of the baby's life over that of the mother? That is the calculus our medical system is currently supporting.


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