Minimum interference in childbirth urged

Press, Volume CXV, Issue 33774, 21 February 1975, Page 5

Minimum interference in childbirth urged

(Rew Zealand Press Association) DUNEDIN, February 20. A warning against doctors interfering more than 1 necessary in the process of childbirth was sounded today by an .1 eminent British obstetrician and gynaecologist.

' The note of caution carnet . from Professor A. C. Turn-1 ’ bull. Nuffield Professor of; Obstetrics and Gynaecology at Oxford University, in an address to delegates attend-i ing the biennial conference of the Medical Association; of New Zealand in Dunedin.! Speaking on advances i

timade in recent years in the (induction and management of : labour, Professor Turnbull said that obstetricians had! developed a remarkable! (ability to control labour. These advances have sig--[nificantly reduced the deathI rate of both mothers and (children during childbirth. However, he warned that; (it was no longer a question;; of whether these advances!] be developed further.'l ;but in what way they were'i [to be used. “There is a need for a fur- i ther reappraisal of where, < doctors are going. We need I to see how little they can i interfere in labour and child-'1 birth. ! (

‘lf the same results car be achieved with very little interference, this would be much better,” Professoi Turnbull said, INQUIRY The induction and control of labour has become an isspe in Britain. Following criticism from some organisations that doctors are interfering too readily in the natural process of childbirth, a Health Department inquiry has been set up. Professor Turnbull said he was concerned at this criticism which had reached its height at a time when good results were being obtained. In the Oxford area, only one naternal death had occurred in 30,000 births, a death rate which was only one third of :he national average. However, he considered :hat the criticisms should tot be ignored. While obstetricians could expedite abour, eliminate labour pain md otherwise control childbirth, they should also ask ihemselves whether all these ichievements were necessary. He said that the full experimce of labour and childbirth was vital to some

women, but the gadgetry; ;asociated with the management of labour appeared to be acceptable both to; patients and their husbands,' who were generally reassured ■by the complex equipment 1 ‘used. In answer to a question. ' Professor Turnbull said that' ; while the ability to induce; 1 ■and accelerate labour was a ’ Igreat achievement, it could;' 'be taken too far in thisil industrialised age. 1 “It is dangerous to induce * a patient simply for the sake of convenience — there must * be a serious reason concern- ‘ ing the patient’s safety * before induction is carried * out.” <

; EMERGENCIES ■ The diagnosis and manage- • ment of emergencies in ; labour were considered by Dr E. W. Wilson of the 'Department of Obstetrics I and Gynaecology at the Otago Medical School, dur- ; ing a symposium on obsetrical emergencies. In his paper, Dr Wilson said the type of problem which occurred in labour had ‘changed during the past few ‘years, and this meant ‘changes in obstetrics. ‘ He said women tended to; have shortened labour terms' now. First-stage labour was 'seldom longer than 20 hours! ■compared with up to 40 hours when he began studying obstetrics, 13 years ago,! while the second stage of labour had been shortened so that it was virtually extinct. These changes had led to a difference in the significance of some emergencies, Dr Wilson said, but new emergencies had also been introduced. “The failure to diagnose multiple pregnancies or foetal abnormality will continue to humble obstetricians,” he said.