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The value of symphyseotomy compared with caesarean section in cases of obstructed labour : Medical and anthropological considerations

By Elly Engelkes and Jos Van Roosmalen

Abstract

Caesarean section in developing countries is a relatively unsafe obstetric intervention with a maternal mortality rate of more than one percent. Scar rupture in subsequent births occurs rather frequently and women are often reluctant to undergo the operation. Symphyseotomy is described as an alternative in some cases of cephalopelvic disproportion. Maternal mortality after symphyseotomy is negligible. Morbidity after symphyseotomy as compared to post-caesarean morbidity, although different in nature, shows no difference in frequency. It fulfils the cultural need for vaginal birth, thereby avoiding implications of witchcraft and magic for the woman. It is argued that although anthropologists know much about normal childbirth, an anthropology of abnormal birth does not exist. This can be accomplished by cooperation between the two disciplines of medicine and anthropology. Research on the attitudes of women towards caesarean section as compared to symphyseotomy is suggested as a starting point for such cooperation.cephalopelvic disproportion caesarean section symphyseotomy women's attitudes medical anthropology transcultural obstetrics

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