I really appreciated Katherine Dettwyler's clarification on the
implications of stunting vs. being genetically short on the size of the
pelvic outlet. I think this is a very important and useful distinction!

I never really considered my son's size as having anything to do with my C-
section, nor was I worried about height beforehand because women in my
family generally had easy short labors and so I just assumed we had great
pelvises. I was just astounded at the time of his delivery that two such
genetically short parents could produce such a large baby. He's drifting a
little more towards average now.

I don't read much on the topic of C-sections since child birth is not
something I know much about.I have to say I find that there is an
impossible bias in studies conducted in countries with as high a C-section
rate as the United States.  I read one study that showed a higher C-section
rate among women who gained more than 35 pounds during pregnancy.  While
the authors controlled for a variety of factors that could influence this
outcome, they did not control for one obvious problem. When the vast
majority of C-sections are not necessary, how can you rule out that the
obstetrician, the parents, or both were influenced by the belief that a
higher weight gain would lead to a greater risk of obstructed labor?  It
seems to me that these underlying beliefs could lead to many decisions
along the way that could increase the possibility of C-section without
weight gain really being the cause. Those of you who know more about this,
am I wrong in my puzzlement over this?

More on the topic, I'm still pondering the implications of Kathy
Rasmussen's study on weight gain in pregnancy and risk of lactation
failure. The brief press reports I've read don't give enough detail to
really do anything other than speculate. I can't wait for the full
publication. Did anyone actually attend her talk at FASEB and hear more of
the details of the study?

Susan Burger, PhD, MHS

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