Once again, I seem to be having a lot of trouble expressing myself.  Re
Catherine Genna's response to my comments on cephalo-pelvic disproportion,
OF COURSE I know that many women in the U.S. have unneccesary C-sections for
all kinds of reasons.  I didn't mean to imply that all cases of C-section
are due to cephalo-pelvic disproportion.  Nevertheless, it is the case that
in true situations of cephalo-pelvic disproportion, where the baby's head is
simply too big to fit through the mother's birth canal, IN THE U.S. the
mother gets a C-section and goes home with a live infant, while IN THE THIRD
WORLD the mother dies after days of exhausting labor and the infant dies also.

I sat at the bedside of a woman in Mali for two days while she tried to push
her baby out, and she eventually died, as did the infant.

I also find it very difficult to believe that smaller babies are not easier
to birth, just given my own experience.  My first was 8 lb 1 oz and I
thought I was going to die.  She had shoulders larger than her head and I
had to push several more huge pushes after delivery of the head to get her
out.  The second was my son with Down Syndrome.  He was three weeks early,
weighed 6 lb 7 oz and had a small head.  I was walking around, joking with
my husband, daughter, friend, doctor, and nurses until 2 minutes before he
was born.  One small push and he was out.  Nothing at all like my first
birth.  The third child was like the first, he weighed 9 lbs. 2.5 oz. and
had shoulders MUCH larger than his head.  It took 30 minutes of
excruciatingly hard labor to deliver those shoulders after the head was out.
Unfortunately, you can't resort to a C-section once the head has been
delivered, and the doctor was reluctant to break the baby's clavicles.  Now
I can look back and joke that they could use a videotape of that delivery
(if there was one) to discourage teenage girls from having sex!

End of tirade.
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Katherine A. Dettwyler                                email:
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Anthropology Department                               phone: (409) 845-5256
Texas A&M University                                    fax: (409) 845-4070
College Station, TX  77843-4352