BMJ  2007;335:1226 (15 December), doi:10.1136/bmj.39423.481285.BE

Letters

Caesarean section

Points raised in responses

The first 150 words of the full text of this article appear below.

In her rapid response, Amy B Tuteur, an obstetrician from Sharon, Massachussetts, argues that the definition of elective is misleading in the study by Villar et al.^{1 2} "The study compares women who had vaginal deliveries with women who had medically indicated caesarean sections, both non-emergency and emergency. It never investigated elective caesareans and therefore it reaches no conclusions about them."

"Equipoise exists," writes Robert G Buist, a visiting obstetrician at the Royal Hospital for Women in Randwick, Australia. "The time has come for a large prospective long term observational study comparing outcomes for women without absolute indications for caesarean who plan to give birth by caesarean v those planning to give birth vaginally."¹

Maureen Treadwell, a Hampshire committee member of the Birth Trauma Association, highlights that the important issue of maternal mental health is almost always forgotten, despite being a leading cause of death in the year around childbirth. "We . . . [Full text of this article]

¹ BMJ, BMA House, London WC1H 9JR

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BMJ 2007 335: 1025. [Abstract] [Full Text] [PDF]