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More episiotomy craziness
MORE EPISIOTOMY CRAZINESS
Open Letter John O.L. DeLancey, MD Professor Division of Gynecology University of Michigan Medical School John, You ask: "How could episiotomy prevent damage?"^^^ You answer: "[Episiotomy] opens the diameter of the pelvic outlet..."^^^ Be advised: OBs are closing pelvic outlets up to 30% then surgically/fraudulently claiming they are opening pelvic outlets with episiotomies. See my Open Letter to Libby Baxley, MD, below. Todd Dr. Gastaldo ^^^Delancey JOL. Anterior pelvic floor in the female. In Pemberton et al. (eds). The Pelvic Floor. London. WB Saunders 2002:26. PREGNANT WOMEN: OBs knowingly close birth canals up to 30%. See PROOF in the postscript. For simple instructions on how to allow your birth canal to OPEN the "extra" up to 30%, see the very end of this post... SHOULDER DYSTOCIA... When baby's shoulders get stuck, OBs KEEP the birth canal closed! Again, see PROOF in the postscript. BAXLEY and GOBBO SAY: "Episiotomy...because the primary problem is a bony impaction, episiotomy by itself will not release the impaction...Radiographic studies indicate that pelvic diameters increase when laboring women change from the dorsal recumbent position..." --Baxley EG and Gobbo RW. Shoulder dystocia. Am Fam Physician 2004;69:1707-14. http://www.aafp.org/afp/20040401/1707.html (Changing from dorsal recumbent to semisitting only closes the birth canal with more force. Adding suprapubic pressure is...BAD... See below.) OPEN LETTER Elizabeth G. Baxley, MD Department of Family and Preventive Medicine University of South Carolina School of Medicine 3209 Colonial Dr. Columbia, SC 29203 Libby, You and Bob picture BAD McRoberts which keeps the birth canal closed - up to 30%. Adding suprapubic pressure (same picture) only keeps the birth canal closed with more force. Please tell pregnant women how easy it is for them to allow their birth canals to OPEN the "extra" up to 30%. See the very end of this post. Sincerely, Todd Dr. Gastaldo PS PROOF that OBs and CNMwives are routinely closing birth canals up to 30%... First, the fact that semisitting and dorsal close the birth canal is simple biomechanics. See Gastaldo TD. Letter. Birth 1992;19(4):230. Here's my source for the 30% figure... "[T]he outlet increases with moulding by approximately 20-30 per cent." --Russell JGB. Moulding of the pelvic outlet. J Obstet Gynaec Brit Cwlth 1969;76:817-20. NOTE: In 1973, Ohlsen verified Russell's 20% figure on Borell and Fernstrom's 1957 intrapartum x-rays. Ohlsen pointed out that the authors of Williams Obstetrics were claiming that the pelvic diameters *don't change* during delivery (!) - so the authors of Williams Obstetrics decided (erroneously) that dorsal delivery widens! Interestingly, early last century, J. Whitridge Williams, MD, the original author of Williams Obstetrics demonstrated MASSIVE amounts of change in pelvic outlet diameter change at-term - and the just mentioned 1957 intrapartum x-ray study accorded with the average amount of pelvic outlet diameter change Williams found clinically... See: http://home1.gte.net/gastaldo/part2ftc.html Jason Gardosi, MD, director of the British National Health Service/NHS West Midlands Perinatal Institute/WMPI states the grisly biomechanics of the semirecumbent delivery position (semisitting): "...the weight of the mother is in part taken on the sacrum which is therefore pushed upwards, thus decreasing the antero-posterior diameter of the pelvic outlet..." http://www.wmpi.net/reviews/oe/oe_shoulder_dystocia.htm The funny thing is, Jason Gardosi, MD also *recommends* semisitting (closing the birth canal) - or used to! "The second stage...You might want to remain in bed with your back propped up with pillows...As you push, try to let yourself 'open up' below..." http://www.preg.info/book/chapter11.htm NOTE: Jason Gardosi, MD and his fellow British OB pal Malcolm Griffiths once got me censored from an international OB/GYN listserv - but fortunately not before two of my posts were archived thereon: http://forums.obgyn.net/forums/ob-gy...9707/0128.html http://forums.obgyn.net/ob-gyn-l/OBGYNL.9707/0153.html Anyone interested in some entertaining obstetric reading, check out Jason's 1989 Lancet "randomised controlled trial of squatting" - where nobody squatted... See Sarah Key's huge balls (also: Kids can SQUAT motionless for hours)... http://groups.yahoo.com/group/chiro-list/message/2084 MORE PROOF According to the Merck Manual: "When shoulder dystocia occurs...the mother's thighs are hyperflexed to increase the diameter of the pelvic outlet..." http://www.merck.com/mrkshared/mmanu...er253/253g.jsp WHY are OBs and CNMwives (nurse midwives) waiting until the head is out and shoulders get stuck before giving the baby maximum pelvic outlet diameter? WHY are OBs and CNMwives forcing babies' heads through birth canals senselessly closed up to 30%? WHY are OBs and CNMwives KEEPING birth canals closed when babies' shoulders get stuck? (Merely hyperflexing the thighs does NOT get the woman off her sacrum. This is BAD McRoberts maneuver. ON A POSITIVE NOTE: Gardosi et al.'s WMPI site (quoted above) recommends a version of GOOD McRoberts if the shoulders get stuck... http://www.wmpi.net/reviews/oe/oe_shoulder_dystocia.htm) LADIES: HELP PROTECT YOUR VAGINAS... OBs and CNMwives are slicing vaginas (euphemism "routine episiotomy") - surgically/FRAUDULENTLY inferring everything possible is being done to OPEN birth canals - even as they CLOSE birth canals - up to 30%! See Criminal medical CAM at Hawai'i's John A Burns School of Medicine http://health.groups.yahoo.com/group...t/message/2256 Sorry to be repetitive but... WEIRD: In 1993, the authors of Williams Obstetrics published the correct biomechanics at my request but they left in their text (in the same paragraph!) the "dorsal widens" bald lie that first called my attention to their text. The "dorsal widens" bald lie was created when Ohlsen informed the authors of Williams Obstetrics in 1973 that they were still claiming that the pelvic diameters *don't change* at delivery! ALSO WEIRD: Before Ohlsen stimulated their "dorsal widens" bald lie, the authors of Williams Obstetrics were ignoring Borell and Fernstrom's 1957 RADIOGRAPHIC demonstration that the diameters DO change - and this MANY years after (way back in 1911) J. Whitridge Williams, MD - the first author of Williams Obstetrics - clinically demonstrated 4cm of AP outlet diameter change! For details: See my Open Letter to FTC at: http://home1.gte.net/gastaldo/part2ftc.html SIMPLE INSTRUCTIONS PREGNANT WOMEN: It is EASY for you to allow your birth canal to OPEN the "extra" up to 30%. Just roll onto your side as you push your baby out - or deliver on hands-and-knees, kneeling, standing, squatting, etc. BUT BEWA "Midwives...encourage...semisitting." (closing the birth canal!) --Yale CNMwifery Prof. Helen Varney. Varney's Midwifery. Sudbury, MA: Jones and Bartlett. 4th ed. 2004:839] Some MDs and MBs will let you "try" "alternative" delivery positions but will move you back to dorsal or semisitting (close your birth canal!) as you push your baby out! If your baby's shoulders get stuck OBs and CNMwives will KEEP your birth canal closed! Yale CNMwifery Prof. Varney (just cited) writes: "In the event of...shoulder dystocia...the woman should be in a lithotomy position..." (p. 839) Lithotomy position keeps the birth canal closed! So does semisitting! Talk to your CNMwife or MD or MB about this TODAY. (For further details see "Criminal medical CAM," URL above.) CNMwives/MDs/MBs: If you must push or pull - and sometimes you must - first get the woman off her sacrum - off her back/butt. Thanks for reading everyone. Sincerely, Todd Dr. Gastaldo Copied to: Barbara S. Apgar, MD, MS Deutchman, Carter and Apgar [2004:1610] write: "In this issue of American Family Physician, we begin an article series based on the Advanced Life Support in Obstetrics (ALSO®) course with an article on shoulder dystocia by Baxley and Gobbo." http://www.aafp.org/afp/20040401/editorials.html Closing the birth canal up to 30% is NOT Advanced Life Support in Obstetrics... It's sort of an emergency - some babies are dying unexplained deaths as OBs knowingly close birth canals and KEEP birth canals closed when shoulders get stuck. Again, those SIMPLE INSTRUCTIONS... PREGNANT WOMEN: It is EASY for you to allow your birth canal to OPEN the "extra" up to 30%. Just roll onto your side as you push your baby out - or deliver on hands-and-knees, kneeling, standing, squatting, etc. BUT BEWA "Midwives...encourage...semisitting." (closing the birth canal!) --Yale CNMwifery Prof. Helen Varney. Varney's Midwifery. Sudbury, MA: Jones and Bartlett. 4th ed. 2004:839] And some MDs and MBs will let you "try" "alternative" delivery positions but will move you back to dorsal or semisitting (close your birth canal!) as you push your baby out! Thanks for reading. Todd Dr. Gastaldo |
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