Catching up on research - after 50 years

Jul 14 2008 by Laura Davis, Liverpool Daily Post

Catching up on research – after 50 years

Laura Davis meets the experts planning to save mothers and babies from the trauma of Caesareans

WHAT would you think if you were told that 1,700 healthy young women undergo major surgery each year?

And what if all of them were from Merseyside?

Would you be calling for an official investigation or would you start planning to leave the area before it happened to you?

Both these statements are true, and yet the women involved are not the victims of some bizarre satanic ritual, nor are the operations the result of some terrible medical mistake.

They refer to the Caesarean sections carried out during one in five labours at the Liverpool Women’s Hospital – many of which could be avoided, experts say, if doctors understood more about the female body.

Next year, the hospital will open a new Centre for Better Births where scientists from the University of Liverpool will study the uterus – research they hope will eventually cut the rate of emergency Caesareans across the UK and farther afield.

“If you’ve had a two-day labour and then a Caesarean, it’s two major assaults on your body and it takes a long time to recover,” says Dr Siobhan Quenby, consultant obstetrician at the Women’s Hospital.

“You’ve got your new baby and you should be really excited, but all you can do is lie on the couch.

“We have women asking why we couldn’t predict they would need a Caesarean earlier so they wouldn’t have had to go through two days of labour and pain for nothing. But that’s where medical research is up to.”

Emergency Caesareans are usually needed for one of two reasons – either the uterus is not contracting as much as is needed to push the baby out, or the baby has gone into distress.

This operation is the only treatment, if a drastic one, because it is not understood why a uterus would have problems contracting.

The difficulty is finding the reason for this, explains Dr Quenby. Once it has been identified, it is much easier to come up with a solution.

It is astonishing then, given the huge numbers of women who go through Caesarean surgery each year (around 50,000 nationally) that we have waited so long for such research to be carried out.

Yet this is an area that has largely been ignored by scientists and the medical profession for more than 50 years.

“In a way, we’ve been victims of our own success,” says Dr Quenby. “Because both mother and baby survive, it hasn’t been seen to be a major problem but it is a traumatic experience to go through and in modern medicine that’s just not good enough.

“If you have a heart that contracts badly, then there are 50 different drugs you can try, but if you have a uterus that contracts badly there’s only one, and it doesn’t work.”