I just read an article about shoulder displacia and non-cesarean, low tech techniques for safely addressing this often fatal birth complication, compliments of the awesome midwives at The Farm (where the C-section rate is 2%).

This fairly technical paper from the WHO revealed to me that “distacia” is one of the conditions that qualifies as obstructed birth.  Others include “labour lasting more than 12 hours to uterine rupture, feto-pelvic disproportion or abnormal fetal presentation.”

Fistulas are often a side effect of obstructed birth, once the baby is delivered.

When I think about the future of mother and infant care in the developing world, this category of mortality has me stumped.  In some cases  midwifery skills aren’t enough – you need a surgeon.  The risk factors aren’t conclusive for screening and according to the WHO  the problems often are clear during delivery — not before.

What are the chances that women, lacking transport and far from hospitals, will make it to a surgeon in the precious moments between determination of “displacia” and the death of the baby?  Not good.