Does a preference for symphysiotomy over caesarean section reduce the operative delivery rate?

Abstract

We analysed the data from a hospital that had practiced symphysiotomy and caesarean section (c/s) for many years and where symphysiotomy was acceptable to the parturient women, in order to determine the effects of symphysiotomy on c/s and on the overall operative delivery rates. Regression analysis revealed significant negative correlation between symphysiotomy and c/s (R = −0.610, P = 0.03 at 95% confidence interval [CI]) and a non-significant negative correlation between symphysiotomy and combined operative deliveries (R = −0.108, P = 0.383 at 5% CI). This study has confirmed that, in our environment, the practice of symphysiotomy significantly reduces the c/s rate and may save some women from operative deliveries in subsequent pregnancies. With the widespread aversion for c/s in the developing countries and a preference for symphysiotomy in some communities, symphysiotomy should be offered as an alternative to c/s whenever possible. Urgent revival of the dying skill of symphysiotomy is recommended in developing countries.