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A breech of trust

Hmm, did I hear that right?

Retired obstetrician Prof Wendy Savage appeared on the 'Today' programme on Radio 4 this morning to comment on NICE’s recommendation that women should be free to opt for a Caesarean section at the NHS’ expense.

As that would really only formalise the status quo ante I’m not much fussed either way, but it was something she said, almost in passing, that caught my ear. One of the reasons for the inexorable rise in the number of C sections was obstetricians’ desire to avoid malpractice suits and the subsequent practice of so-called defensive medicine.

But she went on to comment that she was unable to find a single ObGyn specialist in an unnamed hospital who would be willing to deliver a breech presentation vaginally because, and I’m sure I heard this right, 'Most of them didn’t know how to do it, because they haven’t been trained'.

I’m already on record having a moan about the fact that GPs in training can get as far as the consulting rooms in my surgery without, for example, being shown how to examine a shoulder or a knee. But a department full of career ObGyns who have never dealt with a baby arriving bottom first?

I wouldn’t fancy my chances of delivering a breech successfully in the small hours on someone’s sofa but at least I’ve helped out at a few. The thing that really scares me is that the guys in the Obstetric Flying Squad ( or whatever they call themselves nowadays ) might never even have seen one, let alone managed one.

Dr Tony Copperfield is a GP in Essex