Pelvic Types vs. Delivery

[Reasonable Rascal]

In the textbook we are using in Maternal Cild Nursing (Maternity Nursing by Loudermilk and Perry, pg. 264) there is a chart detailing female pelvic types, i.e. gynecoid, android, anthropoid, platypelloid) as well as a percentage listed for the presence of each type within the population (presumably North American).

Between android and anthropoid types some 47% of the population is said to be affected. Usual delivery types are said to be Cesarean for android pelvic types, with the notation that forcep-assisted vaginal deliveries are difficult.
For anthropoid types vaginal delivery with forceps assist seems to be the norm.

My question for persons more studied in this area than I (can you guess what my current semester is concentrating on, and for that matter where my clinical assignments are?) how are these issues addressed in the austere/third world setting, assuming that the percentage of such pelvic types are represented across the female population worldwide? How about outcomes and labor difficulties?

RR

[Craig]

I thought all this stuff about pelvic shapes and ability to have a normal vaginal delivery was largely discreditied BS - its really disappointing that a recent textbook is making comments like this. Yes, there are different shapes - but most women regardless of pelvis shape can have a normal vaginal delivery - the only way to know for sure is to try. There are a very small subset of women - with a small/narrow pelvis, but an enormous baby who get into trouble and for them c/s is the safest option - but its proportion rather than a specific shape - also those with previous pelvic #'s or true congenital abnormalities. But in general thanks to ligament laxity and moulding of the fetal head 99% of babies can fit out of mum pelvis - regardless of the shape. An Occiput posterior position is different again - but not related to mums pelvis. Sad your book makes comments like that RR

The austere management is the same - everyone labours and you see how you go - if you have the option for a c/s then if failure to progress occurs bailout - otherwise your options are unfortunately limited. Im out of time now - but will try and make a few more comments later


cheers

Craig

[Reasonable Rascal]

I appreciate the info and wondered about the stats as presented. Seemed to me an abnormally large percentage of women would have significant problems with delivery if taken as gospel. If true how did we as a race of being manage all these millenia?

I do wonder how much info presented in texts represents the authors' personal prejudices vs. proven reality.

RR

[RESQDOC]

Ditto Craig. This info is worthless. Typical nursing text though - regurgitation of conventional wisdom by authors who haven't done patient care in living memory. I find the nursing texts especially bad about that, with apologies to those good nurse educators out there who do stay current.