Abstract
In developed countries there is a low prevalence of obstructed labor and little aversion to cesarean delivery. In fact delay in performing a cesarean section often results in lawsuits. For these reasons symphysiotomy is rarely necessary and has been abandoned in those countries. However developing countries are characterized by a high prevalence of obstructed labor (from cephalopelvic disproportion—CPD) poor obstetric services and a cultural dislike for cesarean delivery. Because of the dislike for cesarean delivery and the higher mortality and morbidity associated with cesarean section than symphysiotomy for obstructed labor symphysiotomy has been advocated for the management of obstructed labor from CPD in resource-poor settings. Despite this we have observed surprisingly that indigenous Nigerian obstetricians rarely offer symphysiotomy as a therapeutic option for obstructed labor because they consider it dangerous compared with cesarean section. Currently we do not know whether Nigerian women prefer symphysiotomy or cesarean section for obstructed labor. The objective of this study was to determine the preferences for either symphysiotomy or cesarean section for obstructed labor in a Nigerian obstetric population. (excerpt)
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