[Symphysiotomy. A thought-provoking example of appropriate technique in the Third World]

Cutting through the symphysis pubis cartilage as a means of widening the birth canal during long, drawn-out deliveries was probably common in Europe at the turn of the century and presumably occurred even later. As a result of progress in hygiene and clinical practice, Caesarean section has become much more common in such situations. In developing countries, where supervision of pregnant women is non-existent or extremely poor, Caesarean section can be a dangerous operation. Mortality figures around 1-3% are common, and the women are left with the unfavourable prognosis of a uterine scar. Therefore, symphysiotomy is still practised in settings where neither hygiene nor material resources permit. Caesarean section, because it is simple to perform and makes a negligible demand on resources.