A recent study is creating controversy over the conclusions to be drawn from the data, to explain a possible effect of the c-sections. By becoming ever more c-sections from the years 50, it has saved the lives of many babies, in the absence of the c-section, they would have died in childbirth, and could even have finished with the life of the mother.

Speaking of births in which the baby is big for being born (what is known as cephalopelvic disproportion), in a situation in which, at the death of the baby, and perhaps also the mother, not traspasarían genetically the problem to their descendants and the human evolutionary to a few deliveries easier. Is this true? What is the c-section affecting the human evolution to allow the survival of big babies to be born?

What he is commenting about the study

The research, published just a few weeks ago, that highlights what we are about to consider a "dilemma-obstetrical", to show that thanks to c-sections, the cases of cephalopelvic Disproportion (DCP) have increased by 20 per cent from that in the 50 years the c-section would be extended as a regular practice in hospitals all over the world.

According to the researchers, there are babies that are too large to pass through the pelvis of its mother, which under normal conditions would die at birth, and in some cases would mean the death of the mother also. This would happen by the size of the baby (too large), the size of the pelvis (too narrow) or by a combination of both situations.

According to the laws of evolution, if women with pelvic narrow do not get enough seed or even die in childbirth, their line of succession slows down, following through the line of women most likely to survive: those with the pelvis wider. In addition, babies that are too big, to die in childbirth, not living to also have grown children (by genetic heritage), and only survive those who are not so big as to not be able to be born. This evolution would, in the future, the women would have the pelvis more or less wide, and the babies size not too exaggerated.

But as explained, thanks to the c-section, babies are surviving despite being large, and the women, with narrow pelvises also have their babies (and they survive), so that natural selection does not act and we evolve as a species.

On data from the researchers, as we read in Cadena Ser, the cases of DCP have increased from 30 per 1,000 births in the decade of the 60 to 36 per 1,000 in the current period.

But, how are you going to change both the species in so little time?

Since this is the first thing that we all ask ourselves. That from the years 50 it's only been 66 years, and in so little time it seems very difficult to produce a variation so important as to be seen in the data.

As we read in New scientist, the evolution of a species can occur in a short time if the environmental changes are sufficiently drastic, and we speak not of one but of two or three generations.

However, we are comparing 66 years with hundreds of thousands of years has our species. In all that time, the line of succession of women with narrow pelvises have been more than extinguished, so that as we now live in the era in which women have a pelvis quite correct for the size of the babies. In addition, the environmental change is not as drastic. A worldwide epidemic itself is an environmental change drastic, a war that affected the entire species, that begin to have water shortages, or scarcity of sunlight, or shortage of food. But the c-section may not explain a variation so large in so little time.

And what about the cases of cephalopelvic disproportion on the rise?

Although researchers have commonly attributed to the human intervention that affects the evolution (these women would have died and their daughters would not now births with FADS, which increases the rates of incidence), the more likely it is that a simple increase in the diagnosis: the medicine today is not the same as that of six decades ago, so that now it is said that there are cases of PKD in women who by then would not be diagnosed (that is why they have also increased the rate of caesarean sections in all these years).

I want to say that I doubt very much that in just two or three generations of cases have increased by 20% in a matter of descent, and everything seems to indicate that being diagnosed with PKD more times than you really should, especially because it is very rare for a woman to have a pelvis so narrow as to not be able to give birth to his own son. In fact, you do not have too much sense to be able to bring your baby and then the baby can't be born because it does not fit through the pelvis of its mother.

This happens in cases of rickets of the mother's (pelvis is really small due to vitamin D deficiency in childhood), or in cases of accidents that cause some type of problem in the pelvis. Beyond this, that in our time is unlikely, it is difficult for there to be a true DCP, if it is not because the woman is grave to give birth, for example (avoiding the sacrum is open towards the back and thus causing that of truth, the pelvis may not open enough), or because the woman is in an inappropriate environment to relax and dilate and give birth on the basis of their rhythms and needs.

But in truth there are cases in which the woman cannot give birth to your baby

Clear, and that is the c-section. But WHO establishes that should be done a c-section as much in 10-15% of births, and yet we are quite over the top.

The difference is, above all, in the care delivery. A care that the woman has time, quiet, a friendly atmosphere, proper support, the words timely, caring and professionalism will result in rates of caesarean section are much lower than a attention in which the woman does not have freedom of movement, must remain lying down next to a monitor and do not feel in a climate of trust because the professionals make you feel little able.

In other words: when a woman believes in their potential, is able to give birth, on many occasions, a baby bigger than that I may not be able to give birth in an environment that does not seem conducive to giving birth.

"If you're only pushing, the baby fits or doesn't fit", many say. But it is not so. It is not a question of physics. We do not speak of a ball rigid you fall through a hole also, stiff. We talk about a baby's soft and malleable, it must pass through a birth canal that can be opened more or less according to the position in which the woman (lying, sure it opens less) and according to the trust, and the environment in which everything happens, which are absolutely key in the process.

What I want to say with this? It is likely that if hospitals in the entire world takes this into account and start to follow more and more protocols up to date for a normal delivery (like we do in Spain, for example), cesarean deliveries will begin to decrease, it will increase the confidence of women in their birthing process (right now many are going to give birth without knowing very well what's going to happen, simply doing what they are told to do, instead of being prepared and aware of what is going to happen) and likely come to view that cephalopelvic disproportion is a condition very rare in reality.

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