The Superiority of the South African Negro or Bantu as a Parturient. Part Iii

Vaginal delivery after caesarean section in sub‐Saharan Africa

“…Obstetricians who have practised in sub‐Saharan Africa have long been aware of the problem of disproportion. Early radiological and post‐mortem examinations of the pelvic bones confirmed the clinical impression of reduced diameters of the pelvic brim but did not identify the cause 16–18 . The antero‐posterior diameter of the pelvic brim of African women is similar to that of European women but the transverse diameter is smaller, giving the brim a rounder shape and a reduced area.…”

“…The recent small series study of pelvimetries by Walton 19 supports the view that disproportion in African women is generally encountered at the pelvic brim; once the brim is negotiated in labour by the fetal head vaginal delivery normally follows. Although black African babies appear to be marginally smaller than Caucasian infants, some studies show that this does not compensate for the reduced pelvic capacity 16,17,20 . Consequently, there is an increased risk of cephalo‐pelvic disproportion in African women.…”