A pioneering study at a Birmingham hospital aims to discover why some women spend hours in labour while others give birth easily. Health Reporter Emma Brady found out how this could help cut the soaring rate of Caesarean deliveries... The risks associated with what should be the most natural event in life - a mother giving birth - have increased since medical technology began intervening in the 1970s. Since then delivering babies by Caesarean section has become commonplace, as those mothers dubbed "too posh to push" see the procedure as a lifestyle choice. But one in four pregnant women in Britain have to give birth this way for medical reasons, often because of a prolonged labour. Midwives at Birmingham Women's Hospital have gone back to basics for two-year study to see if the baby's position in the womb has any impact on its mother's health. More than a fifth of their patients have a Caesarean after they experience difficulties in birth, which researchers believe is due to the baby being in the wrong position. The Apollo study - Analysis of the fetal Position at Onset of Labour and Labour Outcomes - aims to find out if this can result in a difficult or easy delivery. Aishah Bibi, who is leading the team, said: "The C-section rate has never been so high. At the Women's Hospital about 21 per cent of mothers give birth using this method. "One of the most common reasons why women have this procedure is when they fail to progress in natural delivery, ie their cervix is not dilated enough. "As midwives we believe that's due to the baby's position in the womb, but that diagnosis has never been formally made." Since it began in May, more than 300 women have taken part in the study, but the midwives want to scan 1,000. First-time mothers, who are expecting a single baby, are being recruited for the research. Ms Bibi said: "When the mother arrives here in early labour, she will be scanned. "This will be able to show the fetal position at this stage. We will then be able to see if there is a particular fetal position that gives a better outcome at birth. "If we do find one position is better or worse than the others, then future studies could develop to change the fetal position when labour begins, which in turn could lower Caesarean section rates." The Apollo study is inspired by a retired midwife in New Zealand who has promoted the notion of an optimal fetal position for many years. Jean Sutton, a 76-year-old midwifery "guru", is expected to come to Birmingham to discuss the research at the Women's Hospital in November. She originally claimed that lifestyle changes could effect the baby's position. The fact that women are less active during pregnancy than their mothers or grandmothers is also a possible factor. Midwife Sara Webb said the study was forcing staff to "get back to basics". "I think we've come to the point where if there are problems during labour we think 'Well we can always do a C-section'," she said. "So this study has really got us thinking about birth and the whole labour process. Since the 1970s, when medical intervention began in labour, it seems to have become less of a natural process." However the team - which also includes midwife Bernadette Early and the University of Central England's senior midwifery lecturer Susan Dover - urgently need extra research staff to assist them. Ms Webb added: "We're doing this in our own time, on top of our full-time work, and we need a research midwife and a statistician to help us collate all this information and analyse it. "For that we need £40,000 to fund both posts, but it took us nearly three years to get this study off the ground. "What we're doing could make a major difference to the way women give birth in the future - but for that we need more help." | 
