
Car Mechanic Dreams Up a Tool to Ease Births - danso
http://nytimes.com/2013/11/14/health/new-tool-to-ease-difficult-births-a-plastic-bag.html?ref=health&_r=0
======
Scaevolus
This looks much safer than the alternatives of forceps, vacuum extraction, or
C-section.

The intuitive leap from "extracting cork in wine bottle" to "extracting baby
in birth canal" happening during a dream is fascinating. Neurons rearranging
during sleep cause the oddness of dream logic and can find unexpected
correlations -- like the link he found.

~~~
tantalor
It appears to be very comparable to vacuum extraction. In fact it allows the
same ~40 lbs of pulling force.
([http://www.odondevice.org/device.php](http://www.odondevice.org/device.php))

However, the device looks a _lot_ less likely to fail (let go) than vacuum
extraction, due to the firmer grasp.

~~~
Scaevolus
Similar effects, but the force is spread over a larger area, and shouldn't
swell the scalp.

~~~
JshWright
On top of that, the force is spread over an area that is much more suited to
withstanding that force (as opposed to the as-yet unfused parietal bones of
the skull)

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jonah
I bet we'd reduce the need for extreme intervention like this if we'd
encourage women to deliver in more traditional positions. Prone and sedated is
just about the worst possible way to have a kid.

~~~
coffeemug
Do you think it likely that an entire field that evolved over a period of
thousands of years, has thousands of people doing the job all over the world
daily, and is so common and important that there is scientific research
performed on it pretty much not-stop, just missed this idea?

~~~
rosser
Western medicine treats pregnancy and childbirth _like a disease_. So, yes; I
do think they probably get delivery wrong.

~~~
rayiner
Western medicine treats pregnancy and child birth like a high-risk situation,
which it is. It's the same principle behind having doctors standing by at a
boxing match, except the natural rate of maternal mortality in child birth is
far higher than the mortality rate of even the dirtiest fight scenes.

~~~
toomuchtodo
Outcomes of planned home birth with registered midwife versus planned hospital
birth with midwife or physician

[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2742137/](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2742137/)

"The rate of perinatal death per 1000 births was 0.35 (95% confidence interval
[CI] 0.00–1.03) in the group of planned home births; the rate in the group of
planned hospital births was 0.57 (95% CI 0.00–1.43) among women attended by a
midwife and 0.64 (95% CI 0.00–1.56) among those attended by a physician."

No offense, but the data says you're wrong.

~~~
rayiner
The problem with such comparisons is that high-risk pregnancies won't be
planned for home birth to begin with. Also, in a hospital, a physician will be
called in at the first sight of any complication, so midwives won't be
attending births that go wrong.

A comprehensive study in Oregon found death rates 6-8x higher in home births
than hospital births:
[https://olis.leg.state.or.us/liz/2013R1/Downloads/CommitteeM...](https://olis.leg.state.or.us/liz/2013R1/Downloads/CommitteeMeetingDocument/8585).

See also this meta-survey of the literature:
[http://www.ajog.org/article/S0002-9378(10)00671-X/abstract](http://www.ajog.org/article/S0002-9378\(10\)00671-X/abstract)
("Less medical intervention during planned home birth is associated with a
tripling of the neonatal mortality rate.").

~~~
mtrimpe
For what it's worth, the Netherlands was well knowm for a long time because we
defaulted to midwife supervised hone birth with effective escalation in case
of complications.

Up until I think 10 or so years ago we had one of Europe's best delivery
success rates with that.

After that it seems that hospital deliveries became a safer choice and we've
had relatively bad percentages since then because we culturally still value
home births highly.

------
riggins
here's a fun trivia question.

How many years did the Chamberlen family keep the invention of the forceps
secret so they could enjoy monopoly profits?

~~~
jlgreco
_" The brothers went to great length to keep the secret. When they arrived at
the home of a woman in labour, two people had to carry a massive box with
gilded carvings into the house. The pregnant patient was blindfolded so as not
to reveal the secret, all the others had to leave the room. Then the operator
went to work. The people outside heard screams, bells, and other strange
noises until the cry of the baby indicated another successful delivery."_

Holy hell...

~~~
ggchappell
It's worth pointing out that this is why we have patents. Inventors disclose
how their inventions work, in exchange for a legally enforced temporary
monopoly.

~~~
femto
Try keeping a secret since the widespread adoption of the Internet.
Paradoxically, we now have trade secrets laws to help inventors help keep
inventions secret, so they can obtain a patent, so they can reveal how the
inventions work.

~~~
raverbashing
Elon Musk seems to be successful at this at SpaceX

There was a story mentioning this some time ago "We don't patent anything
that's part of our secrets"

~~~
femto
That's exactly my point! Musk almost certainly wouldn't be able to keep
employees or visitors from spilling his secrets, if it wasn't for the laws
that are in place to protect trade secrets [1]. I'd contend that it only makes
sense to argue for patents on an information dissemination basis in the
absence of laws to protect trade secrets.

[1] [http://acuriousguy.blogspot.com.au/2013/04/protecting-
space-...](http://acuriousguy.blogspot.com.au/2013/04/protecting-space-
technology-through.html)

------
Gigablah
There's some irony in that plastic bags wrapped around the head are normally a
suffocation risk for children, yet used in this manner could potentially be a
lifesaver.

~~~
kosei
Yes - very cool. Ah, the miracle of life and umbilical cords.

[http://blog.al.com/smarter-every-
day/2012/02/why_you_didnt_d...](http://blog.al.com/smarter-every-
day/2012/02/why_you_didnt_die_at_birth_a_l.html)

------
yetanotherphd
This is amazing. It makes me so happy to see people coming up with technology
like this to make people's lives better.

I know almost nothing about the medicine of childbirth, but I think this is
most likely a great technology if the WHO got behind it so fast.

------
RokStdy
This reminds me of an idea I've had. I think it'd be nice if there were a
website where experts from a certain field could go and post their problems.
Then knowledgeable people working in other fields with other backgrounds could
weigh in on their problem and provide possibly novel solutions.

I have always thought that you don't necessarily need to be in a field in
order to be able to provide new insights into issues.

~~~
sliverstorm
The problem is the signal-to-noise. You get cross-field insights sometimes,
but they are very rare and more often come from someone who is actually versed
in both fields. The majority of the time you'd spend fielding hare-brained
ideas.

------
drawkbox
Great idea and he's kept a young and innovative mind at almost 60. Ideas are
what you do with them, this guy went to work.

------
f7t7ft7
Clearly the real solution is to insert the air hose from an impact wrench into
the uterus, past the baby, to inflate the uterus and blast the baby out. This
way the pressure isn't just on the baby's head.

~~~
malandrew
Interesting idea. I wonder if it has been tried.

------
everettForth
It reminds me of this patent:
[http://www.google.com/patents/US3216423](http://www.google.com/patents/US3216423)

~~~
refurb
That apparatus would seem to make the unpleasant experience (for most) of
childbirth even more unpleasant.

~~~
duskwuff
Morning sickness, meet motion sickness!

Bad jokes aside, an opera was recently written (and performed - as part of the
Ig Nobel ceremony!) about this device and its inventor, titled "The Blonsky
Device".

[http://www.henryakona.com/the_blonsky_device.html](http://www.henryakona.com/the_blonsky_device.html)

------
stereo
So, how do you remove a cork from a bottle like that?

~~~
ggchappell
[http://www.youtube.com/watch?v=uL1ovAYtKuQ](http://www.youtube.com/watch?v=uL1ovAYtKuQ)

------
Wingman4l7
We need more collaboration between engineers and the field of medicine. I'm
reminded of Tal Golesworthy, an engineer who did a TED talk or two about how
he collaborated with his doctors to design a cardiac implant that fixed his
dilated aorta. He had some very insightful comments about the development
process and his doctors' opinions of different approaches coming from outside
the medical community.

------
rokhayakebe
Isn't this going to stop the baby from breathing?

~~~
ianferrel
What do you think the baby is breathing in the womb/birth canal?

(presumably you don't leave the baby in a plastic bag after it's out)

~~~
chrsstrm
Ha, I read this in Morpheus' voice.

"Do you think that's air you're breathing now?..."

------
frank_boyd
> Car Mechanic Dreams Up a Tool to Ease Births

Pure gold.

~~~
kineticfocus
There's a TED talk about a Plumber fixing his own Heart (Aorta)...
[https://www.youtube.com/watch?v=9-qHrhrTktc](https://www.youtube.com/watch?v=9-qHrhrTktc)

------
ceautery
Safe my big ol' butt. You're inflating something against baby's head and
pulling on it. You're also losing tactile feedback that you'd get by direct
contact with baby, which may cause you to inadvertently pull harder than you
intended to.

~~~
PeterisP
Umm, 'direct contact with baby' like when pulling his head with an attached
suction cup and the damage often caused by that?

~~~
ceautery
No. That wouldn't be direct contact, and is, again, more likely to cause
injury because you're not getting good kinesthetic feedback. What I'm talking
about is what the L&D doctor did when my daughter was born a couple months ago
to aid my wife, who was exhausted and in pain: manual manipulation of the
vaginal opening, and carefully inching baby's head forward using nothing more
than his fingers.

As it turned out, this doctor some work delivering babies in Africa in third-
world conditions, and only low-tech solutions were available. Things that
American hospitals aren't fond of, like having mom stand up and move around,
eat and drink to keep her strength up, and finding a birthing position
comfortable for the mom, like squatting, hands and knees, whatever her body is
telling her to do.

This device is better than forceps only that it is less likely to crush a
skull, but it still carries a risk of breaking baby's neck.

~~~
jlgreco
Forceps also have the risk of injuring the baby in other ways. Part of
Sylvester Stallone's face is paralyzed because of forceps used during his
delivery.

------
utopkara
How is the bag supposed to securely attach into the canal?

~~~
utopkara
Here it is in action:
[http://www.youtube.com/watch?v=eW-n914Vqtc](http://www.youtube.com/watch?v=eW-n914Vqtc)

------
goggles99
_> The current options in those cases are forceps — large, rounded pliers — or
suction cups attached to the baby’s scalp. In untrained hands, either can
cause hemorrhages, crush the baby’s head or twist its spine._

Really? you mean these things are going to be available at WalMart so that
_untrained_ people can use them?

I really cannot see this being adopted. how are you going to slip this thing
past the cervix and pubic bone? The whole reason that you need this thing in
the first place is that there is literally zero room there. Also, the
inflation is going to cause an even larger object to have to move through the
birth canal thus exacerbating the original problem.

How are you even going to know if you have it on completely? you really cannot
see in that tight space.

What about fetal distress? I cannot imagine that this thing squishing their
entire cranium would bode well for distress which leads to many potential
complications.

Maybe most importantly is the fact that this device would likely prevent the
infant from ingesting the very important birth canal bacteria which colonized
as flora in the baby's gut. c-section births lack this as well and they are at
much higher risks for many things because of it.

This is a poor replacement for vacuum extractions (suction cup method) IMO.
Maybe in developing countries it could be helpful (MAYBE safer for untrained
midwives), but I doubt even that, given it's own disadvantages.

~~~
jkldotio
"I really cannot see this being adopted. how are you going to slip this thing
past the cervix and pubic bone?"

This is a typical HN top comment dismissal. It works with corks, it works with
his basic prototype, it works with medical training dummies and it works with
the 30 Argentinian women in live births but a comment dismissing it as being
impossible is the top HN comment. Unbelievable.

~~~
goggles99
You use a naive argument to attempt to refute one point of my whole comment
(which contains several reasons this will not work) and call the whole thing
garbage? Yours is the _typical HN top comment dismissal_ , not mine.

On top of this, your criticism is not even valid. Let me explain why.

You clearly have never given birth with or even assisted in an obstructed
delivery? Corks, prototypes, and dummies are not made to fit as tight as an
obstructed birth canal and do not even try to replicate this scenario.

If you've read the article carefully, and paid attention to the details you
would know the live births used are no evidence that his will work when it is
actually needed.

> _So far, the device has been safety-tested only on 30 Argentine women, all
> of whom were in hospitals, had given birth before and were in normal labor._

So the diameter of these women's birth canals were far larger than typical
obstructed ones because they had given birth before. They also were in normal
labor. There would be far more room available to use this device when it is
not actually needed. Try shoving something like this down and around a curved
surface with an obstruction preventing it's passage. The material would have
to be very stiff, but to curve properly around the head and face, it would
have to be very flexible. These things are mutually exclusive. Even if you
managed to get it worked into place eventually (without it folding over
someplace) it would take a fairly long period of time to work it into place.
Suction is very quick to attach and is often used when that baby is already in
distress (needs to come out in a hurry).

Here are some more reasons this won't work.

Sizing. Babies craniums are vastly different sizes. Either they will need 8
sized of these hanging on the wall, or the inflation part will have to allow
for dramatic size differences. If there is only one size, and the baby's head
is small, you are increasing the size of the object that needs to pass through
the canal by a large margin (Actually adding to the problem). I suppose that
big hospitals could have 8 sizes of these on hand, but not third world
midwives.

If there is enough room for this thing to fit on, there is enough room for the
Dr or midwife to just use their hands. This is far better anyway as they will
have far more tactile feel.

