The Relationship Between Obstetrically Preventable Intrapartum Asphyxia, Abnormal Neonatal Neurological Signs and Subsequent Motor Impairment in Babies Born at or after Term

Abstract

In the comprehensive review Prenatal and Perinatal Factors Associated with Brain Disorders recently published by the National Institutes of Health, the editor, Freeman (1985), commented that “many of our assumptions about factors associated with brain disorders, such as cerebral palsy, mental retardation and epilepsy, remain rooted in outdated ‘knowledge’”. Yet, as Freeman implies, these assumptions still dominate public and professional beliefs about physical and mental handicap. Hey (1985), a British paediatrician, has described the situation in the United Kingdom: the House of Commons’ Social Services Committee’s “bold statement (1980) that at least 5000 children in England and Wales are surviving each year with handicap that could have been prevented by better obstetric care neatly encapsulates the current climate of expectation — a climate fostered by expert (medical) witnesses to that Committee and further enhanced by those of our (medical) colleagues who tell mothers, ‘If you don’t do as I say you may damage your baby’”. He later continues “the profession’s ideas about the obstetric antecedents of cerebral palsy are, at present, dangerously simplistic; those of the general public are even more so”.