 What does the Tydeman tube do?
Incisions have been made in the lower part of the mother's abdomen and womb. I've pushed my gloved hand inside and managed to slide my fingers between the baby's head and the surrounding uterine tissue. She comes with a vulva, a pre-cut incision in her abdomen and, most importantly, a uterus containing a foetal head that should, in the normal way of things, be free to emerge between her legs. Its sole purpose was to test the effectiveness of a novel device called a Tydeman tube. The inventor of the tube and of Desperate Debra is Dr Graham Tydeman, a consultant in obstetrics and gynaecology at Victoria Hospital in Kirkcaldy, Fife. Although the Tydeman tube is still in gestation, Desperate Debra herself is now thriving. To understand the desperation of Debra and how the Tydeman tube might help to relieve it requires a brief foray into basic obstetric knowhow. Evolution has endowed us with heads proportionally so large that even when labour runs according to plan, the delivery process involves a bit of a squeeze. For the baby's head to get stuck on the way out may not be usual, but it's by no means a rarity. One audit has suggested that roughly 8,000 babies get stuck and have to be delivered by caesarean at a stage when their mothers are fully dilated. "Some of the babies will be so close to coming out by the normal route," says Tydeman, "that it's then difficult to get them back up and remove them through the hole in the woman's tummy." "There are strong opinions about why it happens and what to do, but very little research evidence," says Tydeman, adding that many of these opinions are contradictory. In a protracted birth that's destined to end with a caesarean, the longer the labour is allowed to go on before the obstetrician decides to intervene, the greater the likelihood that the baby's head will become impacted. When obstetricians doing planned caesareans slice open a mother's womb, what they usually see is the baby's head. By slipping a hand round and below it they can easily guide the baby out. "When you do a caesarean for an impacted baby," says Tydeman, "you make the incision in the same place, but what you might come across is a shoulder because the baby's so much further down As I'd discovered for myself, sliding a hand around the baby's head is then far more difficult.
 The Tydeman tube is placed in the uterus near the baby's head. The tube opens into a soft silicone cup, which is placed on the part of the head that is exposed through the cervix. Pushing air in through the tube releases suction forces that may be holding the baby in place.
 The Tydeman tube is placed in the uterus near the baby's head. The tube opens into a soft silicone cup, which is placed on the part of the head that is exposed through the cervix. Pushing air in through the tube releases suction forces that may be holding the baby in place.  The Tydeman tube is placed in the uterus near the baby's head. The doctor can inflate or deflate the tube as necessary to help ease the baby out of the birth canal.  The Tydeman tube is placed in the uterus near the baby's head. The tube opens into a soft silicone cup, which is placed on the part of the head that is exposed through the cervix. Pulling air out through the tube releases suction forces that may be holding the baby in place.  The Tydeman tube is placed in the uterus near the baby's head. Pushing air in to inflate the tube keeps the umbilical cord from closing around the baby's neck.