Re: Surrogacy: a family‐building option in search of legitimacy

Sir, We thank Dr Shunji Suzuki for his interest in our study and his remarks. We have not assessed the pelvis shape in our trial. We analysed our main outcome according to ethnicity (reported to be associated with pelvic shape) and to the degree of fetal head descent at randomisation. There was no statistically significant difference between groups for occipito-anterior position of the fetal head 1 hour after the randomisation when stratifying for the ethnic origin (Caucasian 36/266, 14%; African 11/58, 19%; Asian 6/22, 27%; Hispanic 6/65, 9%) (P = 0.22), and for the station of the presenting part (above ischial spines, at ischial spines and below ischial spines) (P = 0.71). The analysis of the latter is limited by the small number of women with a fetus in low presentations. Another randomised trial evaluated the efficacy of maternal posturing according the fetal head station during labour in preventing persistent occiput posterior position and failed to demonstrate any maternal or neonatal benefit to a policy of maternal posturing for the management of occiput posterior position during labour, according the fetal head station. We are therefore unable to provide evidence for the hypothesis raised by Dr Suzuki.&