I seriously considered the logistics of including actual repairs on the tape. In a hospital practice cameras can be set up during the day, in one place, with optimal lighting. But the logistics of filming at home are not so easy! I discussed the possibilities at length with the film crew. The problems were many. First of all, to get an example of all the techniques presented on film would take a very long time and necessitate the camera crew being constantly on call.

I explored using home video equipment but it was pointed out that, by the time it got through editing to finished copy, we would lose a great deal of quality in the process. It seemed an awful lot of effort for a fuzzy result--not up to my standards.

Asking women ahead of time if a strange video crew could be called to the birth in the event that she needed repair, and then the wait involved for their arrival, etc. etc. seems a huge imposition on a newly postpartum mother. This, combined with the time factor in gathering willing mothers in need of the right kinds of repairs made the whole idea that much more unwieldy. (Think about it, would you want to impose this on your clients? To what degree would you put up with it at your own birth?)

The value of showing actual repairs would be in demonstrating tissue layers. I clearly remember that, even with the 25-year-old clitorotomy film I've shown in classes, I still have to point things out; and tissue layers are unclear to students, in part because they are hard to see on the film. The film seemed to demonstrate the prowess of the doctor, rather than teaching very much about tissue layers. I did that with models. Even with someone's bottom right in front of you, it takes time to learn to distinguish tissue layers. So, unless the quality was far better than the film I've used, and it translated well to what you will actually be seeing on your VCR (picture quality varies widely), I knew it would be a huge effort for no real benefit.

I also felt that many things could not be shown closely enough in an actual repair for adequate demonstration. Going slowly enough and getting what I'm trying to demonstrate perfectly in the field the first time (with camera angles, lighting, etc., etc.) came to mind as additional difficulties. (It was hard enough in the studio with optimal lighting.)

In the future, I may find a suitable means of adding footage which demonstrates actual repairs. Meanwhile, if you learn all that is on this tape, you'll be way ahead of the game. You can learn a great deal from the studio presentation I have prepared. Once you have the techniques and anatomy down, as well as the logistics of how they work together, learning tissue layers and landmarks will fall into place.