Why isn't breech/breech twins acceptable for a vaginal delivery? - Page 2

[royaloakmi]

My ob told me it's b/c obs are no longer trained in med school for breech deliveries. She would do a breech delivery for twin B, but preferred that A present head-down. She said only one other "old school" doctor in her practice would do a breech delivery anymore, even for singletons.

As it was, I ended up with a c-section because both mine were breech (A was footling and B was complete breech, sorta sideways with her head under A's) and all the cord was down by my cervix.

[~bookcase~]

i was advised to have a section for mine but decided to wait it out a bit. at one point i asked the doctor 'so when will we know if i can have them normally or not' and he said 'when they come out or not' or some silly thing like that
and they did both come out breech and well, praise God

birth is unpredictable and i feel sorry for these doctors sometimes.

[Kikibell]

Originally Posted by turnquia

I found a study that said pretty much data proves the outcomes are exactly the same as vertex/vertex deliveries with a skilled provider

That's the issue. Breech birth can have the same results developmentally (and often do in studies based in Europe) because Dr.s there have experience w/ breech birth. Most practitioners here have attended very few, and knowing how to maneuver the babies is crucial to successful outcomes.

I have interviewed with many practices in my area and not a one is willing to do a vaginal delivery if Baby A is breech. I would have to have a homebirth.

[~bookcase~]

outcome of singleton breech births is NOT reliant on skilled care providers.
i can find the study somewhere if necessary (or search pubmed)

i'm not convinced it's different for twins tbh. do you have stats? the uterus is pretty powerful and competent at getting babies out if people don't interfere. i know there are always tricky exceptions, but in many cases, leave well alone and all will be well: no matter how many babies need to come out

(think nigeria where trips are commonly born naturally. yes, some need help, but not the majority)

[turnquia]

Well I just found out the local hospital. The one with the NICU... the one that delivers upwards of 2000 babies a year. Has only EVER done 4 sets of vaginal twins. Yes FOUR.

My midwife has done 12 at home in the last 10-15 years. Sooo... while I was origionally leery for a homebirth with twins given the additional risks. I will be going for the homebirth. I am disgusted to hear only the hospitals stats on twins, and think no matter what I'm better where someone is more skilled no matter where that is. LOL so since she is breech trained and delivered quite a few breech, we will no longer be as stressed about babies positions. However I remind them head down every day

[ladydodson]

bumping this post to say THANK YOU for posting it...loved the links within and am about to go immerse myself in positive breech/breech birth stories...xoxoxox.

[turnquia]

I will update too... both babies were born at home in the caul.... both vertex :)   So no anecdata from me on breech breech twins!

[DWife03]

This is what my OB told me also. He's been practicing for 30+ years and has delivered many breech/breech twins vaginally.

I wish there were new OB's trained and skilled in this area.
 

Originally Posted by Freeman 

Originally Posted by queenofchaos

I think it boils down to malpractice insurance issues. I have an OB that is very experienced with twin births and says that breech/breech births seem to be much rougher on everyone. And that's why he won't do them. He's ok with baby A vertex and the other breech, tho.
In general though, there are less and less OBs that have any experience delivering breech babies. So many OBs won't deliver breech at all because they don't know how.

This is what an OB practicing for 30+ years told me -- that it's really not taught much in medical school these days and is somewhat of a dying art-- they're taught to do c-sections. More than one OB has told me that malpractice issues are a large part of it. Even if one OB knows what he/she is doing, if she does something that is not deemed medically reasonable in today's birth culture (i.e., deliver vaginally when the majority would have recommended c-section in a particular scenario) and a problem occurs, then she is going to be judged by that standard. Frankly, I think it's just not worth it for many of them to risk getting sued--which is a large part of why the c-section rate is so high. From the OB perspective, a c-section offers a very controlled birth, esp. when delivering multiples. Of course, I think you can always sign a release acknowledging that OB gave you advice on delivery and that you refused a c-section, etc.