Breech in PA?

[Mushy1127]

My 3rd baby was Breech at my 20 week ultrasound.  I fully understand that s/he will, with almost certainty, flip many times before the big day... but I do like to prepare and think about things some.

Is it true that a vaginal delivery (in Pittsburgh) is entirely out of the question?  We are planning to birth at a birth center and I am 99.99% sure they do no do breech births.  Home birth was already ruled out by two different midwives for other reasons.  I am not opposed to going to a hospital to deliver vaginally, but have always been told it was "illegal" here.  

I can't find any information about this one way or the other.

Meanwhile I was already seeing a chiro well versed in the Webster technique and had already planned on doing acupuncture so I think I really have nothing to worry about.  But it makes me feel better to be at the ready with information.  

Thanks in advance!  

[parsley]

There is a family doctor at Magee who has expressed a willingness to deliver a breech baby vaginally.  Apparently, others have expressed a willingness to deliver a breech baby vaginally but said that ACOG forbids it.  I found my info through the Pittsburgh ICAN chapter and also through a local doula. 

My DD was breech and I had to deliver by c-section (in NYC).  I've been worrying about this since I got pregnant with with this one.

PM me if you want more details. 

[nukedwifey]

As far as I understand it's not "illegal" it's lack of experience and the fact that PA has crazy high malpractice insurance here.  I do believe that the MWC said during my last pregnancy that Drs here just aren't experienced with it and therefore don't do it.  And frankly I wouldn't want someone with a lack of experience doing something like that.  So you go round and round.  I'm sure if the malpractice wasn't driving them out of the state they might be willing to get the experience but at this point for most their license isn't worth the risk.  That was what I got from the midwives in our conversation about it anyway.  The MWC won't do it because they have an over seeing OB/GYN who would never OK that to occur at the center and then if you go to the hospital Magee wouldn't allow it to happen either.

[serenbat]

As far as I understand it's not "illegal" it's lack of experience and the fact that PA has crazy high malpractice insurance here.  I do believe that the MWC said during my last pregnancy that Drs here just aren't experienced with it and therefore don't do it.  And frankly I wouldn't want someone with a lack of experience doing something like that.  So you go round and round.  I'm sure if the malpractice wasn't driving them out of the state they might be willing to get the experience but at this point for most their license isn't worth the risk.  That was what I got from the midwives in our conversation about it anyway.  The MWC won't do it because they have an over seeing OB/GYN who would never OK that to occur at the center and then if you go to the hospital Magee wouldn't allow it to happen either.

I disagree with part of this

my DS was breech until the last 4 hours and the OB I had was very experience (older and had done several breeches and also teaches) and simply was not allowed to by the hospitable and would loose privileges not to mention other ramifications 

it's far more the hospitable not the Drs. here that set the rules--they make others here in PA as well that many OB and MW disagree with, some bend and flat out lie to the hospitable on certain issues but breech----hospitals go crazy over it

[cameragirl]

I don't know about your local area, but if are still breech in the 3rd trimester, I would look into chiropractic care. Find a chiropractor trained in the Webster technique. It is a gentle adjustment of the round ligaments and pelvis, and it is pretty effective. My doctor said that the only time it hasn't worked as when the mom came in at 39 weeks. By that point the baby didn't have much room to move.

[Mushy1127]

Well. I had my 35/36 week appointment today and learned the baby is Breech again/still. Somewhere in between this post and my last appointment I was told baby was head down. I'm not sure that was right... Regardless. I will be having an ultrasound in 2 weeks. 

Im seeing a chiropractor today and Friday. I have an accupuncture appointment on jan 7. I'd still love any info about OBs  who will deliver breech. 

I'll admit it. I'm totally devestated. 

[serenbat]

Im seeing a chiropractor today and Friday. I have an accupuncture appointment on jan 7. 

you will need several apts (IF you go to a good chiro and a acupuncturist- if they tell you only need one treatment they are not good!) take a lot, several times a week! and get the Moxibustion sticks so it can be done on you at home

 I will be having an ultrasound in 2 weeks. 

it's very easy to tell with a ultrasounds!- why are you have this done?

The ultrasound won't help you (they often turn during labor) so unless you are having other issues, it's of no use.

Edited by serenbat - 12/21/11 at 8:26pm

[AnkaJones]

Did you check with your local ICAN chapter?  And, importantly, can you go out of state?

The politics around breech birth are complex, but here it goes: in order to practice in Pennsylvania you have to have malpractice insurance and, if you want to deliver babies, you have to have hospital privlidges.  So either your malpractice insurer or your hospital can keep you from attending breech births, even if you are experienced.  Add to that that this is the way it has been for years, and you have a situation where even if there was a hopsital willing to do it, and a malpractice insurance provider willing to still insure you, you'd still have a hard time getting the experience.

Frankly, I think the situation is absurd -- basically, it is "more legal" to force a woman to have major intraabdominal surgery than it is for a doctor to assist with the natural process.  But that sort of advocacy work will have to wait until after you bring your child into the world.

Anka

[harli]

Look into hypnosis to turn the baby as well. Hypnosis supposedly has a lot of success with turning breech babies. 

[mom2tatum]

Are you planning on doing the external version at the ultrasound then? That's usually around the time they'd do that, but they usually monitor the baby really closely and prepare you to be ready for an emergency cesarean as well. Although, I've found amongst my clients, they've had a lot of luck with a good doc turning a baby very gently and patiently during versions.

[Mushy1127]

I have already had 5 or 6 chiropractic adjustments since finding out the baby was breech. I'm going three times a week.  I would love to see a accuouncturist, but they're all closed for the holiday!  I called six places. I have an apt with one on the 4th and with another on the 7th. 

I have a hypnosis session scheduled for the 9th. 

The trouble is, I *think* they'll do a version after the ultrasound on the 5th. I had hoped to have the baby turn by then. My last baby was pretty big so waiting on the version makes me nervous too. :(

[serenbat]

my OB was opposed to doing an version because he felt that most likely our DS would not stay in that position and that many go from a version to an emergency C too fast (if I had opted for it I had to have the papers signed for the C prior to starting the version - this was the hosp requirement and not my OB's view as my best interest and also versions, at least in my are of PA are only done in the hosp! the chance of cord twisting it what I was told) -- I don't know what the case is with you or what the odds are that you can keep yours turned but I did have an experienced OB how felt most do turn with the aid of accupunture and also at the start of labor and prior was not that useful --- hope yours turns on it's own and not with the added stress a version can cause

I was due at the time on the 21 of Jan and had on the 13th and had started the "turning" accupunture in early November (twice daily) and once a week with needles and the webster I started the week of Christmas and did until Jan 10th - but what is for one is not for another, form early Oct almost 24/7 he was breech and I could see and feel it, most likely was prior to that!

is your OB willing to let you go into labor naturally? and do C only at that point

my feeling were I was willing to not have my OB over waiting till the very end

[mom2tatum]

Yes, versions have their risks, too.

As far as hypnosis, I also had a client use Hypnobabies "Turn your Breech Baby" - I found the CD here on amazon. She did other things as well, as many do, so one never knows what did it or if baby would've turned anyhow on its own - but her baby turned at 36 wks (ish) I believe.

Stay positive, relaxed, and talk to your baby a lot about what you need him/her to do. But also that you will understand if he/she cannot do it because he/she needs to be born a different way for some reason...but put the idea out there at least :)

Best of luck! Let us know how it goes, mama!