Vaginal Breech Delivery and Adverse Mental Outcomes?

[tammylc]

Saw an OB yesterday about my breech baby. We're going to try a version, and hopefully that will work.

I didn't think there was anyone in the area that would attempt a vaginal breech delivery, but I found out last night that there might be someone about an hour away who specializes in breech delivery. I need to find out if that's true.

But in the meantime, my OB claimed that there was a large body of research correlating vaginal breech delivery with adverse mental outcomes later - learning disabilities, ADD, etc. But I can't find a bit of this supposedly large body of research on the internet. Maybe I'm not using the right search terms - does anyone have any references on the subject? I'd like to see if the studies lumped all breech deliveries together (including pre-term, etc) or if it separated out healthy, full term breech deliveries.

Thanks.

[stafl]

Have you tried chiropractic care to get baby to turn? Search for info about "webster technique" before you try the external version.

Sounds like typical ob scare tactics to me. Ask him for the sources of his information, then examine the studies yourself.

These links may be helpful - http://www.gentlebirth.org/archives/breech.html

http://www.breechbabies.com/

pub med search results for breech presentation

here's a link to a study on the safety of vaginal breech delivery

[tammylc]

If you check out the post "Breech and Depressed" you can read the whole long story... I'm pretty much trying every trick in the book - ECV is my last best hope. My OB does about 2/month and had never had anyone require an emergency c-section because of the procedure, so I feel comfortable making the attempt.

Thanks for the links - I'll check them out.

I don't think they're really scare tactics per se - I'm pretty impressed with the doc - he took me on at 38 weeks, knowing that if we get the baby to turn, I'm going to go have a homebirth, and he's totally cool with that. So I'm really willing to give him the benefit of the doubt, and believe that he really does believe the evidence is there to indicate that a c-section will mean a better fetal outcome. Doesn't mean that I'm not going to check it out myself, though...

Off to the chiropractor for my fourth Webster adjustment...

[Serenity Now]

I wonder if these studies could be what he was referring to?

Hannah ME, Hannah WJ, Hewson SA, Hodnett ED, Saigal S, Willan AR. Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial. Lancet 2000; 356: 1375-1383

Mode of delivery in breech presentation at term: increased neonatal morbidity with vaginal delivery.
Herbst A - Acta Obstet Gynecol Scand - 01-AUG-2001; 80(8): 731-7

The first study isn't listed in PubMed, which may be why you couldn't find it.

[candiland]

IMO, there are far more risks to both mom and baby in a planned cesarean. My homebirth midwife does breeches and has never had a problem. It's all in the technique of the provider. I'm sure many of the issues you are talking about are directly related to the "management" of the pushing and delivery phase.