Breech baby = automatic C section?

[maliceinwonderland]

I was talking to a friend/coworker of mine today who's a doctor, and had him check the baby's position (he's head down). I mentioned I hoped he stayed there as I didn't want to give birth to a breech baby, and he said that around here it's an automatic c section, and that even my midwives wouldn't back me up on a breech delivery (he actually knows the midwives, he wasn't just being a jerk ). I had always thought it was more difficult, but I had no idea that normal practice was to do a c section! Is this the case everywhere? And what's so bad about breech presentation anyway?

[Jimibell]

check out this website:

http://web.mac.com/breechbirth/iWeb/Site/Welcome.html

website of a poster on mdc
very interesting and some heartbreaking stories

[Mama K]

I think that's pretty common, sadly enough.

My midwife would not feel comfortable delivering breech. My OB also said she didn't do vaginal breech births of singletons, but if a woman were pregnant with twins and the first one was vertex she would let the woman deliver vaginally. (In fact, she birthed her own twins this exact way, first one vertex, second one breech.) She did say, however, that she would be more than willing to do ECV, and if that didn't work and I wanted a vaginal breech birth, she could refer me to another OB who does them.

[mamimapster]

what's bad about breech presentation is that they don't train doctors on how to handle vaginal breech birth- many Breech C-secs are purely due to Doctor ignorance and malpractice issues. My Dp was a was a vaginal frank breech and is doing very well all theese years later, thanks! Here's the ironic part- her mother's OB was named Dr. Frank

[maxmama]

I was offered a vaginal breech induction five years ago for my frank breech 3900 g 36-weeker, and ended up not choosing the induction. Had I known then how hard it would be to get a VBAC, I would have tried the vag breech induction.

There was a large study out of Canada that disproved the idea that provider experience is the deciding factor for breech birth outcomes, and I've no idea what happens when you add into the equation the recent study showing worse outcomes for scheduled sections over vag births. Food for thought, at any rate.

[SashaBear]

My hospital "says" that no first time mother is "allowed" to vaginally deliver a breech baby because they are worried that the baby's head will get stuck. However the OB nurse said they wouldn't let me deliver a breech baby either because I'm short! I must say I was a bit upset about that one!

[MCatLvrMom2A&X]

It is common practice with breech to do a section That was one of my biggest fears that I would have a breech baby and be forced to have a section because I didnt know of any Dr. that would delever breech.

When I got pg the second time it was still on my mind and I had mw's they told me that if the baby was breech they actually had a Dr. at a nearby hospital that did breech births. I was able to relax the rest of that pg.

I am happy that it wasnt a issue with either of my kids. But at least with #2 I had a option that I didnt have with #1

[Robinna]

Jimibell thanks for posting my website - it's also www.breechbirth.ca, which is easier to remember and forwards to the mac site.

malice, links to the research papers are there. There are practitioners in the Ottawa area who will deliver a breech "if you walk in pushing" and that's going to be the story until the SOGC changes their guidelines. Once those change, in theory, these practitioners will be able to offer it openly rather than in CYA format. The problem is they're all ready to retire. anyway please please everybody - Canadian or not - go sign the petition that the site links to. And mws in Ontario, even if they have the skills, aren't allowed to do it in the hospitals (by hospital policy, this is pretty much universal), and if you're delivering at home, CYA says they have to call you an ambulance (which you then refuse to get into, if your MW is on board and qualified to catch) (see Jen's story "I carried two breech babies" on the birthstories page). MWs will probably never get hospital priviledges that include catching breeches - much professional snobbery at play here. But I digress.

i had an email from Henci Goer about a month ago. She said "Refusal of vaginal breech is a human rights violation in that it forces a woman to have surgery in order to obtain medical care. The right to informed consent is meaningless where there is no right to informed refusal." Hear hear. "informed consent" in regards to c/s for breech is a JOKE.

xo Robin

[AugustLia23]

There is at least one homebirth midwife that I know of in my area that will deliver breeches at home, but in the hospital, it is a definite surgery. Sad state of things, especially since in my area less and less docs are even doing ECV...

[g&a]

I am in Alberta. We were told the same thing - that nobody would help us deliver our breech baby. It's against policy because of the term breech study (see robinna's website. while you're there look at the study that looks at outcomes for the mother c/s vs. vaginal. Weigh that against the risks to the infant.).
We actually happened upon a doctor who would have given us a chance to birth her vaginally, we just had to sign the AMA release (we had a c-section, though, it's a long story.).
I don't think there are many out there who will do it these days, though, as they are afraid and inexperienced.

g.

[hapersmion]

That's how it was here in Knoxville - no doctors in the city were willing to let me even have a trial of labor with my breech ds. All they offered was c-section, which I don't believe is safer than vaginal delivery for the baby, and I KNOW it's much more dangerous for me, and for my future children. (A c/s increases your risk for miscarriage, placental abruption, etc, in future pregnancies.) It's crazy how so many people are given no options besides surgery. My son was the seventh breech in my family, and my husband was the only one to be born by c/s. (Everyone was fine - but they cut my husband's bottom during the surgery.)

I went to the Farm Midwifery Center, and had a beautiful, natural, problem-free vaginal breech birth. I wish there were more options for people, since not everyone lives near the Farm! However, the Farm has houses where you can stay while you wait to go into labor, if you live far away. There was a woman who'd come up from Florida while I was there, I think she had her son two days after I had mine.

hapersmion

[sarabrynn82]

Grrrr... reminds me of the stories of breech babies on the Farm when the dr was making them perform routine (fairly large) epis until they realized that it wasn't necessary.

My mw will deliver breech babies for non-first time moms, but her backup ob will let a first time mom attempt a vaginal breech birth. With my twins, she'll deliver as long as my first one comes head down, she doesn't care if the second is breech. And if my first one ends up breech, the back up ob will still let me deliver vaginally.

***side note on breech babies - one of my mw's favorite tricks for convincing a breech baby to flip is to sit in a warm bath with an ice pack on top of your belly! in an attempt to get away from the cold, most babies will settle right down to where they need to be!***

[alegna]

It's pretty normal. Though my midwife will attend a breech.

-Angela

[Robinna]

I would urge anybody, pregnant or not, who hears a practitioner (or anybody else for that matter) say that breech is automatic c/s, to say these words:
"That is not acceptable." Until we as consumers start saying this clearly and consistently, and demanding that the choice be OURS, nothing will change. If we don't demand that the breech birth skills be maintained and offered, even the option of an option will be gone.

(stepping off soapbox... )

xo Robin

[Nitenites]

I know that my OB was comfortable delivering a breech baby - he said he felt perfectly fine with a frank breech, that footlings can be dangerous if not handled properly. We had the discussion when DS3 was transverse. Thankfully, he turned (baby, not doc ) vertex after a chiro appointment.

However, I know that my doc mentioned that his comfort had to do with the fact that he'd delivered breech babies in his internship, and I had a proven pelvis. I'm not sure what his stance would've been had I been a first-time mom. He did express his frustration that new docs didn't get to see many breech births anymore, because of CYA - teaching docs wheel mom off for a c-section at the first mention of a breech baby.

[Peppermint]

Interesting. I had rather interventionist-type OBs my first time around and there were perfectly willing to deliver frank breech, in the end, the baby ended up shoulder presentation with the cord wrapped, so I had a section, but it was planned as a natural breech birth, even with an "unproven" platapoid pelvis.

[bobandjess99]

Around here it would be an auto C/S.