Did I have any other options? - Page 3 - Mothering Forums

Forum Jump: 
Reply
 
Thread Tools
#61 of 73 Old 01-04-2007, 03:53 PM
Banned
 
accountclosed3's Avatar
 
Join Date: Jun 2006
Posts: 11,906
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
OTF:

i will reiterate again that both scheduled and emergency c-section are appropriate. i have always asserted that a mother should make an informed decision, and i fully support that. This asserts that breech presentation is a valid reason. thus, these 3-4% mothers with breech presentation is fully covered and supported by these previous two statements.

it might also be noted that we are in agreement about the excessive use of c-sections. I find it problematic that 96-97% of breech presentations are not problematic and yet the medical establishment recommends c-sections for breech presentations when the majority of these women can birth vaginally without a problem. And, those 3-4% can be either A. sorted out prior to birth to determine cause such that a c-section can be appropriately scheduled, or B. cause determined during birth such that an emergency c-section would be appropriate. this seems more logical and medically responsible toward the other 96-97% of women with breech presentation, for whom the c-section would be more dangerous to her and the child than the vaginal birth.

Again, this is not to say that there isn't cause for c-sections with breech presentation. it is also not to say that mothers should always "wait it out" if they don't know whether or not they have an anomoly which would require a c-section. A woman needs to make an informed choice, understand the risks of going either way, and be supported in her choice by her caregivers.

i also agree that caregivers should be trained in appropriately aiding during breech births--something that is rare in our modern context. i believe that by changing the medical perspective and culture surrounding birth, there would be more study of breech birth and alternative methods (such as webster, etc) for turning before and during birth--when that is applicable and appropriate, which it may not be or isn't necessarily for that 3-4% who have anomolies.

similarly, i never placed 'blame' on anyone as to whether or not babies are breech. being breech is not a moral issue. breech is something that simply exists--sometimes with a cause, sometimes without, and there's no one to say that it's "wrong" or "bad" to be breech. similarly, i've never said that it's "wrong" or "bad" to have a c-section because of breech, but rather when it's an 'uninformed' or 'forced' decision.

for myself, i'd take the odds that i'm in the 96-97% and if i need an emergency c-section, then i'll get one. for myself, it seems unnecessary to schedule a c-section because of a 3-4% chance of having an anomoly that would cause me to need one. thus, i would likely simply 'take the risk' and have my UC, and transfer if i feel the need to (for the c-section or whatever other care i felt i needed).

this isn't setting my into a heirarchy as if i'm 'better' than another woman. i do not believe that. There's nothing wrong with birthing in the way that one thinks, feels, believes, and knows is right for her and for her children--including c-sections. i simply take a different approach; doing so isn't judging someone else.
accountclosed3 is offline  
#62 of 73 Old 01-04-2007, 03:58 PM
 
heartmama's Avatar
 
Join Date: Nov 2001
Location: In the bat cave with Irishmommy
Posts: 6,252
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
OP I have no idea what decision was right for you I think you will have to decide that for yourself and build confidence in whatever belief you have about your experience.

Quote:
think its real easy for several posters in this thread to blame mothers for their breech mothers or to say the csection was unnecessary because they could have UCed at home. (which is dangerous with a breech birth, great for you if it was successful but it carries its own risks)
I agree with part of what you are saying and disagree with another part.

Ds was born breech at home. I have a bicornuate uterus (just a note, you mentioned a septum, and that is Septate uterus~very different in terms of treatment, but often confused by doctors). It is extremely unlikely that ds could have turned around at term inside of a bicornuate uterus. And the blame associatated with breech babies is often ignorant of uterine abnormalities. So I agree with you there.

There is also a correlation you mentioned (that is not understood) between breech babies and birth defects. I find that interesting, since ds was born breech with a major heart abnormality. Again, we don't know why these two issues co exist. And blaming a mother for a breech presentation is, I think, ignorant of the possible reasons her baby could be breech.

I disagree that at the time of birth there is necessarily more risk to a mother if the baby is breech. If she has reached term, then at least with bicornuate or septate uterus-the greatest risks have been overcome-the greatest risks of those uterine abnormalities being problems related to miscarriage and premature birth (and since ds' birth I have lost two babies by three months gestation).

There could be some placental detachment issues at birth. But I don't know that there is statistical evidence of this, and i don't know that it's any greater than a normal oval uterus. If anything, it's seems possible that a bicornuate uterus, being two small chambers rather than one large chamber, will expel the placenta with greater speed after the baby is birthed, than a placenta in a spacious rounded oval

In terms of birth defects, if that is a concern, you can pursue ultrasound to eliminate at least the kinds of defects likely to present as a medical emergency at birth. A level ll ultrasound that is looking for defects in major organs stands a good chance of finding them.

Which is why I'm saying, in terms of where she births, I am not convinced that breech presentation alone means anything especially risky is about to happen. If she has reached term and there is no evidence of a birth defect, I am not convinced a breech baby at that point, is going to present any greater risk than a head down baby.

From a purely anecdotal point of view, having had a breech birth, I feel that some of the common fears really are based on lack of experience with breech.

Just my 2c

Mother is the word for God on the hearts and lips of all little children--William Makepeace Thackeray
heartmama is offline  
#63 of 73 Old 01-04-2007, 04:16 PM
 
OnTheFence's Avatar
 
Join Date: Feb 2003
Location: Alabama
Posts: 3,742
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
My uterus is bicornuate with a septum. So I am not confused, neither are the OB or REs who have treated me in the last ten years.

Also, Zoebird you misunderstood my post, I said breech presentation presented itself 3-4%, not a uterine anomaly. Uterine Anomalies occur more frequently than that, but may not present a malpositioned baby.
OnTheFence is offline  
#64 of 73 Old 01-04-2007, 04:25 PM
 
OnTheFence's Avatar
 
Join Date: Feb 2003
Location: Alabama
Posts: 3,742
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by heartmama View Post
I disagree that at the time of birth there is necessarily more risk to a mother if the baby is breech. If she has reached term, then at least with bicornuate or septate uterus-the greatest risks have been overcome-the greatest risks of those uterine abnormalities being problems related to miscarriage and premature birth (and since ds' birth I have lost two babies by three months gestation).

There could be some placental detachment issues at birth. But I don't know that there is statistical evidence of this, and i don't know that it's any greater than a normal oval uterus. If anything, it's seems possible that a bicornuate uterus, being two small chambers rather than one large chamber, will expel the placenta with greater speed after the baby is birthed, than a placenta in a spacious rounded oval

Which is why I'm saying, in terms of where she births, I am not convinced that breech presentation alone means anything especially risky is about to happen. If she has reached term and there is no evidence of a birth defect, I am not convinced a breech baby at that point, is going to present any greater risk than a head down baby.

From a purely anecdotal point of view, having had a breech birth, I feel that some of the common fears really are based on lack of experience with breech.

Just my 2c
Women who have uterine anomalies who have breech presentation are at a greater risk of prolapsed cord. There are also other problems that can be present if a woman makes it to term. I think it actually varies on the mullerian anomaly. I have had 2 38 weekers and 1 36 weeker, my first was at the greatest risk of having cord related problems had my water broke.

Also there has been some evidence that placentas do not detach as well in a uterus with a mullerian anomaly, even with a vaginal birth. One horn can actually contract harder than the other. Most my placentas have been normal, but I have seen pictures of ones that were really weird looking, smaller than normal, from births where the mother had a uterine anomaly.
OnTheFence is offline  
#65 of 73 Old 01-04-2007, 04:42 PM
Banned
 
accountclosed3's Avatar
 
Join Date: Jun 2006
Posts: 11,906
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
OTF:

thank you for clarifying. does that change the underlying message or tone of my post at all for you such that i would need to go through the information with this new understanding?
accountclosed3 is offline  
#66 of 73 Old 01-04-2007, 05:13 PM
 
ndunn's Avatar
 
Join Date: Mar 2006
Location: BC, Canada
Posts: 1,302
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Just to add, most of those "studies" that have shown that section is better for breach babies, have been done by doctors who have no education on how to deliver the babies. I believe the trail that was done in Canada is actually going to be thrown out at some point because we are recognising that it wasn't valid due to the reasons I just mentioned.
ndunn is offline  
#67 of 73 Old 01-04-2007, 05:44 PM
 
OnTheFence's Avatar
 
Join Date: Feb 2003
Location: Alabama
Posts: 3,742
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by ndunn View Post
Just to add, most of those "studies" that have shown that section is better for breach babies, have been done by doctors who have no education on how to deliver the babies. I believe the trail that was done in Canada is actually going to be thrown out at some point because we are recognising that it wasn't valid due to the reasons I just mentioned.
Actually that isnt true. One I referenced was done spanning 26 countries, another in Switzerland -- where vaginal breech delivery is still common. Another I mentioned spanned nearly 50 years. My aunt is 48, another relative in her mid 30s -- breech vaginal births were still pretty common.
OnTheFence is offline  
#68 of 73 Old 01-04-2007, 05:51 PM
 
lrlittle's Avatar
 
Join Date: Nov 2005
Location: Austin, TX
Posts: 1,137
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
If you're talking about the Hannah term breech trial...AJOG says recommendations should be withdrawn. Hannah is a big reason why docs won't give vaginal breeches a chance these days. I'm sure they've all somehow missed the updated recommendation, though. :

http://www.ajog.org/article/PIIS0002...13621/abstract

Mama to two beautiful sons Wife to DH
lrlittle is offline  
#69 of 73 Old 01-04-2007, 06:04 PM
 
heartmama's Avatar
 
Join Date: Nov 2001
Location: In the bat cave with Irishmommy
Posts: 6,252
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
My uterus is bicornuate with a septum. So I am not confused, neither are the OB or REs who have treated me in the last ten years.
Yes, the variations are unlimited I am addressing what I know my support groups find to be a common problem though~medical doctors who interchange the terms Septate and Bicornuate uterus.

Quote:
Women who have uterine anomalies who have breech presentation are at a greater risk of prolapsed cord. There are also other problems that can be present if a woman makes it to term. I think it actually varies on the mullerian anomaly. I have had 2 38 weekers and 1 36 weeker, my first was at the greatest risk of having cord related problems had my water broke.

Also there has been some evidence that placentas do not detach as well in a uterus with a mullerian anomaly, even with a vaginal birth. One horn can actually contract harder than the other. Most my placentas have been normal, but I have seen pictures of ones that were really weird looking, smaller than normal, from births where the mother had a uterine anomaly.
Even if I agreed the research regarding those risks is absolutely correct, a woman can take steps to address those concerns *if she wants a homebirth*. It does come down to the individual woman, what risks she faces, and whether she feels those risks can be managed better at home or in the hospital. I don't think any of the risks of uterine anomalies are statistically strong enough to warrant discouraging full term women who happen to have an ma choosing a homebirth. I'm not sure if that is what you suggest?

Mother is the word for God on the hearts and lips of all little children--William Makepeace Thackeray
heartmama is offline  
#70 of 73 Old 01-04-2007, 06:25 PM
 
OnTheFence's Avatar
 
Join Date: Feb 2003
Location: Alabama
Posts: 3,742
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by lrlittle View Post
If you're talking about the Hannah term breech trial...AJOG says recommendations should be withdrawn. Hannah is a big reason why docs won't give vaginal breeches a chance these days. I'm sure they've all somehow missed the updated recommendation, though. :

http://www.ajog.org/article/PIIS0002...13621/abstract
Actually no, it wasnt but thanks for the link.
OnTheFence is offline  
#71 of 73 Old 01-04-2007, 06:31 PM
 
OnTheFence's Avatar
 
Join Date: Feb 2003
Location: Alabama
Posts: 3,742
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by heartmama View Post
Even if I agreed the research regarding those risks is absolutely correct, a woman can take steps to address those concerns *if she wants a homebirth*. It does come down to the individual woman, what risks she faces, and whether she feels those risks can be managed better at home or in the hospital. I don't think any of the risks of uterine anomalies are statistically strong enough to warrant discouraging full term women who happen to have an ma choosing a homebirth. I'm not sure if that is what you suggest?
I personally believe it is unwise to attempt a homebirth with an MA, even though I know several people who have (or in birthcenters), however several of them ended up with 4th degree tears and babies with birth injuries that needed transfer. I guess its all in a matter of what you are willing to risk and if you can find someone to attend you at home in those situations.
OnTheFence is offline  
#72 of 73 Old 01-04-2007, 09:19 PM
 
heartmama's Avatar
 
Join Date: Nov 2001
Location: In the bat cave with Irishmommy
Posts: 6,252
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
I personally believe it is unwise to attempt a homebirth with an MA, even though I know several people who have (or in birthcenters), however several of them ended up with 4th degree tears and babies with birth injuries that needed transfer. I guess its all in a matter of what you are willing to risk and if you can find someone to attend you at home in those situations.
You know, I really empathize with the fact that it can change a person when certain risks become real to you (general you).

Anyway, I appreciate you clarify this is a personal belief you have come too based on experience.

I think mullerian anomalies are just too varied to go beyond the individual woman's experience and condition in knowing what risks, if any, she is likely to face. In our case, the homebirth did not conflict with the other issues that emerged. If I'd felt there was a conflict, I would have made a different choice.

Mother is the word for God on the hearts and lips of all little children--William Makepeace Thackeray
heartmama is offline  
#73 of 73 Old 01-04-2007, 11:22 PM
 
ndunn's Avatar
 
Join Date: Mar 2006
Location: BC, Canada
Posts: 1,302
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by OnTheFence View Post
Actually that isnt true. One I referenced was done spanning 26 countries, another in Switzerland -- where vaginal breech delivery is still common. Another I mentioned spanned nearly 50 years. My aunt is 48, another relative in her mid 30s -- breech vaginal births were still pretty common.
Are you even reading what I'm writing? I said MOST.



And yes I was really referring to the trial the next poster left a link for. Thank you.
ndunn is offline  
Reply

Quick Reply
Message:
Drag and Drop File Upload
Drag files here to attach!
Upload Progress: 0
Options

Register Now

In order to be able to post messages on the Mothering Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
If you do not want to register, fill this field only and the name will be used as user name for your post.
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



User Tag List

Thread Tools
Show Printable Version Show Printable Version
Email this Page Email this Page


Forum Jump: 

Posting Rules  
You may post new threads
You may post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off