Join Date: May 2002
Location: North of Atlanta, GA
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|One needs to distinguish between breech births - that is, babies born by the expulsive efforts of the mother, which in my opinion are safe, and breech deliveries - that is, babies born by traction by midwives and medical practitioners, which in my opinion are pretty dodgy.
We have reasonably good, safe caesarean section in the year 2000. We should use it for the breech births that do not progress spontaneously. If the labour progresses spontaneously, ie the contractions come oftener, last longer, get stronger, the cervix effaces and dilates, and the breech descends through the pelvis, the baby will be born. If this does not happen there is no place for augmentation - trying to push the baby through the pelvis with contractions driven by oxytocic drugs. Nor is there any place for trying to pull breeches through the pelvis with managed breech extractions. Labours that don't progress are telling us that the baby should be born by CS.
In my experience, if a breech presenting baby is too big for that particular woman's pelvis, the presenting part does not descend and the labour does not progress. It is when we try to be clever and stimulate/augment the labour or try to do breech extractions that we get into trouble. Furthermore a big well grown baby has a big bum. The bi-trochanteric diameter is very similar to the bi-parietal diameter..