Vaginal Breech Delivery by OB - Mothering Forums
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Maryland, Metro D.C. Area, Delaware > Vaginal Breech Delivery by OB
imnottelling's Avatar imnottelling 12:18 PM 07-22-2009
Any Baltimore doctors who would attempt a vaginal breech in a first time mother? Mother is not willing to attempt a homebirth. Baby refused to be turned through ECV, acupuncture being tried, etc etc but we're at 38 weeks now. Good recommendations?

And if not, or breech position doesn't allow for a vaginal attempt, who are good surgeons locally that can be recommended?

AllofGrace's Avatar AllofGrace 02:18 PM 07-22-2009
Has she seen an osteopath (D.O) to try to resolve any of her musco-skeletal issues that may be causing baby to stay this way? I recommend Dr. Harold Goodman in Silver Spring. Even though he's a licensed physician, he doesn't take insurance, but it may well save her a c-section. He's done some amazing things for other pregnant ladies!

His office # is 301-565-2494.

Best wishes!
imnottelling's Avatar imnottelling 04:01 PM 07-22-2009
Quote:
Originally Posted by AllofGrace View Post
Has she seen an osteopath (D.O) to try to resolve any of her musco-skeletal issues that may be causing baby to stay this way? I recommend Dr. Harold Goodman in Silver Spring. Even though he's a licensed physician, he doesn't take insurance, but it may well save her a c-section. He's done some amazing things for other pregnant ladies!

His office # is 301-565-2494.

Best wishes!
I doubt she'd travel that far at this point in pregnancy. She's feeling very discouraged. ECV tried by 2 different practitioners. Constant swimming.
I'm trying to get her to see a chiropractor. Not sure if she went ahead with the acupuncture appointment.
But if the baby doesn't turn, what are good options for delivery in a Baltimore hospital?
mfrank's Avatar mfrank 05:02 PM 07-22-2009
Quote:
Originally Posted by imnottelling View Post
But if the baby doesn't turn, what are good options for delivery in a Baltimore hospital?
Dr. Atlas at Mercy was really great when my baby went breech and I didn't know it until I was in labor. I lucked out that he was on call at the time (I was w/ Kathy Slone's practice). He tried doing a version first and when that didn't work he immediately started talking to me about VBAC w/ the next.

I hope the baby turns though!

ETA: I see you are looking for an OB who will try to deliver breech. Sorry! I don't know of any that will.
imnottelling's Avatar imnottelling 05:22 PM 07-22-2009
Quote:
Originally Posted by mfrank View Post
Dr. Atlas at Mercy was really great when my baby went breech and I didn't know it until I was in labor. I lucked out that he was on call at the time (I was w/ Kathy Slone's practice). He tried doing a version first and when that didn't work he immediately started talking to me about VBAC w/ the next.

I hope the baby turns though!

ETA: I see you are looking for an OB who will try to deliver breech. Sorry! I don't know of any that will.
Yeah, Atlas was very nice to me when he did my (successful) version last year, and was the second practitioner to attempt hers. I don't think he mentioned letting her attempt a vaginal delivery though
womancaredoula's Avatar womancaredoula 06:42 PM 07-22-2009
I recently posted about this on the Baltimore/DC doula yahoo list and the only OBs who were offered were all in the DC area. I think she'd have to be willing to travel.

Did she check with Kathy Slone? Can Evelyn do a breech in the hospital?

-Barbara Stratton
babylightsagain's Avatar babylightsagain 08:12 PM 07-22-2009
Susquehanna OB and MWs at Upper Cheasapeake in Abingdon. There is a doctor there that I have heard delivers breech. I think it is Bellatoni or something like that. Worth calling and asking what their policy is especially so late in pregnancy.

Perhaps she'd rather deliver by c-section? or just wait until labor starts and give the baby the extra time to turn on its own?

I'd say with 2 ECVs that the baby has good reason for not turning.

Let baby do its thing.
homewithtwinsmama's Avatar homewithtwinsmama 08:20 PM 07-22-2009
Quote:
Originally Posted by babylightsagain View Post
Susquehanna OB and MWs at Upper Cheasapeake in Abingdon. There is a doctor there that I have heard delivers breech. I think it is Bellatoni or something like that. Worth calling and asking what their policy is especially so late in pregnancy.

Perhaps she'd rather deliver by c-section? or just wait until labor starts and give the baby the extra time to turn on its own?

I'd say with 2 ECVs that the baby has good reason for not turning.

Let baby do its thing.
A midwife from Maryland General told me they are still doing them there. It's worth a call.
Awaken's Avatar Awaken 11:11 AM 07-23-2009
I had a friend who delivered a breech at MD General- I don't think all the OB's are supportive, but some are, and there are midwives as well. She may luck out with who's on call.

I would really rec. the chiropractor or osteopath route if she will go for it! Can't hurt, and might do a lot of good! Relatively inexpensive and easy, when compared with the cost of c/s and recovery.
imnottelling's Avatar imnottelling 11:48 AM 07-23-2009
Quote:
Originally Posted by womancaredoula View Post
Did she check with Kathy Slone? Can Evelyn do a breech in the hospital?

-Barbara Stratton
She goes to Kathy already
Evelyn doesn't deliver breeches in hospitals (as far as I understand it when I had a breech baby last year with her).

And if she decides a C-section is her only option she'll consider ( ) what reading recommendations do you have for her? She has not prepared herself at all regarding a C-section. She's been hoping for an intervention free birth the whole time. But there is only so far she'd go, and I think traveling to DC to try for a vaginal delivery is beyond where she is right now in her mind.

(Any local osteopath recommendations?)
imnottelling's Avatar imnottelling 11:48 AM 07-23-2009
Quote:
Originally Posted by homewithtwinsmama View Post
A midwife from Maryland General told me they are still doing them there. It's worth a call.
Oh, really? Even for first? That's good information if it's doable.
imnottelling's Avatar imnottelling 11:50 AM 07-23-2009
Quote:
Originally Posted by babylightsagain View Post
Susquehanna OB and MWs at Upper Cheasapeake in Abingdon. There is a doctor there that I have heard delivers breech. I think it is Bellatoni or something like that. Worth calling and asking what their policy is especially so late in pregnancy.

Perhaps she'd rather deliver by c-section? or just wait until labor starts and give the baby the extra time to turn on its own?

I'd say with 2 ECVs that the baby has good reason for not turning.

Let baby do its thing.
Excess amniotic fluid is the reason. The baby hasn't engaged in any position....it's just an unstable lie (which also affects her options since she doesn't know how the baby will present even if it stays breech).
NaturalMama311's Avatar NaturalMama311 02:40 PM 07-23-2009
My DD was breech and I also tried everything possible to get her to turn with no success. I had low amniotic fluid so no OB would even attempt a version because of the risk factors with low fluid. I ended up having a c-section at AAMC in Annapolis. I used a MW but the doctors that did the surgery were from Annapolis OB/GYN and they were fabulous.

Dr. Hays did my section and she was fanstastic.....Dr. Guckes also attended as a backup (I guess there are always 2 doctors present?) I would highly recommend them for a planned c-section. Although I did not want a c-section I was very happy with them and they made it a great experience.
imnottelling's Avatar imnottelling 04:11 PM 07-23-2009
Is there any doctor closer to the Baltimore area that is good in terms of low postop pain/ negative side effects?
imnottelling's Avatar imnottelling 01:22 PM 07-24-2009
Can people please think positive thoughts that the acupuncture will work?
NaturalMama311's Avatar NaturalMama311 02:55 PM 07-24-2009
: Sending lots of positive thoughts!!! I do believe it can work, when I had it done I definitely felt DD trying really hard to flip over. But, since I had such low amniotic fluid I think it was almost impossible for her to get in position. It was pretty amazing though, I could feel her trying to move as the accupuncture was being done!
womancaredoula's Avatar womancaredoula 11:59 AM 07-27-2009
Quote:
Originally Posted by imnottelling View Post
She goes to Kathy already
Evelyn doesn't deliver breeches in hospitals (as far as I understand it when I had a breech baby last year with her).

And if she decides a C-section is her only option she'll consider ( ) what reading recommendations do you have for her? She has not prepared herself at all regarding a C-section. She's been hoping for an intervention free birth the whole time. But there is only so far she'd go, and I think traveling to DC to try for a vaginal delivery is beyond where she is right now in her mind.

(Any local osteopath recommendations?)
After she makes the calls to U of MD midiwives, MD General, and Upper Chesapeake please let me know the results so I can keep a file on this for ICAN inquiries. Again, the only names passed along to me during my last search for an inquiry were in the DC area.

For UCMC, she can contact me at ICANofBaltimore @ Comcast.net for the contact email for the doula who does the most births there and will be able to shed some insight.

In terms of preparation for a planned c/s, she is welcome to contact me to discuss options. She can also spend some time on the national website ican--online.org and on the Baltimore one icanofbaltimore.org where she can download a sample c/s birth plan. The plan isn't meant to be used in its entirety but rather to use it as a tool to figure out what is most important to you. I feel that ALL moms should have a c/s birth plan ready just in case. Learned this myself the hard way.

I don't have a recommendation for the best place or the best caregiver to have one's c/s. We assume that having an uneventful recovery is based on a mixture of surgical skill, age of the mother and her genetic tendency as to whether she heals well or builds a lot of adhesions. Also add in how gentle she is with her body during recovery - getting the help of a postpartum doula - not lifting anything more than her baby (no lifting the baby in his carseat, no carrying loads of laundry, no carrying bags of groceries) for as long as possible. Some women feel that acupuncture can help the healing process and we do have a local acupuncturist who will make home visits for post-cesarean moms. The mom can contact me for info on that as well.

For the best location the only thing that comes to mind is to inquire with the state health dept. regarding the hospital's infection rates. Also, the cesarean deaths we've had recently have been Franklin Square, GBMC, and Carroll County. Another death was associated with Anne Arundel Medical Center but the mom had been home a week and died of a blood clot. The breech mom would have to consider whether AAMC's postpartum approach to preventing and educating mothers about blood clots was sufficient. The family of that victim definitely feels that the education on the warning signs and their serious nature was lacking.

-Barbara
imnottelling's Avatar imnottelling 02:08 PM 07-27-2009
Thank you, Barbara. I'll pass on the info to her (hoping that the acupuncture visit she has today is what works though Her first one she said she felt the baby moving, so she really is hoping this will do the trick.)
MegBoz's Avatar MegBoz 02:17 PM 07-27-2009
Quote:
Originally Posted by babylightsagain View Post
Susquehanna OB and MWs at Upper Cheasapeake in Abingdon. There is a doctor there that I have heard delivers breech. I think it is Bellatoni or something like that.
Yes, I was going to mention Bellantoni. I had a discussion with him & he actually used the word "epidemiologically!" Rare for an American OB to be so evidence-minded.
So considering that, it might be worth trying to talk with him.

Good luck!
womancaredoula's Avatar womancaredoula 12:05 PM 07-29-2009
A woman who works at U of MD emailed me this post:

<<How many weeks along is this mom? Has she entertained the possibility of having someone use a rebozo to flip the baby? Moxibustion? Tilting exercises and/or doing flips in the swimming pool?

I work at UMD and (as far as I am aware of) they do not offer vaginal breech delivery for singleton gestations. They will deliver a breech twin if the first is vertex. There is an experienced OB named Dr.Alger who I've heard knows how to deliver breech...maybe she'd make an exception for this mom? Idk...maybe worth a shot calling to ask. >>

-Barbara
imnottelling's Avatar imnottelling 01:30 PM 07-29-2009
Quote:
Originally Posted by womancaredoula View Post
A woman who works at U of MD emailed me this post:

<<How many weeks along is this mom? Has she entertained the possibility of having someone use a rebozo to flip the baby? Moxibustion? Tilting exercises and/or doing flips in the swimming pool?

I work at UMD and (as far as I am aware of) they do not offer vaginal breech delivery for singleton gestations. They will deliver a breech twin if the first is vertex. There is an experienced OB named Dr.Alger who I've heard knows how to deliver breech...maybe she'd make an exception for this mom? Idk...maybe worth a shot calling to ask. >>

-Barbara
She's 38-39 weeks I think.
She's been swimming away, in the middle of acupuncture/moxibustion. Hasn't tried the rebozo but are the outcomes much greater than ECV when we're talking about physically trying to get baby to move? (She tried ECV with 2 different practitioners.) Excess amniotic fluid is what is preventing the baby from settling in a good position. It's more of an unstable lie than a stubborn breech baby that is engaged butt first.

Thanks for the name of Dr. Alger. It can't hurt for her to call. (I am not sure at what point I'm nagging her by all my suggestions! I feel so bad for her. I just wish the baby would turn! She does feel like the acupuncture with moxibustion is helping as she feels the baby moving when she goes.)
Bmorefarmgirl's Avatar Bmorefarmgirl 05:24 PM 07-29-2009
i did not know what a rebozo was, so i looked it up and found this video.

http://www.homebirth.net.au/2008/09/...ion-shots.html
womancaredoula's Avatar womancaredoula 05:27 PM 07-30-2009
I just spoke with Dr. Pleeter. He won't do a breech vaginal birth for a first time mom. He wondered why, with plenty of fluid, the two EVs didn't work?

-Barbara
phathui5's Avatar phathui5 07:08 PM 07-30-2009
Have you checked out the spinning babies site?

http://www.spinningbabies.com/
imnottelling's Avatar imnottelling 11:35 AM 07-31-2009
Quote:
Originally Posted by womancaredoula View Post
I just spoke with Dr. Pleeter. He won't do a breech vaginal birth for a first time mom. He wondered why, with plenty of fluid, the two EVs didn't work?

-Barbara
Supposedly it's "too much".

Not to say that I've heard Pleeter's success rate at ECV being better than the doctors who tried. I know people who he's failed with as well...

Thanks for checking into all this!
imnottelling's Avatar imnottelling 11:38 AM 07-31-2009
Basically, the baby is moving plenty (hence, why I think it's unstable lie) -- it hasn't settled into any one breech position. It's staying basically head up/to the side, but moves a lot. She feels it moving during her acupuncture appointments especially.
We're beyond spinningbabies at this point She's tried basically all the home techniques she can. I was reading in an old book "Active Birth' that walking for an hour sometimes helps gravity take its course. I'm going to suggest it to her, but I'm not sure she can keep on her feet that long at this point.

Any good chiropractors around Baltimore excelling in Webster's?
homewithtwinsmama's Avatar homewithtwinsmama 12:02 PM 07-31-2009
Quote:
Originally Posted by imnottelling View Post
Basically, the baby is moving plenty (hence, why I think it's unstable lie) -- it hasn't settled into any one breech position. It's staying basically head up/to the side, but moves a lot. She feels it moving during her acupuncture appointments especially.
We're beyond spinningbabies at this point She's tried basically all the home techniques she can. I was reading in an old book "Active Birth' that walking for an hour sometimes helps gravity take its course. I'm going to suggest it to her, but I'm not sure she can keep on her feet that long at this point.

Any good chiropractors around Baltimore excelling in Webster's?
Dr. Traci Ball in Ellicott City is EXCELLENT!
imnottelling's Avatar imnottelling 01:11 PM 07-31-2009
Quote:
Originally Posted by homewithtwinsmama View Post
Dr. Traci Ball in Ellicott City is EXCELLENT!
I knew there was one in E.C. my midwife recommended, but I never got the name because my baby turned beforehand and I was too wiped out to make more appointments.
Thanks! I'll look up her number and pass it on
GOPLawyer's Avatar GOPLawyer 06:48 PM 08-05-2009
Obviously not around Baltimore but there's Dr. Tchabo who catches breeches at Virginia Hospital Center.

There's also the option of just refusing a c/s. If I had a breech baby that I *had* to have in the hospital, I'd show up at Virginia Hospital Center during labor and just flat out refuse the c/s. Not fun to have to fight while in labor but legally, they can't force the c/s (I had to do this w/ my VBA2C).
emilyb24's Avatar emilyb24 11:58 PM 08-05-2009
My husband is an acupuncturists and he said she should get acupuncture 1-2 times a day until the baby turns. He says acupuncture is 80% effective if the breech is not the result of a physiological issue like contracted pelvis or uterine deformity. Let me know if you would like more info......
Sending positive thoughts and good vibes!

Good Luck!
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