[jobudz]

I'm 35 weeks tomorrow and my doctor just tried ECV unsuccessfully. He is supposed to be very skilled at it (was gentle, no anesthesia, etc) and is actually experienced in delivering breech babies vaginally (he's been around a while and used to work out of a birth center), but I think he's basically made the decision to work within the hospital system for whatever reason and so his advice was basically you can have a home birth with "some midwife willing to do it" or come to terms with having a scheduled c-section. Not the kindest way to help me come to terms with it...

I was planning on trying to have an unmedicated birth, as active as possible, in a hospital with a doula. I don't think I'm comfortable having a home birth, especially if baby is breech, but would be comfortable attempting a vaginal birth with a skilled provider in or very near a hospital. At the very least I want to explore my options further. My baby is frank breech and has been in the same position for essentially months now, so I think the likelihood of him turning on his own is low - tho I've been trying spinning babies techniques, etc. and will do acupuncture, see the chiropractor, and all those things over the next couple weeks to see if anything can work.

Anyway, I'd love to find out if there are Dr's/hospitals/midwives in the NYC area that are willing to deliver breech babies vaginally. My doula gave me the name of one doctor who does, Dr. Readke, but she's out of network and really expensive (around 15k if you waited to the very last minute to switch to her and basically just had her deliver the baby) and I just don't think that is an option, especially considering there are no guarantees and you might end up having an emergency c-section anyway if things don't progess well.

Any help, thoughts, similar experiences would be much appreciated!

 

[nadja2112]

I'm really sorry for what your doctor has said to you. I remember how stressed I was at that point in my pregnancy, so sending you my best wishes. I hope everything will work out in the end!

See, I could have written almost the exact same post 11 months ago. Short version: I was 35 weeks with a breech baby. I switched to Dr Rodke's practice. The baby flipped before birth, but Dr Rodke still ended up saving me from an unnecessary C-section for other reasons. And, finally, my insurance unexpectedly paid me back for the doctor's entire delivery fee.

The detailed version is the following: I was 34/35 weeks when my practice told me they would not be willing to do a vaginal breech delivery. A midwife at the practice had misinformed me earlier, lulling me into a false sense of security. My baby kept flipping, so I wasn't really concerned he would be breech at term, but - just in case - wanted to have a doctor who would know what to do. And then at around 34 weeks I got a phone call from an administrative assistant at the practice asking me to schedule a C-section. I couldn't believe it. I went in for a meeting with my doctors and was told it was "irresponsible and dangerous" to attempt a vaginal breech. "But the midwife told me..." "You must have misheard" "But research shows..." "We're not aware of such research." "Well, how about the latest ACOG opinion on the subject?" I had to literally show them a print-out of the ACOG statement in order for them to finally admit it was all about their malpractice insurance. Needless to say, my confidence in my providers took a major hit. Breech or no breech, how could I trust those guys?

At that point I started a frantic search for a better, more honest provider. A wonderful doula whose childbirth-prep class I had taken gave me the following list of providers known to have done vaginal breech. Here is the list (with my comments in parentheses):

In New Jersey:

• Dr Yaakov Abdelhak, Hackensack (I haven't called him because I was scared of the Hackensack C-section rate, but worth a shot.)
• Dr Judy Banks, Morristown (A friend delivered with her recently and spoke to her about vaginal breech. The doctor said that she would most likely do a C-section with a primagravida. Still, I hear she's wonderful, so worth a phone call.)
• Dr David Garfinkel, Morristown

In Connecticut:

• Dr David Weinstein, Stamford

NYC area:

• Dr Gae Rodke, St Luke's Roosevelt, including the Birthing Center (She does vaginal breech, and her C-section rate is <10%.)
• Dr Rebarber, Mt. Sinai (I know for a fact he does *not* do singleton vaginal breech deliveries.)
• Dr Matheson, formerly of St. Vincent
• Dr Neal Rosenblum, Brookdale
• Dr Judy Beyer, Mt. Sinai

In the end, I made a switch to Dr Rodke. I saw her for a consultation and was blown away by how much she knew about a very obscure subject that was relevant to me earlier in my pregnancy. Delivering babies is not just a job for her, it's her true vocation. She has the courage and knowledge to do what is right. And I imagine that it *does* take enormous guts to go against your malpractice insurers and against your typical hospital administrators in order to practice the way you believe is best for mothers and babies.

The switch turned out to be the best decision of my entire pregnancy. I have a very strong feeling it saved me from an unnecessary C-section. It was a very tough decision initially, of course. I felt strange about switching so late. I had to do the hospital tours all over again. And I felt guilty about going out of network. (Was I being unreasonable demanding a chance to have vaginal birth if my baby is breech? I thought so initially. But now I strongly believe that what is unreasonable is the system that forces women to go through an unnecessary surgery.)

Also, in the end, my insurance covered the entire delivery fee. I was so surprised that I called them to ask about it. They explained that it was because Dr Rodke was at an in-network hospital and that the procedure counted as a hospital procedure. I'm not pretending I really understood it. Especially that when I had inquired about it beforehand, I was told they would only be covering 60% of what they consider "reasonable & customary". So it's *really* worth checking and double-checking with your insurance company.

My baby did flip before birth. However, he had problems descending because of a bad arm position, which meant I was basically stuck in the transition stage for way longer than any human should have to. My previous providers would have just rolled me over to the OR. Not Dr Rodke. She used her experience (and her hands) to gently coax the baby out. I've heard that babies in such position usually give mothers painful tears. But I only had one small tear that required a single stitch. No epidural, fantastic birthing center nurses & atmosphere, and a beautiful birth with 100% healthy baby and mom. (He's sleeping right next to me now as I write this.)

 

[jobudz]

I'm really sorry for what your doctor has said to you. I remember how stressed I was at that point in my pregnancy, so sending you my best wishes. I hope everything will work out in the end!

See, I could have written almost the exact same post 11 months ago. Short version: I was 35 weeks with a breech baby. I switched to Dr Rodke's practice. The baby flipped before birth, but Dr Rodke still ended up saving me from an unnecessary C-section for other reasons. And, finally, my insurance unexpectedly paid me back for the doctor's entire delivery fee.

The detailed version is the following: I was 34/35 weeks when my practice told me they would not be willing to do a vaginal breech delivery. A midwife at the practice had misinformed me earlier, lulling me into a false sense of security. My baby kept flipping, so I wasn't really concerned he would be breech at term, but - just in case - wanted to have a doctor who would know what to do. And then at around 34 weeks I got a phone call from an administrative assistant at the practice asking me to schedule a C-section. I couldn't believe it. I went in for a meeting with my doctors and was told it was "irresponsible and dangerous" to attempt a vaginal breech. "But the midwife told me..." "You must have misheard" "But research shows..." "We're not aware of such research." "Well, how about the latest ACOG opinion on the subject?" I had to literally show them a print-out of the ACOG statement in order for them to finally admit it was all about their malpractice insurance. Needless to say, my confidence in my providers took a major hit. Breech or no breech, how could I trust those guys?

At that point I started a frantic search for a better, more honest provider. A wonderful doula whose childbirth-prep class I had taken gave me the following list of providers known to have done vaginal breech. Here is the list (with my comments in parentheses):

In New Jersey:

• Dr Yaakov Abdelhak, Hackensack (I haven't called him because I was scared of the Hackensack C-section rate, but worth a shot.)
• Dr Judy Banks, Morristown (A friend delivered with her recently and spoke to her about vaginal breech. The doctor said that she would most likely do a C-section with a primagravida. Still, I hear she's wonderful, so worth a phone call.)
• Dr David Garfinkel, Morristown

In Connecticut:

• Dr David Weinstein, Stamford

NYC area:

• Dr Gae Rodke, St Luke's Roosevelt, including the Birthing Center (She does vaginal breech, and her C-section rate is <10%.)
• Dr Rebarber, Mt. Sinai (I know for a fact he does *not* do singleton vaginal breech deliveries.)
• Dr Matheson, formerly of St. Vincent
• Dr Neal Rosenblum, Brookdale
• Dr Judy Beyer, Mt. Sinai

In the end, I made a switch to Dr Rodke. I saw her for a consultation and was blown away by how much she knew about a very obscure subject that was relevant to me earlier in my pregnancy. Delivering babies is not just a job for her, it's her true vocation. She has the courage and knowledge to do what is right. And I imagine that it *does* take enormous guts to go against your malpractice insurers and against your typical hospital administrators in order to practice the way you believe is best for mothers and babies.

The switch turned out to be the best decision of my entire pregnancy. I have a very strong feeling it saved me from an unnecessary C-section. It was a very tough decision initially, of course. I felt strange about switching so late. I had to do the hospital tours all over again. And I felt guilty about going out of network. (Was I being unreasonable demanding a chance to have vaginal birth if my baby is breech? I thought so initially. But now I strongly believe that what is unreasonable is the system that forces women to go through an unnecessary surgery.)

Also, in the end, my insurance covered the entire delivery fee. I was so surprised that I called them to ask about it. They explained that it was because Dr Rodke was at an in-network hospital and that the procedure counted as a hospital procedure. I'm not pretending I really understood it. Especially that when I had inquired about it beforehand, I was told they would only be covering 60% of what they consider "reasonable & customary". So it's *really* worth checking and double-checking with your insurance company.

My baby did flip before birth. However, he had problems descending because of a bad arm position, which meant I was basically stuck in the transition stage for way longer than any human should have to. My previous providers would have just rolled me over to the OR. Not Dr Rodke. She used her experience (and her hands) to gently coax the baby out. I've heard that babies in such position usually give mothers painful tears. But I only had one small tear that required a single stitch. No epidural, fantastic birthing center nurses & atmosphere, and a beautiful birth with 100% healthy baby and mom. (He's sleeping right next to me now as I write this.)

Wow thank you so much for the in depth reply and all the information. I'll definitely look into those doctors/options some more and give my insurance a call.

 

[nadja2112]

Keep us posted!

Also just wondering: are you considering doing another version, maybe at 37 weeks, possibly in a hospital setting? And is your provider known for being good at ECV? What's his success rate? It might be worth looking into having a version with a different doctor. Another thing is that I have heard of so many people for whom the baby turned head down literally the day before - or even the day of - labor. It's been a while now, so I don't remember the risk/benefit stats/analysis, but perhaps it would be better to wait for the labor to start? (Honestly, I wish I had asked my Dr about it - she would have given it to me straight. =))

Anyway, again, best wishes!