I am busy figuring out my Hypno-Doula Statistics. This year I had 10 doula clients. 3 of them had breech babies!
They all had cesareans. 2 attempted ECV, 1 the breech baby was discovered when she was 6cm.
None of the moms were presented with an option of vaginal birth. That is getting rarer and rarer since the 2000 study on breech birth came out. The Washington Post had an article looking at this position of an automatic cesarean if your baby is breech. They talk about a newer study showing that for some moms breech birth is as safe as a cesarean. The problem is getting OBs and hospitals on board. Canada has made the shift. At the very least moms should be given the information and allowed to choose, rather than not being presented with a choice at all.
Breech babies account for between 3 and 4 percent of full-term pregnancies worldwide, according to the 2000 study.
So that is pretty crazy I had 3 moms out of 10 doula clients, with breech babies this year. 2 were in the same week.
I think one of the biggest problems is that now care providers are not even being trained in breech births. This is a HUGE problem. At some point there may not be time for a cesarean and they should at least know what to do.
I know of a doc who routines uses forceps, just to keep his skill level current with them. I admit, he does do a great job with forceps, but I’m not happy when it’s done for no real reason. (How do we balance it all? Practice to keep up to date, or let the skills get rusty and not be able to do it when it’s really needed?)
I agree that mothers should be given the choice. Canada’s not all that though! (speaking as a Canadian). While we applaud the move towards the option of breech vaginal birth, the problem is that they have not recognized yet that midwives have more skill in this area than OB’s. And right now, the standard of care will be that a client in midwifery care will have to transfer to an OB should she choose a breech vaginal birth. Yikes. They should have seen midwives as been the ideal careprovider for this birth, seeing as how they get so much practice with it when they go to developing countries as part of their training!
My first and third babies were breech – the third was footling breech. They never offered me the option. (I had a VBAC with #2) However, as I was laboring with #3 the nurse with me waited until everyone left the room and then said in a low voice, “You can have this baby vaginally, you know.” I said yes, I could, but not with a doctor who doesn’t know how to deliver babies that way anymore. I didn’t trust the capabilities of my physician to do that – otherwise, with a more trained birth attendant – I would have totally been on board with the idea.
I completely agree with Nicole – the irony in those “dumb midwives” (*eyeroll*) are actually the ones with way more skill level in this arena than OBs, the supposed medical gods. As if.
That is kind of scary. Using forceps when not needed. It is a fine line to walk.
I completely agree with you. My 5th baby was a surprise breech about 6 months ago, but because I was having a home birth I was able to birth him vaginally in the birth tub. We didn’t know he was breech until I started pushing. It was such a beautiful experience, and he was able to manipulate his own body under the water to actually help push himself out as I pushed. Amazing.
I’ve realized since then that if I had planned a hospital birth as I’d done with my first 4 babies I would have had a c-section. I’m so grateful I was open to another way of birthing and as a result had such a wonderful birth experience and avoided an unnecessary surgery.
I’m grateful for those who are trained to catch breech babies, and I find it so very sad that so many women are denied that possibility.
I think the lack of training is a huge issue. Right now, with the older doctors who have done more breech deliveries, it may be safer to have a vaginal delivery. But there may come a day when that’s not so because no one is trained in it. I remember reading a critique of that study you mentioned and they said that the doctors who were a part of that study were interns. That would make a difference in the outcomes of the study too. I haven’t actually read the study myself, so I’m not sure.
My 1st son was born via c-section because he was breech. I wish I had known then what I know now, I would have hired my current midwife for a home delivery. She’s completely comfortable doing a breech delivery, and has even had a breech herself!
I agree that the lack of training in OBs is a huge problem. Obviously, as Cherylyn’s story shows, breech births can be completely safe if you have a provider that knows what they are doing.
Susan, I’m not sure if I could have done a vaginal breech delivery if it had been my first baby. I was instructed by my midwife to push as hard as I could and get my breech baby out as fast as possible. The time frame is still pretty fuzzy, but it felt like I only pushed for about 10 minutes. Having had 4 babies before, two of which were unmedicated births, I knew how to push effectively and required no assistance from the midwives in actually getting the baby out. Had it been my first baby, I likely would have required a LOT of assistance. With my first baby I pushed for over 90 minutes. There was also no way I was prepared mentally and emotionally for a breech baby with my first. At that time I put all my trust in the doctor and hospital staff. My, how people change 🙂
Here in Canada, we haven’t entirely made the “switch”. The Society of Gynecologists and Obstetricians (SOGC) has stated that breech babies shouldn’t be an automatic Cesarean; but that unfortunately hasn’t filtered down to women getting to have vaginal breech births yet. There are very few OBs skilled in the art of breech birth in my city (Ottawa). You REALLY have to fight if you want a vaginal breech birth, and then you have to be in labour on the right day when one of the OBs who will catch the baby is on-call. It also has to be measured to be a reasonably small baby by u/s, and it’s strongly preferred that it isn’t your first baby. You are also strongly encouraged to have an epidural.
Progress is slow. 🙂 But at least the medical body of OBs supports it!