I recently was sent a link to The Coalition for Breech Birth website and I wanted to share it with all of you because it is both interesting and informative.
I learned in nursing school and have since witnessed as an L&D nurse the hard truth that all breech babies are born by cesarean section in the United States nowadays unless 1) the baby turned from vertex to breech during the labor and no one realized it or 2) the baby actually delivered in the bed before her doctor could wheel her into the operating room. I knew from books and stories told to me by older nurses that in the “old days” they used to deliver breeches vaginally but never learned why it isn’t even presented as an option for the women of today.
According to the Coalition for Breech Birth website:
“Vaginal breech birth was practically banned following a significant international research study in 2000. This study, the “Term Breech Trial” or TBT, appeared to prove that caesarean section was substantially safer for the delivery of all breech babies. The trial was highly criticized, but many birth care providers took this opportunity to do what they wanted to do anyway – to stop offering vaginal breech birth to their clients, and to insist instead upon a surgical delivery. In addition to all the professional criticism, the TBT’s own two year follow up negated the original results, suggesting that any difference in safety between vaginal and surgical birth of a breech baby is negligible – for both mother and child. Despite this evidence, many birth care providers (BCPs) still avoid balanced informed choice discussions with their clients, denying them the opportunity to make an informed choice.”
It is disappointing enough when a woman is not given the choice and is just scheduled for an elective pre-labor cesarean section (often at about 39 weeks, which could still be early for many babies) related to her baby being breech. It’s also frustrating when a provider doesn’t even offer the patient an external version before scheduling her for surgery. But what I find really upsetting as an L&D nurse is when a woman comes in 8, 9, or 10 centimeters dilated and because she is found breech is rushed of for an emergency cesarean section. Many doctors say that one of the reasons they don’t “do” vaginal breech births is because the buttocks are not as effective at dilating the cervix as a nice round head is and labor can be too long and difficult. But when a woman comes in at 10 centimeters dilated clearly her body did just fine!! And when a woman “accidentally” delivers a breech baby in the bed before we could get her to surgery, everyone (doctors, nurses, midwives) seem to be so excited that the patient was able to “avoid” surgery, yet this hasn’t EVER made ANY doctor think twice about scheduling every one of their breech patients for surgery anyways. So frustrating!
If you have never seen a breech delivery before, this site has links to pictures and videos as well as other resources for mothers wanting to be more informed of their birth choices.
The sad thing is that if things continue the way they are now, less and less doctors and midwives will be properly trained to assist in the delivery of a breech baby and by this vicious cycle, less and less opportunities for women to make this birth choice will exist.