Breech Birth

Here is a short article related to a vaginal breech birth with links to the scientific studies showing it can be safe. Many doctors don't offer vaginal breech births-- not because they aren't safe, but because they aren't trained. You can click on the title to find the original source of the article.

I Would Do Anything For My Babies, But I Won’t Do That…

Oct 30th 2012

© arztsamui

Last week, Kimberly Van Der Beek (yes, “Dawson’s” wife) posted a story about having a breech vaginal birth for her second child. As she explains, her original obstetrician offered her no option except a cesarean delivery of that child. But upon seeking a second opinion from another highly qualified obstetrician (not a witch doctor, mind you, but an actual OB) who’s skilled in breech vaginal delivery, she decided to transfer care so she could have her baby the old-fashioned way.

Some of the commentors on the article were outraged:

“How DARE you put your “experience” ahead of the safety of your baby!”

“Why are you so selfish??? I would do ANYTHING for my babies!”

“I would never risk my baby’s life that way!”

“Why wouldn’t you just listen to your doctor? You’re so stupid!”

But I guess those commentors missed the part where Kimberly DID listen to a doctor who recommended, and attended, her breech vaginal home birth. And Kimberly’s homebirth doctor, Dr. Stuart Fishbein, is no quack. In fact, The Society for Obstetricians and Gynecologists of Canada has been pushing more toward the option of breech vaginal delivery for years and has called for OBs and midwives to become trained in this lost art. The Royal College of Obstetricians & Gynaecologists also lists breech vaginal birth as an option for mothers based on certain criteria. Numerous scientific studies (like this one, this one) support vaginal breech delivery as a safe option for many mothers. Physicians supporting breech birth are coming from all over the world to the “Heads Up! Breech Conference” to discuss the topic in Washington, DC next week.

Unfortunately in the US, vaginal breech births can be difficult, or almost impossible, to come by. One of the main reasons OBs and midwives in the US do not, or cannot, offer the option of breech vaginal delivery is not necessarily because it’s not safe, but because they are not trained at all in how to deliver these babies. If a provider does not know how to attend a breech vaginal birth, then, yes, I would argue that a cesarean, which OBs are specifically trained for, may be safer for both mom and baby.

But Kimberly’s obstetrician is skilled in breech delivery and found Kimberly to be an ideal candidate. Her birth went perfectly and she was able to avoid a major abdominal surgery.

Yet some of those outraged commentors continued to insist that Kimberly didn’t love her baby if she didn’t have that cesarean. Kimberly’s decision not to expose herself and her baby to the risks of, what would have turned out to be, a completely unnecessary surgery, confounded many people. The comments section became filled with folks who proudly asserted they would have had a cesarean because they would do “anything” for their babies.

Well, I’m sorry. I love my babies and I’d do anything for them, but I will not have an unnecessary surgery just to please the ignorant masses. I won’t do that.

I would have done exactly what Kimberly did. She found herself in a difficult position, so she carefully weighed her options, consulted the most experienced and skilled providers she could find, and made a decision that felt right for her family.

That, to me, is the hallmark of a wonderful mother.

C-Section Options

During the 12 weeks of instruction students get in my Bradley classes, we cover choices and options they have regarding their birth. During the week we cover variations and complications, couples are often surprised to know that just because their birth veers from their natural birth plan, doesn't mean they stop having a say in how things go! Parents should be able to give informed consent to all aspects of the birth. In class, we learn how to do that and cover many of the options parents have. I'm sharing on the blog an article that helps parents who have learned they must have a planned cesarean section. It may be disappointing, and a little scary, but when done for the mother's or baby's safety know that you have done what was necessary.

Here are tips for having The Best Cesarean Possible

Don't forget that the American College of Obstetricians and Gynecologists (ACOG) now states, "Attempting a vaginal birth after cesarean (VBAC) is a safe and appropriate choice for most women who have had a prior cesarean delivery, including some women who have had two previous cesareans."