This month’s ICAN meeting, we had two newcomers, both seeking a VBAC, both had their first babies by C/S due to breech. I was so glad that my baby is no longer breech, because I’m not entirely sure how zen-like I would have been able to be during the meeting.

What’s so sad is that neither of those surgeries needed to happen.

This is why I’m active with ICAN.

Some C/S need to happen. When there are actual problems necessitating intervention, up to and including surgery, then everyone is (and should be) very glad we have the technology necessary to do that safely.

But C/S for breech? Doesn’t need to happen. Breech delivery is very safe. But a C/S is easier, and more appealing to OBs who are not likely to want to sit around waiting for a breech vaginal delivery (which can be lengthy, and in which the OB can do nothing but sit and wait). So, over the years, more OBs have opted to deliver breech by C/S, to the point that the only OBs who have vaginal breech experience are older, and retiring. This is a skill that is literally dying out.

Combine that with another sad fact: few OBs put their hands on a woman’s belly and feel the baby. Few OBs who bothered to do so would know what they were feeling. (I was never once felt when PG with Wally, and talking with several recently pregnant friends yielded the same responses.) So, many times, a breech baby can be undetected until the woman is in labor and receives a vaginal exam. Well, at that point, she usually has literally no choice. Her OB will not allow her to deliver vaginally. She could refuse surgery (an option which is likely not presented to her), but then she takes her chances with an OB who is likely NOT skilled in breech, and the risks with breech go way, way up with an unskilled care provider.

So off she goes to surgery.

It’s so preventable.

And why would we not want to prevent unnecessary surgery? It’s more expensive, takes longer to recover, has many known side effects (difficulty breastfeeding, difficulty feeling attached to the baby, difficulty just plain moving), not to mention the risks that accompany any surgery.

It’s not the end of the world, no. But it’s so unnecessary.


3 responses to “

  1. I agree with you, but aren’t there some breech presentations that really are unsafe for vaginal delivery? (transverse, footling)

    I have a friend who had a frank breech baby more than 20 years ago. At that time doctors didn’t even raise the possibility of c-section, and it wasn’t even her toughest delivery (she has four kids).

  2. You’re right, I should have mentioned that. Transverse I don’t think WOULD come out vaginally. Footling there are more risks, and I think it’s really important that someone with a breech of any type look into the risks of both vaginal as well as surgical delivery before deciding. But the key there is that they SHOULD be allowed to decide. Too often, they are not even presented with options.

    The breeches in question above were both Frank.

  3. The truth is, vaginal delivery is becoming a lost art — esp. when done w/ out drugs, interventions and instruments. Health care providers just don’t know how to deal with that and it’s a very very sad. First, went breeches, then twins, then VBACs…and unless it’s a rare woman w/ a straightforward delivery, a plain, old singleton birth is going too. Very very sad.

    Sometimes, c/s ARE necessary — no doubt about it. But most these days are done out of impatience, lack of education, lack of education and/or fear. And society and the medical world is trying to find justfication and convince us that it is all OK. All while practicing bad medicine based on poor research… Grrr…

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