Vaginal breech

palesarah · Mar 12, 2006

current hospital, no way, none of the docs will go there, not even for vertex/breech twins.

previous hospital, there were a couple incredible docs who would consider it with multips or twins. In 2 years I was involved in 2 lady partsl breech deliveries- one a breech extraction of "twin b" after "twin a" was delivered vertex. The other was a multip who delivered precipitously- LGA double footling breech, intact perineum, infant did well. It was an interesting case.

rn/writer, RN · Mar 12, 2006

current hospital, no way, none of the docs will go there, not even for vertex/breech twins.
previous hospital, there were a couple incredible docs who would consider it with multips or twins. in 2 years i was involved in 2 lady partsl breech deliveries- one a breech extraction of "twin b" after "twin a" was delivered vertex. the other was a multip who delivered precipitously- lga double footling breech, intact perineum, infant did well. it was an interesting case.

all i can say is, ouch.

SmilingBluEyes · Mar 12, 2006

All is done by our OB's avoid lady partsl breech delivery. That is not to say they are unable to perform this skill, but risk management policies (and insurers) made this ruling a reality and a considered necessity years ago.

JeanettePNP, MSN, RN, NP · Mar 12, 2006

The lithotomy thread made me ask this question... My SIL had a breech a year ago and the OB she was using wanted to schedule a C. She shopped around and found a hospital in NJ willing to take her (at 39 weeks) and she delivered lady partslly. HOWEVER they made her give birth in the lithotomy position, to provide greater maneuverability to the birth team. I understand their reasoning, OTOH isn't gravity even more important for a breech lady partsl than a headfirst?

Kelky · Mar 12, 2006

Yes, I've seen a planned lady partsl breech, multip. She was in stirrups as forceps were used for the head. it was a very easy relaxed birth and they both did well.

babyktchr, BSN, RN · Mar 12, 2006

One of the most beautiful deliveries I have ever attended was a multip breech delivery of a 9lb baby girl..and an intact peri. The doc was cool calm and collected and directed everyone in what to do. The key is keeping the head flexed as it makes its way out. This was about 8 years ago and it is stuck in my head like it was yesteday. Alas...as a rule now, as with any high risk delivery (VBAC) we don't routinely do them, but if it happens, it happens.

fergus51 · Mar 12, 2006

The single worst birth I've seen was a breach. Resulted in a severely injured mother and a permanently damaged baby. (They then sued btw). I don't know any hospitals that will knowingly accept breach deliveries. That isn't to say some women don't refuse c-sections because they only want a lady partsl delivery.

SmilingBluEyes · Mar 12, 2006

I saw an ugly breech birth, too. Kid has permanent brain damage today.

Saw a couple of well-executed and great ones, also, by a couple of very skilled OB's.

capribry · Mar 13, 2006

I'm not a nurse yet but my son was breech. I live in Norfolk, VA and had my baby at Sentara and they let me push. He was butt-first. For precautions, they put me in the OR. By the time we got there, my baby was almost out since I was pushing down the hall (I tried to hold him in but the pressure felt like a bowling ball hanging out of my a**) I guess it depends on the doctor b/c my doc said that he trusted that I could do it since I have taken child birth classes. All I did was 3 pushes in he was out! I didn't even have any stitches (by the way this was my first child).

The only thing that made me wonder to this day is where did they put his fetal scalp monitor? An hour before the delivery, the doctor claim that he was head down and place one in to trace him better. But it turns out that it must have been his butt!(unless he flipped, which I don't think is possible while in the birth canal). :lol2:

Capribry

RN130 · Mar 13, 2006

Not done in our hospital.

SuperFlyRN · Mar 13, 2006

Out of all our OB's we have one that will consider it and he is always very successful. He is always calm, cool and collected and never panics (when everyone else is getting ready for a crash section) he skillfully manoevers (sp?) that baby out. The one I most remember is a primp pregnant with twins-the first slid out beautifully and the other was breech and he delivered that baby breech without missing a beat! :bow: He is :bow: my favorite OB(sadly, he will be retiring soon-we are going to miss him!)