Vaginal breech

FLOBRN · Mar 13, 2006

Actually they can flip that fast...had one just last week. Vertex in the office in the afternoon, breech at 730 that night and when we got into the OR at 8pm it was transverse when we cut. You just never know. It was an 8 pound baby too, not at all tiny, just average.

FLOBRN · Mar 13, 2006

Hey Superfly

I worked with a Dr like that when I lived in Halifax "back in the dark ages" haha. Where in the Great White are you located?

epiphany · Mar 13, 2006

Actually they can flip that fast...had one just last week. Vertex in the office in the afternoon, breech at 730 that night and when we got into the OR at 8pm it was transverse when we cut. You just never know. It was an 8 pound baby too, not at all tiny, just average.

Just had like that last week. Vertex according to clinic, came in the morning was breech. Brought into OR, turned vertex - finally delivered lady partslly. Polyhydromnious.

fergus51 · Mar 14, 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.

I'm really pro-vag birth and all, but breeches make me uncomfortable still. I just don't know if it's worth the risk.

Penguinelane · Mar 14, 2006

I have been to breech births. The large problem with them, legality nonwithstanding, is that few practitioners are being taught how to deliver one.

Many of those who are attending lady partsl breech insist on forceps, episiotomy, and epidural, in other words, a breech extraction, not a spontaneous breech birth.

If anyone would like references, I will try to dig them up and post.

I did attend an 8 1/2# double footling. There is a way to do it.

Tri · Mar 14, 2006

I see quite a few deliveries.

Seems that the MD's with lots of experience attempt breech deliveries, while "newer" OB's don't try - they rarely use forceps.

May be because of all the lawsuits, they don't get the experience in their training.

palesarah · Mar 14, 2006

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).

I personally know someone who, while her mom was in labor with her, was breech and flipped vertex very close to delivery- the doc had put a scalp clip on, and when she flipped before delivery the end of the clip snapped off. After delivery they looked and looked for it, but it was never found... until 16 or so years later, during a GYN exam, when it was found embedded in the wall of her lady parts. Amazing, eh? The GYN removed it under local and all was well with my friend. I think she said the doc even wrote it up for a journal, since it was such an unusual case!

mitchsmom · Mar 16, 2006

My doc with my second baby said that he'd attempt a lady partsl breech under certain conditions (head flexed, certain breech positioning, etc.). He's in Miami now and I don't think anyone in my area currently would consider it unless it just happened that way unknowingly/precipitously.

Here's a good photos of a breech birth if anyone is interested:

http://www.birthdiaries.com/diary/47vbirth.htm

(kind of cool aside, it states the mom only had one breast due to an injury and fully breastfed baby too)... oh, and the baby was 8lbs 11oz too fairly big on top of the breech).

gcrhodenrnc · Mar 16, 2006

We do not plan any lady partsl breech deliveries at our hospital, however, I've been exposed to two of them in the last few years.

We had a primip come in pushing, out of control, unable to check her, but terminal looking meconium gave us a hint, she kept screaming the baby is coming, no doctor inhouse of course. I ran down to the room where she was screamin and when I entered the room I saw one of our newest nurses, who had never even done a lady partsl delivery, up on the bed, and the patient on all fours, and what was that she had in her hands but a pair of legs and a butt that she was trying to menuver out of this lady's lady parts. My heart went to my feet, I called a neonatal code, and continued to coach her thru the delivery, now all of the baby out except for the head. She reached up inside and grabbed the baby's child and mouth and flexed the head downward and out it popped. The baby and mom did great, no problems. As far as our new nurse, she learned how to deliver baby's the old fashion way. She later told us that a week before this happened, she and one of the docs had this conversation about lady partsl breech births, and he had explained to her how to successfully deliver a lady partsl breech baby. Thank God she was there that night, she knew exactly what to do......want to know something even funnier? Two years later this same patient came back to our unit, again she came in complete, no doctor inhouse, but this time head down and I caught the baby while she was standing on her knees..

Messink · Mar 16, 2006

May sound stupid, but could somebody explain to me exactly what a breech delivery is?

JeanettePNP, MSN, RN, NP · Mar 16, 2006

Baby coming out in any position other than headfirst. Could be footling (feet presenting), frank breech (buttocks first, feet straight up) complete breech (baby "sitting up"), or transverse - sideways (practically impossible to deliver lady partslly). Breech is considered high risk because of the chance of baby getting stuck on the way out. Head is the widest and hardest part of the body, so having the baby come out headfirst usually means that the rest of the body slips right out after. When it's bottom first, the head can get trapped.

Spryte · Mar 16, 2006

On March 20 and 21 there will be a Breech Birth Conference in Vancouver, BC. From the site:

We aim to bring together practitioners and researchers from around the world to discuss issues such as research and safety, as well as techniques associated with breech birth. It is to be a multidisciplinary forum, and will contain discussions, presentations and interactive workshops.
Objectives

Analyze research in this area, and hear of current work in the field
Participate in hand-on skills workshops for both lady partsl breech birth and emergency skills, led by both doctors and midwives
Hear about some of the different approaches to breech birth around the world, including the rationale for selected use of oxytoxics in second stage, and the preferences for different birth positions