Vaginal breech

CEG · Mar 16, 2006

What are the real concerns with breech? Is it cord compression or the baby getting stuck? Or is it cord compression if the baby gets stuck? Are there more birth injuries for babes with breech deliveries (aside from those due to use of forceps)?

Dies the cervix tend not to dilate without pressure from the baby's head or do the buttocks have the same function?

Just curious why breech birth is so often not considered as an option. Do the risks overwhelmingly outweigh those of c-section?

Courtney

Messink · Mar 16, 2006

Thanks for the explanation ChayaN.

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

What are the real concerns with breech? Is it cord compression or the baby getting stuck? Or is it cord compression if the baby gets stuck? Are there more birth injuries for babes with breech deliveries (aside from those due to use of forceps)?
Dies the cervix tend not to dilate without pressure from the baby's head or do the buttocks have the same function?
Just curious why breech birth is so often not considered as an option. Do the risks overwhelmingly outweigh those of c-section?
Courtney

Or is it lawsuits in the event that anything -anything - goes wrong, even if unrelated to breech?

facetiousness aside, as other posters said it takes a skilled OB to manage a breech birth and many don't have that training. So, breech lady partsl goes out the window and yet another childbirth choice is taken away from women.

CEG · Mar 16, 2006

Or is it lawsuits in the event that anything -anything - goes wrong, even if unrelated to breech?
facetiousness aside, as other posters said it takes a skilled OB to manage a breech birth and many don't have that training. So, breech lady partsl goes out the window and yet another childbirth choice is taken away from women.

But does it necessarily need to be "managed"? Like a PP said, there is "breech extraction" and breech birth. Why has breech birth become so rare? Is it just lack of training?

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

There's a whole school of thought that breech is just a variation of normal, and that breech births can proceed smoothly as long as mother is relaxed and as upright as possible. Gravity helps birth especially in the case of breech. But I'd like to hear what the experienced RN's have to say.

fergus51 · Mar 16, 2006

Here's a good page that lists some risks associated with breech birth. There are real risks here beyond litigation. IMO, in our attempts to encourage natural birth (which I agree with), we sometimes downplay the dangers of breech births too much. If you see one head entrapment resulting in a signifigantly brain damaged child, you may feel like I do now.

http://en.wikipedia.org/wiki/Breech_birth

fergus51 · Mar 17, 2006

There's a whole school of thought that breech is just a variation of normal, and that breech births can proceed smoothly as long as mother is relaxed and as upright as possible. Gravity helps birth especially in the case of breech. But I'd like to hear what the experienced RN's have to say.

I don't think it's that simple. Gravity is great, but it won't make up for an unfavorable position by the baby. A footling breech or transverse isn't likely to be delivered lady partslly no matter how relaxed and upright the mother is. Frank or complete breeches would be helped with the mother in a good position, but even then we have to rely on some skillfull work by the healthcare provider and a favorable position of the baby. If the baby's head is in a deflexed position or the arm is up beside the face, gravity and relaxation aren't the solution.

ShifraPuah · Mar 19, 2006

FWIW, I was a footling breech w/a prolapsed cord (it was wrapped around my right ankle and foot), plus I was macrosomic (9 pounds even) at birth. I was a lady partsl delivery, not a C/S.

On the aftereffects portion of the breech argument, I do have hearing loss (55dB) in both ears but have worn hearing aids since I was 2 and haven't found it to be a problem (mainstreamed at age 5, studied mutiple foreign languages, graduated from 2 colleges, have a special stet for hearing-impaired nurses).

That all said, I would be more comfortable w/ C/S for a breech birth, just to be on the safe side.

JeanettePNP, MSN, RN, NP · Mar 19, 2006

ShifraPuah, are you a midwife?

fergus51 · Mar 20, 2006

You were one lucky baby!

ShifraPuah · Mar 20, 2006

ShifraPuah, are you a midwife?

No, not yet! I am an L&D nurse, but I have had an interest in maternal-infant health care for as long as I can remember. I plan to get my RN-to-MSN and obtain a midwifery certificate/degree along the way.

RNnL&D · Mar 25, 2006

We have a couple docs who feel comfortable and will attend a breech vag delivery. They are usually twin b in a breech or transverse presentation situations. Although we have had a few singleton breech deliveries. I have never seen a breech extraction with forceps though. If planning a vag delivery, I know the doc's like baby to be under 8 pounds and Mom to have a "proven" pelvis.

I did some research on this a couple years ago and noticed that despite the switch to planned CS with breech presentations, the birth trauma/damage associated with breech birth has not significantly decreased.