Vaginal Breech

Specialties Ob/Gyn

Published

See recent article about lady partsl breech in the Washington Post:

http://www.washingtonpost.com/wp-dyn/content/article/2010/01/04/AR2010010402755.html?hpid=sec-health&sub=AR

Anyone out there attending lady partsl breech in their hospital since the term breech study? If so, do you have a nursing specific protocol/considerations for trial of lady partsl breech? After many years, physicians at my institution are hoping to reintegrate lady partsl breech as an option for carefully screened patients. I am very excited about this decision, and am wondering if many other hospitals are already doing breech deliveries, or are considering moving in that direction.

Thanks for your input!

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Specializes in Community, OB, Nursery.

We have a few attendings that will allow for lady partsl TOL of breech, but they are few and far between, and mostly the older docs. The other night we had a multip come in complete with a double footling breech that the resident wanted to section, which I realize is the norm for footling breeches today. She delivered lady partslly, and why couldn't she? Her pelvis was proven to 8lb+.

I'd love to see an increase in lady partsl breeches, but I think like the article mentioned happened in Canada, if it's going to happen they're going to have to have older docs teach the younger ones how to do it.

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Specializes in Dialysis, Nephrology & Cosmetic Surgery.

I'm delighted to see that the last baby was delivered sefely by a skilled Midwife. My mums second was a breech delivery - at home as my mum didn't want to another hospital birth and only the midwife there to deliver my brother into the world. I am in the UK and for my mums generation it was not unusual to have your first in hospital and providing that all went smoothly any future births could be managed at home by the midwife. I should add that the Medics would rather she had delivered in hospital but didn't object when she requested she be allowed to deliver at home. The Midwife who helped mum with my 4 siblings was also my midwife (post natal) when I had my son.

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Specializes in Aged care, disability, community.

I know the hospital I'm delivering at in a couple of months is letting me labour if I'm breech. That's in Australia and there's a rather high chance of me being breech.

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A woman in my area delivered a footling breech en route to the hospital a few weeks ago. :eek: None of the ambulance personnel had ever seen one.

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Specializes in LTC, Hospice, Case Management.

LOL - I am in a snow storm in the great lakes area and saw this title as Virginia Beach - guess I want outta the snow. Sorry to hijack the thread.

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Specializes in Psych.

I was a lady partsl breech delivery. I was also my mom's first child, although that was in 1980. I think I was basically already coming by the time my parents got to the hospital though. If my mom would have been there longer, who knows? Anyway, I turned out OK. Its nice to hear things are maybe beginning to lean this way.

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Unfortunately I don't see this changing in most facilities anytime soon.

I would also love to be a fly on the wall when a doc who previously told his patients that lady partsl breech was too dangerous now says it is perfectly safe.

I did a project on this for school and the term breech trial authors actually came back with another article saying that c/s for frank breech would not improve outcomes. Interesting how that never made it to practice!

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Specializes in Aged care, disability, community.

I got changed to having a c-section today as the Doctor that was originally going to deliver for me has been ordered to take 3 months leave as he has too much accumulated and he's the only Dr in the Hospital that uses forceps. On the plus side they're going to get a decent look at my uterii whilst they're in there.

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Specializes in NICU, PICU, PCVICU and peds oncology.

I realize that anecdotes don't equal proof, but one of the most memorable experiences of my life was observing the delivery of a baby girl who was discovered to be frank breech when Mom (who was a primip in her 30s) was already well into labour. This was memorable for several reasons... first, I had a GA for all of my own deliveries and had only observed two deliveries to that point in nursing school. Second, the labour was fairly short so I was able to attend despite the fact that the rest of my classmates were already in post-conference. (I had been prepared to stay until the baby was born, no matter what time it was!) The L&D nurse who was assigned that mom was from the UK and had delivered more than a few babies on her own; she picked up on the baby's presenting part and reported it to the OB, who was an older man with a TON of experience. He was quite content to let Nature do what she would. Watching that baby enter the world backwards, pooping all the way, was very exciting. But what really impressed me was that the OB stood back and let Peg deliver the baby with his guidance. He said, "One day you might be in a situation where you're all there is, and you should know how to manage."

The baby was just a little over 6 pounds, with a full head of brown hair. They named her Melissa and she's about 16 years old now.

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Only our old school docs know how to delivery breech and will only do so if we can't get them back in time for a c/s.

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I can only say from personal experience that I wish that they would at least give you the option! My 1st was breech and I ended up having to have all 3 of my by section. I was trying for a VBAC with my 2nd and did not work because I had to go in to labor naturally no later that 2 weeks before my due date (which did not happen). I think it would be nice if you had a say in it. I had a your breech and he wont turn so as soon as your blood work comes back you well have a c-section.

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