Mamas on Bedrest: No more C-Sections for Breech Births?

July 8th, 2013

If you are a mama in Australia or New Zealand, you may well be advised to have a vaginal birth-even if your baby is in breech position.

Reported in The Canberra Times by Kate Hagan, Revised guidelines from the Royal Australian and New Zealand College of Obstetricians and Gynecologists are advising that vaginal births are possible with breech presentations and should be attempted in appropriate women.

While this is a 180 degree shift from previous position statements, members of the college are recognizing that more breech presentation infants could have been born vaginally if health care staff were properly trained. According to College vice president Steve Robson,

“Only 3% of babies were in the breech position late in pregnancy and most were delivered by cesarean section, meaning few young doctors had the skills to perform vaginal births.”

In Australia and New Zealand, vaginal deliveries of breech births dropped from 23% in 1991 to 3.7 % in 2005 due to the shift to cesarean sections.  The shift occurred after an correspondence published in The Lancet in 2000 cited fewer risks delivering by cesarean sections. However, many doctors skilled in breech delivery question the study and the reported results.

Dr. Kobus du Plessis, a physician trained in South Africa, is particularly skeptical of the studies and is now training young doctors and midwives to attend breech births. According to du Plessis,

“Most deliveries are hand-off with breech births, and if all the criteria are fulfilled most of the time we don’t have to do anything. The reason you need experience, and the thing most people afraid of, is the head getting stuck.”

This is great news for mamas and babies worldwide. Whenever one nation or even one group makes major headway in a given treatment or technique, its not long before others seek them out to learn the skills and to disseminate the information and “technology”. Interestingly, in this case, it isn’t technology being sought, but lost skills and as Dr. du Plessis says, “lost art”. Long ago, physicians and midwives both used Leopolds Maneuvers and other manual manipulations to turn babies and facilitate vaginal births. As technology became more sophisticated, medical training became more focused on the technologies, setting aside many of the more “basic” skills needed.

And while technology is good, we are all becoming more aware that technology is not a suitable replacement for nature. The intricate interplay between mother and baby stimulating labor and delivery, passage of the infant through the birth canal and the immediate interaction between mother and baby in the immediate post partum cannot be replicated or substituted.  Removing these critical interactions via induction, cesarean delivery and by separating mama and baby in the immediate post partum are now being noted to be detrimental and the practices halted.

How will this affect births in the United States? Hopefully, obstetricians and midwives will take notice of the changes being made in Australia and New Zealand and will follow suite. Given the Cesarean Section rates and the maternal and infant morbidity and mortality rates, we need to make changes in this country. It would certainly be nice to keep it simple and do things as much in line with nature as possible.

One response to “Mamas on Bedrest: No more C-Sections for Breech Births?”

  1. Ruza says:

    Not to freak you out-But with my son, I was at 41 weeks and had not dilated. He hadn’t even drpeopd into the birth canal! I had to be induced because he was overdue and a little too comfortable in the womb lol. Not typical though, but I believe it’s more common to dilate closer to your due date with first babies. Good luck!

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