Hi Everyone,
I am looking for some evidence based advice. My sister is expecting her first baby and has just discovered that he is breech. (butt first, legs up). She is so upset, and I am too. She was nervous but really looking forward to a natural, vaginal delivery. She has been working with a midwife for her pregnancy; the doctor they work with is very cool, however, like most caregivers in the OB world they are forced to recommend a C-section if she is still breech at full term. They are OK with her going into labor naturally, so she still potentially has a few weeks. The doctor attempted an external version yesterday and was unfortunately unable to turn the the baby. My sister is doing all the alternative stuff, lying on the board, moxibustion, etc. There is also the option of trying for a vaginal breech--there is 1 doctor in the area who will do them, but she has not consulted him yet. What I am interested in is if anyone has any knowledge or studies to compare the risks/outcomes of vaginal breech VS. C-section for a first baby. Such a tough decision, made tougher by the lack of clear information. Thank you in advance for the help!

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Looks like it has already been posted - but Canada recently changes its evidence based practice guidelines to deliver breech births vaginally rather than the automatic cesarean. This has more to do with skills of the practitioner than true danger. I would suggest that your sister consult with the doctor in town that does them. If he does them it is because he knows how to. Auto cesareans are more the result of fear of litigation than anything else - particularly with a frank breech. The widest part of the baby's body descend before the head with a frank breech which ensures that there is enough room for safe passage of the head and therefore the head will not "get stuck". This is one of the larger concerns with a breech birth. Initial c-secs in this country virtually guarantee repeat c-secs. They carry a multitude of risks to mother and baby that have been well documented.

In my opinion, the c-sec should only be an option if there is absolutely no way she can safely deliver vaginally. From what it sounds like, she has a practitioner that is skilled to safely provide a vaginal delivery. I am not sure where she lives, but I know The Farm in Tennessee will also do frank breech deliveries. We had a local midwife who was going to take her daughter there if her daughters breech didn't turn.

In any case, I hope she has a beautiful healthy baby and a healthy outcome for her. Best wishes!
you can find several research studies establishing the safety of vaginal breech births in Henci Goer"s book OB Myths verses Research Realities. I have attended 28 breech deliveries, 3 resulted in cesareans, 2 for failure to descend and one for fetal distress. These babies were born healthy, their mothers were all first time mothers ....I have attended 25 healthy vaginal breech births at home, 9 of these were mothers giving birth for the first time. without overstating the obvious, care providers attending breech birth must be well trained in how to deliver breech babies...if the arms are stuck above or behind the head...if the head is stuck....if the baby is single or double footling breech....also the provider needs to be an expert in neonatal resuscitation...because breech babies are more likely to need some degree of stimulation/resuscitation at delivery...Breech birth is not one of those" trust birth "type of experiences for the midwife or physician...they actually may need to know how and when to intervene....The mother giving birth needs to select a trained team to deliver her baby vaginally or by cesarean and trust and let go. (and let God...Amen!).
I am a prenatal chiropractor and have had many breech babies turn by applying the Webster and the Bagnell techniques. I don't know where you are, but usually consulting midwives in your area will lead you to qualified prenatal chiropractors. Good luck!
Find a chiropractor who knows the Webster Technique. It works. I know because I am a chiropractor and get referrals all the time for this and have had 100% success.
Tammany, I would love to know how everything turned out. I am currently 37 weeks along and baby is breech. Any advice you have is appreciated!
Hi Nicole,
I was composing my lengthy reply and found that they don't give you much room! The short story is that she ended up having a c-section, everything went fine and she and the baby are now doing great. It was a long road to the c-section, and she had an MD lined up to do a vaginal delivery. She went to her midwife group at 3 days past due date for weekly appt and baby was found to have irregular heart beat. Her plan was to proceed with vaginal delivery unless baby showed clear signs of distress. She decided to have C-section at that point and was able to have a good experience at our great local birth center (although c-section recovery is rough). Interestingly, it turned out she has a septum ( midline ridge of tissue dividing her uterus) that is 6 cm in length, which is most likely why the baby was not able to turn. He also had "breech head" (looked like a mushroom from being squashed in a small section of her uterus, which quickly molded into normal appearance. She still wishes that she was able to have a vaginal delivery, and is comtemplating a vbac in the future, but feels the decision was right for her in those circumstances. Would love to hear your story. Best wishes
Would just like to add, although I imagine you have already had your baby, that it seems like a large majority of breech babies are able to be turned using all the usual "tricks" . I would advise anything finding themselves breech from 34 weeks on to try them!

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