Hi - I’m going to chime in here a bit with a couple of comments.
First, people seem to be offering their opinions, which is fine, as personal experience is certainly wonderful to share. No doubt.
However, what I think any woman who is pregnant and facing a decision needs is information based on RESEARCH, and not even necessarily what some people see doctors doing nowadays. Obstetricians are famous for ignoring the research in their field, no matter how voluminous, and simply going by tradition. Hence, you have still have women being denied food and drink during labor (and given reasons for this that have no basis in the literature), confined to bed, made to push in stirrups, continually monitored despite being low risk, etc. etc. It gets frustrating to see this time and time again. I just did a birth in LA and heard more obstetric myths in 4 hours than I had heard in 7 years of being a doula. It was so sad. Even sadder was that the staff actually believed what they were saying, despite overwhelming scientific evidence against them.
I wish, more than anything, that women were given more evidence based options. If you look at places like The Farm, run by Ina May Gaskin, she does breech births with decent frequency and does just fine. The problem with delivering vaginal breech births is more in the training of the doctors - a lot of old docs were trained, a lot of newer docs have not been, so there’s a gap in experience there.
I’m going to quote to you from Henci Goer’s book The Thinking Woman’s Guide to a Better Birth. Henci is VERY well respected in the field of medical writing, and she is a lamaze educator and doula to boot. Her book sums up the research data on a host of pregnancy and birth-related issues.
“Numerous studies have shown that the changeover from mostly vaginal breech birth to nearly universal cesarean delivery didn’t close the gap between breech and head-first outcomes.” (p.32)
“Despite these facts, most US obstetricians today believe that the only safe breech delivery is an abdominal delivery, although as one author who recently reviewed the literature wrote, “The generally applied approach of cesarean to breech is not based on clinical facts.” Authorities in other countries do not share this belief, and neither do a number of eminent American physicians … These experts may debate who makes a good candidate for vaginal breech birth and how vaginal breech birth should be conducted, but they don’t think every woman carrying a breech baby requires a cesarean.” (p.33)
Goer cites that often, c-sec is done as the result of defensive medicine, hardly a “reason behind medical care decisions”. (p. 34) Training, as I also said, is also a reason, though the skills can be learned.
Having said that, here are some options for those who are stuck in a system which advocates universal c-sec for the breech baby:
You can do home version, where you assume different positions to get the baby into an optimal position. I agree with the pp who mentioned spinningbabies.com. Excellent site. For more info on positions, check out Henci’s book. Also anything by Penny Simkin, such as The Birth Partner or Pregnancy, Childbirth and the Newborn.
External cephalic version (ECV) is also an option, one that has been utilized by doctors and midwives alike, both in industrialized and non-industrialized nations, with varying degrees of technology. However, “Babies that don’t want to turn should never be forced.”
Consider hypnosis, which has a higher rate of turning than ECV studies. The study in question looked at 100 hypnotized women, and ultimately turned 80% of the babies. Hypnosis can calm fear and induce relaxation, which may be just what the baby needs.
Chinese medicine can help as well, using something called moxibustion, which uses heat from burning herbs instead of needles. A randomized study using moxibustion posted higher success rates than most ECV trials.
Studies have agreed that ECV is safe, as long as it is done gently. Compared to cesarean, it is definitely an option to explore before scheduling major abdominal surgery. Birth injuries from vaginal breech births, such as a broken collar bone or Erb’s palsy can also occur during cesarean section, as can cuts to the baby from a scalpel. Injury to mother or baby can happen from both vaginal or cesarean birth, so the issue is not so clear cut. Goer notes that “Depending on the individual case, vaginal birth is as much a reasonable, responsible choice as is planned cesarean section.”
The risk of head entrapment is rare, and I would be interested to see what the research data says regarding cord compression, Lyndsey. Is it common or rare? Goer makes only a brief reference to head entrapment, and none to cord compression as significant risks. This is important information to convey when discussing the various risks of any intervention with a woman. Sure, the thought of head entrapment is absolutely terrifying, but knowing that something is rare can be comforting when making an informed decision.
Ok, so there ya go!!! Hope this helps. Get ahold of Henci’s book - it’s fantastic. Also good is her other book, meant for practitioners, entitled Obstetric Myths, Research Realities, in which she analyzes all the date up to the date of publication of her book. She’s writing a new edition of her book, and I can’t wait to read it!
Above all, make your decision with an open heart, a clear head and a full stomach! No matter what, the birth of a baby is a beautiful and wondrous experience, and you deserve to be given all the information and support you need to make a comfortable and informed decision. Best of luck to you, and if you need me to blather on even more, PM me.