Breech Birth

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Every birth is a miracle, of course. But the arrival of Lily Luck-Henderson, just after midnight last Tuesday morning at the General campus of the Ottawa Hospital, was something else as well.

Lily was breech ... But, unlike most breech babies born in Canada ... Lily was delivered vaginally ...

... "The safest way to deliver a baby has always been the natural way," Andre Lalonde, head of the Society of Obstetricians and Gynecologists of Canada, said last year when it began an effort to bring back breech birth. "Vaginal births are the preferred method of having a baby because a C-section in itself has complications."

Not so long ago, evidence said something different.

The practice of delivering breech babies by C-sections was already becoming the norm when a Canadian-based study ... concluded in 2000 that vaginal deliveries put breech babies at risk. The study cited 16 cases of fetal death, 13 of those involving women who delivered vaginally. The risk was considered so significant that the study was shut down early.

It had an immediate and far-reaching impact in Canada and around the world. As a result, having a breech baby, in most cases, automatically meant surgery.

Since then, a reassessment of the earlier trials has come to a different conclusion -- that vaginal deliveries in breech births do not increase complications. As a result, the Society of Obstetricians and Gynecologists of Canada has revised its position, saying physicians should not automatically perform C-sections for breech births, but, under the right circumstances, should allow women choice.

The new guidelines were announced last June, but change has been slow.

The problem is that many doctors have never delivered a breech baby and others have limited experience. It had become a lost art.

Ottawa obstetrician Glenn Posner began practising after the controversial breech birth study and, as a result, had no practical experience delivering breech babies. He is anxious to change that. On Monday night he helped deliver Lily Luck-Henderson. He says watching a video about how it is done in Germany, with women in an upright position or on their hands and knees rather than lying down, helped.

It is time women were given the choice about attempting to deliver breech babies without surgery, he added. "Aren't we supposed to let people make their own choices? It's not the 1950s when you tell people what to do and they say, 'OK, doctor.' "

Daviss, a midwife and researcher has travelled around the world collecting and dispersing knowledge about breech birth deliveries. She was recently in Israel where she taught techniques to help mothers deliver breech babies without surgery. She conducts weekly sessions for mothers and care providers in Ottawa. And she is instrumental in the formation of a "breech birth squad" in Ottawa of physicians comfortable with and experienced in vaginal breech deliveries.

... Since the 1960s, probably before, women have talked about taking back control of birth. Still, with each decade, it has become more a medical procedure and less a natural event.

In the 1960s, about five per cent of Canadian women delivered by C-section. Today, more than 27 per cent of babies are delivered surgically and there is a national debate about whether women should have the option of C-sections on demand.

... Lily's birth turned out to be problem free. "It went very easily," said Lily's mother Jennifer Luck ...

Melissa Maimann, Essential Birth Consulting 0400 418 448