Re: Breech birth

From: DoctorJoe@aol.com
Sat Nov 26 08:46:38 2005


In a message dated 11/26/05 3:54:25 AM, clairec1979@hotmail.com writes:

> I've never heard of her having a bad outcome with a breech - if they
> won't descend she recommends they go for a c-section then, she won't
> induce, use oxytoxics, do ARM etc on a breech and ensures she always
> have oxygen on hand for afterwards.
>
> Even if they end up as a section then the mothers tend to feel that at
> least they gave it a shot and that their section was neccesary.
> This is a rough guide to what she does
>

And I think this is a rough guide to how US Obstetricians try to do it. Only the governing factor is AVAILABILITY OF THE BACK-UP FACILITIES. "Going for" a c-section or other intervention across town, or into town, or by taxi or ambulance is clearly less beneficial than if the help is immediately on hand (e.g. within 30 minutes, as per ACOG protocol).

So her you have the bone of contention here. Midwives (apparently) don't think it's necessary to be within 30 minutes of a skin incision (or feel that they've screened their clients well enough to guarantee they won't need it) while OBs (at least in the US) feel that they don't want ONE BABY to fall through the cracks, so they'll set up a "homey" birthing center IN the hospital.

So I think everyone needs to concentrate on what we're really debating. The few babies who NEED some sort of intervention and how and how fast will it be provided. Selection can do wonders, but you can't fool Mother Nature forever.

Joe P.





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