PREGNANCY-BIRTH Messages for December, 1998: Re: External Version/Breech Delivery

Re: External Version/Breech Delivery

From: anonymous@obgyn.net
Tue, 29 Dec 1998 12:58:30 EST

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Hi Hillary! I am not a doctor, I teach childbirth classes. I am going to send you what I have on turning breech babies. I do believe the 50% rate for an external version is fairly accurate. Depending on your provider a vaginal delivery may or may not be attempted. There have been many successful vaginal breech delivery but you would need someone who is comfortable with this and tons of experience. Talk with your care provider and see what they think - get a second opinion or a third. Maybe consider a cnm. A vaginal breech delvery can be complicated. Hope what Im sending helps! I have tons more if you are interested...just let me know.

Best Wishes, Elizabeth,CCE NJ Turning a Breech Baby

Before doing anything yourself to help the baby turn, you should try to learn how to determine whether or not the baby is breech by feeling your belly to locat so that you know when the baby has turned and don't accidentally "unturn" the baby through your efforts.

General Advice for Helping a Breech Turn

Some of these can be used together, thereby increasing their effectiveness.

- Walk a lot. Creates movement in the pelvis, providing more room for baby to turn. Soaking in water first will help relax everything, creating even more room.

- Breech tilt. If done 10 minutes twice a day for 2-3 weeks after the 30th week the pelvic tilt had an 88.7-96% success rate in research done with 744 women. It is recommended that the this be done on an empty stomach, and that the pelvis be raised 9-12 inches above the head. Gravity pushes the baby's head into the fundus, tucks it, and baby can then do a somersault to a vertex position.

- Talk to the baby about turning. Partner can even speak close to mom, low down on her belly, to encourage baby to move towards the sound.

- Visualization of the baby turning, while practicing deep relaxation. You can imagine a helium balloon attached to the baby's foot, imagine the baby turning somersaults.

- Nice things (music, whale sounds) played through headphones placed near the pubic bone, to encourage baby to move towards the sounds.

- Place a bag of frozen peas or corn on the top of mom's belly. Most babies don't like this cold, and will move away from it.

- Place a flashlight close to the vagina (babies gravitate toward the light).

- Reportedly the most successful technique is going to a swimming pool and doing handstands. Get into the pool and spend at least 15 minutes just paddling around and having fun. This will help you to relax those abdominal muscles to give the baby more room to turn, and the deep water immersion will increase your amniotic fluid, also helpful to the baby's turning. Go to where you can stand with your head just above water, then do 5 handstands in a row.

-Increase the volume of your amniotic fluid to make sure there is enough fluid for the baby to move around in. Drinking plenty of water - about a gallon a day - will help. Frequently immersing yourself in water, like in the bath or swimming pool, also helps. --------------------------------------------- Turning a Breech with Homeopathics ---------------------------------------------

--------------------------------------------- There is a homeopathic called Pulsatilla that is said to be effective in helping a breech to turn, but you should not take this without consulting a homeopathic specialist first. --------------------------------------------- Turning a Breech with Chiropractic Help ---------------------------------------------

--------------------------------------------- There is a technique chiropractor's use called the "Webster Technique." ---------------------------------------------- Routine cesareans for breech babies questioned ---------------------------------------------- >>
---------------------------------------------- >> NEW YORK, Aug 11 (Reuters) -- Routinely opting for cesarean delivery
>> for babies lying in the breech position at term does not necessarily
>> result in lower morbidity and mortality rates for infants or mothers
>> -- and may even raise the rate of maternal complications, a study
>> suggests.
>>
>> A breech delivery occurs when an infant's feet or buttocks emerge
>> before the head.
>>
>> "There is no firm evidence to recommend systematic elective caesarean
>> section for breech presentation at term," say Olivier Irion and
>> colleagues of the University Hospital of Geneva, Switzerland.
>>
>> The study, published in the July issue of the British Journal of
>> Obstetrics and Gynaecology, examined 705 consecutive breech
deliveries >> at term in a single maternity unit at the Geneva University Hospital,
>> over a 12-year period.
>>
>> Results show that compared with women who had elective cesarean
>> delivery, women in the planned vaginal delivery group had shorter
>> hospital stay (5 days versus 7.5 days), and a significantly lower
risk >> of complications such as urinary tract infection and
>> endometriosis. These women were also less likely to sustain a
>> life-threatening complication such as a hysterectomy, pulmonary
>> embolism, and cardiorespiratory arrest.
>>
>> In general, women who underwent planned vaginal delivery were
younger, >> taller, and thinner than women who delivered by cesarean section, the
>> researchers found.
>>
>> There was no significant difference in the risk of neonatal
>> complications between infants born after a trial of vaginal delivery
>> and those born by elective cesarean section. There was also no
>> difference in neonatal complications between infants born by cesarean
>> section performed during labor and those born by elective cesarean
>> section.
>>
>> The authors acknowledge that their study could detect only large
>> differences in neonatal and maternal morbidity, and that a much
larger >> study is needed to detect smaller but important differences.
>>
>> "We have to admit that the best mode of delivery for breech
>> presentation will remain uncertain until large randomised trials with
>> carefully selected outcomes such as long-term infant and mother
>> morbidity are completed," they conclude. SOURCE: British Journal of
>> Obstetrics and Gynaecology 1998;105:710-717.
>

In a message dated 12/29/98 1:18:22 PM, you wrote:

<<I am 38 wks pg and scheduled for an external version tomorrow because my baby is breech. I had read external versions have an approx. 50 percent success rate and wondered if that was accurate.

Also, is the standard practice for breech babies to have a c-section as opposed to attempting a vaginal delivery?

Hillary

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