WOMENS-HEALTH Messages for November, 1997: Re: *Unsuccessful* Version...vaginal breech??

Re: Unsuccessful Version...vaginal breech??

From: Rebecca (anonymous@obgyn.net)
Tue, 25 Nov 1997 12:11:59 -0600 (CST)

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Reply: Garry E. Siegel, M.D.: "Re: *Unsuccessful* Version...vaginal breech??"

At Mon, 24 Nov 1997, Garry E. Siegel, M.D. wrote: >
>Oy Vey!
>
>Seriously, if you have delivered vaginally before, and have a small baby
>greater than 35 weeks (yes, I know the due date is messed up) who is a
>frank breech, then consideration of a vaginal delivery is appropriate.
>That said, you absolutely should be cared for by an Obstetrician, not a
>midwife; the Perinatologist may or may not need to be involved,
>depending on the Ob. Many would want you to have some imaging of your
>pelvis, ie Xray pelvimetry or CT pelvimetry (done to measure your pelvis
>quite precisely) once you are in labor, and if inadequate (it won't
>be!), C/S! Furthermore, the flexion of the head (ie chin on the chest,
>not looking up) must be assessed. Lastly, many Obs might want
>spontaneous, *progressive* labor, and if this doesn't occur, C/S!
>
>Well, life is short, and you'll only have 2 or 3 kids. Rarely, even in
>perfect circumstances in the best of hands, bad things such an trapped
>heads occur. Many doctors and many patients do not wish to take a
>slight chance, and opt for a C/S. While you may not agree, I would
>submit that having a section for a breech in the US is rather standard.
>If your Ob is not comfy with a breech delivery, you will make a mistake
>to push him to do it! You will then need to decide whether you wish to
>shop for a new Ob at this late age (whatever that is) of your pregnancy,
>realizing that when patients shop docs at 36 weeks, 9.8 times out of 10,
>the patient is a bit weird (sorry, don't flame me, it's my
>observation!).
>
>Good luck.
>
>Garry
>
>*Note: Opinions expressed here are for educational purpose only.
>This information is not intended to supplant the need for you to
>consult with your physician prior to choosing therapeutic options.
>
>**Private emails cannot be entertained due to time constraints,
>consequently no private emails will receive a response.
>**Thank you for your understanding ;-)
>
>--
>Garry E. Siegel, M.D., FACOG
>Private Practice
>Roswell, Ga.
>

Hello Dr. Siegal.

No flame; I liked your honest opinion of "Doc shopping" in the final weeks! 8-)

What's intresting in this situation is that I'm with Kaiser. The chances are very remote that I will be delivered by the Ob that managed my care. Delivery is handled by whomever is on duty at that time. However, I think if I opt for trying a vaginal delivery, the on-call perinatologist will be called. So, unfortunately, I don't think I'll be able to sound-out the doctor about his/her feelings about vaginal breech delivery.

Just a quick observation about your comment that c/s is standard in the US for breeches. The nurse I had during the version was trained in England. She had *plenty* to say about the US practice of c/s...Guess it's definately to late to move to England.....8-)

Thanks to you and Dr. Christalli. Your information has been invaluable.

Best Wishes and Happy Thanksgiving.

-- Rebecca

--
Rebecca Mosher: Ard@sirius.com

Next message: christine: "Menopause at 37?"
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