A correct delivery position minimizes complications for the baby and mother during a vaginal delivery. However, not all babies are in the correct position prior to delivery. Breech presentations are very common in pregnancy. Some women find out that their baby is breech several weeks before birth, and they are able to encourage the baby to turn.
Breech babies can be born healthy using a cesarean delivery. While a C-section may not be your preferred choice of delivery, it may be necessary in order to avoid the following risks of a breech birth:.
The squeezing of the cord restricts vital oxygen and blood supply to the baby during delivery. Your baby is also old enough in case there is a problem during the procedure that makes it necessary to deliver the baby promptly. This is rare. External version cannot be done once you are in active labor. Risks are low for this procedure when a skilled provider does it.
Rarely, it may lead to an emergency cesarean birth C-section if:. Most babies who remain breech after an attempt at turning them will be delivered by C-section. Your provider will explain the risk of delivering a breech baby vaginally. Today, the option to deliver a breech baby vaginally is not offered in most cases.
The safest way for a breech baby to be born is by C-section. The danger of breech birth is mostly due to the fact that the largest part of a baby is its head. When the breech baby's pelvis or hips deliver first, the woman's pelvis may not be large enough for the head to be delivered also. This can result in a baby getting stuck in the birth canal, which can cause injury or death. If a C-section is planned, it will most often be scheduled for no earlier than 39 weeks. You will have an ultrasound at the hospital to confirm the position of your baby just before the surgery.
There is also a chance that you will go into labor or your water will break before your planned C-section. If that happens, call your provider right away and go to the hospital. It is important to go in right away if you have a breech baby and your bag of water breaks. This is because there is a higher chance that the cord will come out even before you are in labor. This can be very dangerous for the baby. Barth WH. And the temptation to shift responsibility for bad outcomes to the hospitals where women and babies were transferred.
Allocating responsibility requires independent audit, for a start. Yet, even if the problem lay hospital-side, the safety of out-of-hospital birth is predicated on hospitals being able to bail people out. How did this paper get published and promoted uncritically like this? This paper had just one peer reviewer — clinical, not statistical. And what now? This paper is a good example of how that can go off the rails.
And that can have public health consequences. In this case, this paper could encourage midwives and women into choices they will bitterly regret for the rest of their lives. Because the women tend to be well-educated and paying for private midwifery care, they wrote, this is a choice, and we need to address this with information.
I agree we need to ensure that there is trustworthy information out there for women considering this — especially the data on harm to babies, and a realistic portrayal of what the high number of complicated labors and transfers are like.
Even when disasters are averted, these experiences can be nightmare-ish. The risks for babies in breech, and the extra skill they require, are actually part of the allure of breech births, I think. In the years I spent countless hours talking with midwives and mothers about this, I saw shades of hubris in some midwives, and enjoyment of the challenge and the sense of mastery and empowerment when it works out beautifully — as it will do, most of the time.
Vaginal births after low-risk pregnancies can be taken for granted, at least a little. When the odds would have been against it in a hospital, though, a vaginal birth can mean elation, with the midwife a hero. If the trend against vaginal breech births in hospital continues, though, we need to get more real about what doing it at home means. The price of staying out of hospital to avoid the risk or certainty of cesarean for breech is a high risk of a traumatic birth experience, with serious harm for babies, and far too often, shattering grief and regret.
Disclosures: Both my children were born at home, and I was the Convenor of the national home birth organization, Homebirth Australia, from to Non-vertex presentation, including breech, is listed as category C — requiring referral to an obstetrician and secondary care in 4.
0コメント