Canada Moves to Stop Automatic C-Sections for Breech Babies

Speaking of options, I just came across this article on one of the birthing groups I get e-mails from. Canada is wanting to change their medical policies in regards to vaginal breech birth. Apparently, they will be giving mothers the option instead of just assuming that a cesarean section is the only safe way to deliver.

Here are a few parts from the article although I would highly recommend reading the entire thing:

"Breech babies account for about three to four per cent of all pregnancies in Canada, or about 11,000 to 14,500 pregnancies each year.

"Breech pregnancies are almost always delivered using a cesarean section, to the point where the practice has become somewhat automatic," Dr. Robert Gagnon, a principal author of the new guidelines and chair of The Society of Obstetricians and Gynaecologists of Canada's maternal fetal medicine committee, said.

"What we've found is that, in some cases, vaginal breech birth is a safe option and obstetricians should be able to offer women the choice to attempt a traditional delivery."
An international, Canadian-led study reported in 2000 that the safest way for breech babies to enter the world was via C-section. The study of more than 2,000 women found babies of mothers in the cesarean group were three to four times less likely to die, or have serious problems in the first six weeks of life, compared to those in the vaginal birth group (1.6 per cent versus 5.0 per cent).

The study had widespread influence worldwide. Many doctors stopped doing vaginal deliveries for breech babies, and many medical schools stopped training doctors in how to do them.But the doctor who led the study said the risks, while different, were never huge. "The risks were still quite low," says Dr. Mary Hannah, a professor in the department of obstetrics and gynecology at the University of Toronto and Sunnybrook Health Sciences Centre.

More recent studies, including a study of more than 8,000 French and Belgian women carrying breech babies, found no significant differences in risks to babies whether they were born vaginally or via C-section."

The new guidelines say that many breech deliveries will still require a C-section, and that a vaginal birth is not recommended for a "footling" breech, where the baby is positioned feet-first, with one or both feet pointing directly down toward the birthing canal.
Vaginal breech births also aren't recommended if the woman's pelvis is narrow or small, if the umbilical cord is likely to become entangled or compressed during delivery, or for babies that are too big (weighing more than 4,000 grams, or 8.8 pounds) or too small (less than 2,500 grams, or 5.5 pounds).

Breech deliveries are one of the main reason for C-sections, "and, if you do one (C-section), you increase the risk for another" in future pregnancies, Lalonde says. Repeat C-sections account for 30 to 40 per cent of all cesareans.

I think for most people a breech vaginal birth seems very foreign and down right scary. Before having my babies I knew nothing of it and didn't think it was ever done. When I found out that my daughter (twin A) was breech, I thought there wasn't any other option other than to have a c-section. I'm not sure what I would have done if I had the option and did the research.

It's definitiely a big decision to make. However, I do agree that women SHOULD have the option of a vaginal breech birth if they so choose, because it has proven to be safe in certain situations. Now to get our country on the bandwagon... Go Canada!

Options

Last month I was able to attend the monthly ICAN meeting that was held here in Phoenix. I was excited because May's topic was "Real Births after Cesarean". The purpose was to bring to light the real stories of vbac coming from the women who experienced them. None of the hearsay birth stories would be included.

I so much enjoyed listening to these women who had successful vbacs/hbacs here in Arizona. Each was unique in their circumstances, but they all had the same goal: A better birth experience and ultimately one that involved a vbac. The first woman had an un-medicated hospital birth (labored at home until ready to push) after one cesarean assisted by a CNM. The second had a VBA2C hospital birth assisted by a MD. The third had a home birth after 3 cesarean sections (HBA3C) assisted by a midwife and Naturopathic Doctor (legal here in AZ). These amazing women are inspirations to many including myself. I was so grateful that they were willing to share their birth experiences with others. This is just one of the many benefits that joining ICAN has to offer.

I personally know of many women who have had multiple c-sections and feel that they don't really have another option, other than to have another c-section. While it is a decision that only the mother can ultimately make, I think that it is SO important that they know that a vbac is STILL an option if they want it to be. Here is an article based on scientific research, that found vaginal birth after mutliple c-sections to be a safe option. There are Medical Doctors, Midwives, and Naturopathic Doctors out there who will assist in vbamc and have had success in doing so. It will most likely take a lot of extra work and preparation on your part, but it can and has been done.

Lastly, here is a video that I found on the blog Birth at Home in Az ,of several women who were able to achieve a successful vbac after mutliple c-sections.

A Balancing Act

I left to girls camp this last week to be a cabin mom/youth leader to the girls in my church. I was happy to get away for a little while and have a change of scenery. In a way I wanted to get away from all the normalcy's of life which included the birthing stuff. The e-mail lists, the blogs, the books, the shows. I just wanted to have a simplified day where I didn't think about birth. I didn't want to wonder if I'd get my vbac, if I'd find the right provider, if and when I will be ready for another pregnancy...delivery...baby. I guess I've felt a little overwhelmed lately which is my own fault as I can't seem to keep myself away from all the resources out there. I've felt myself begin to get overworked when reading things, especially those things that leave me feeling helpless in achieving what I really want. Unfortunately I allow these emotions to effect me and follow me throughout my day. At times it has effected my ability to be happy, and in turn concentrate on what needs attention right now {my family}. It's a balancing act that I'm continuously attempting to master.

I will admit that it felt good to just take a break from the birth junkie inside of me. I relaxed those parts of my brain and heart and just lived moment to moment. Because birth is something that effects every women and human for that matter, I should have guessed it would come up at some time while at camp. And alas, it did.

While waiting for my girls to finish their certifications a woman near bye began saying that she hoped she could have twins or triplets so she could have all of her kids at once and they could just "section them out" of her. Sadly, there wasn't much shock involved as I have heard these types of comments before. I kindly responded letting her know that a c-section isn't the easy risk-free option she thought it was. Short, simple, one sentence, and then I stopped. I didn't want to let it bother me, not here. I gently tucked my soap box away and continued on my day.

The next evening I sat at a dinner table with another woman who spoke about birth. She mentioned that she had 4 children; 3 unmedicated hospital births and then the 4th at the birthing center with a midwife. "What was it that made you want a birth at a birthing center instead of a hospital?" a friend of mine asked her. She then related how when her second child had been born, that the hospital staff felt that she wasn't breathing well enough and rushed her off to the ICU before she even got a chance to touch her. Five hours later, and after several tests, they found nothing wrong with the baby. After finally returning the baby to her mother and getting a chance to nurse etc., the baby started breathing normally again. Ouch...Instantly my heart began to hurt thinking of my own daughter being rushed to the NICU for breathing problems and staying there for 18 hours. After all the tests they told us that there was nothing really wrong and things just "fixed themselves." It was then that I finally got to hold her out of the NICU and nurse her for the first time. My eyes stung and began to water but I sucked it up. Not here, not now. I didn't say a word, just sat there looking down at my food. I knew if I said something that I would start to cry and this was not the place.

I have mixed feelings about being a "birth junkie." I love learning all there is about birth and hearing the amazing birth stories and it's something that I feel very passionate about. At the same time I hate the hurt that comes along with the bad memories and wondering whether I will be able to have a better birth experience. I hate having emotional wounds that still sting even though it's almost been two years. On the other hand, it's those bad experiences that drive me to work harder and compel me to be a "birth junkie" in the first place. It makes me wonder how some women find balance amongst everything that drives them in life.