Sunday, June 12, 2011

Breech Birth Choice or Pressure?

Many women have complained that when they wanted to try to deliver their breech babies vaginally (e.g. using ECV), they have been pressured into having a planned cesarean by their doctors.

Obviously, a percentage of these women would have been successful in their trial of labor, and therefore it's good that the SOGC has published guidelines that may help women like this in the future.

In an article that was originally published in 2009, but updated this year (C-section not best option for breech birth), AndrĂ© Lalonde, executive vice-president of the SOGC, said: “Our primary purpose is to offer choice to women”.

But let's hope that the pendulum hasn't swung too far the other way now, and that women who would be more confident having a planned cesarean for breech presentation (as I was) are not being denied this entirely legitimate choice.

Why am I worried?

Because in the same article, while talking about birth plans more generally, Dr Lalonde says: “The safest way to deliver has always been the natural way,” and “Vaginal birth is the preferred method of having a baby because a C-section in itself has complications.”

And the report continues: "The SOGC believes that if a woman is well-prepared during pregnancy, she has the innate ability to deliver vaginally."

This doesn't say 'choice' to me, and given that it was a recent Canadian study (comparing breech babies born via planned cesarean with cephalic babies born following planned vaginal birth) that found better outcomes with babies born via cesarean, it will be interesting to see what happens if women are actively discouraged from planning cesareans for breech births.

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