Friday, April 16, 2010

A breech vaginal HypnoBirth in Canada

This is a news article about a recent vaginal breech birth in Canada, where vaginal breech deliveries are becoming more common. The doula that attended this birth shared that the couple also took HypnoBirthing classes from her. After reading the article, you can listen to Dr. Posner's experience of being the OB that helped to receive this breech baby.

Vaginal Breech in Ottawa

Every birth is a miracle, of course. But the arrival of Lily
Luck-Henderson, just after midnight last Tuesday morning at the General campus of the Ottawa Hospital, was something else as well.

Lily was breech, as are about four per cent of babies, meaning she
emerged from her mother's womb bottom first, rather than head first.
But, unlike most breech babies born in Canada in recent years, Lily was delivered vaginally, rather than by caesarean section.

Her successful delivery is seen as a harbinger of coming change in the
way babies are delivered in Canada -- or at least a step along the way.

At five days old, she has already played a starring role in something
significant, according to Ottawa midwife and researcher Betty-Anne
Daviss, a leading advocate for the return of breech birth deliveries in Canada, who, along with two obstetricians and a doula attended the
birth. It "was a pretty momentous occasion in Ottawa," she said, and an important step toward normalizing childbirth in Canada, something the organization representing Canadian obstetricians stands behind.

"The safest way to deliver a baby has always been the natural way,"
Andre Lalonde, head of the Society of Obstetricians and Gynecologists of Canada, said last year when it began an effort to bring back breech
birth. "Vaginal births are the preferred method of having a baby because a C-section in itself has complications. "

Not so long ago, evidence said something different.

The practice of delivering breech babies by C-sections was already
becoming the norm when a Canadian-based study published in The Lancet
concluded in 2000 that vaginal deliveries put breech babies at risk. The study cited 16 cases of fetal death, 13 of those involving women who delivered vaginally. The risk was considered so significant that the study was shut down early.

It had an immediate and far-reaching impact in Canada and around the
world. As a result, having a breech baby, in most cases, automatically
meant surgery.

Since then, a reassessment of the earlier trials has come to a different conclusion -- that vaginal deliveries in breech births do not increase complications. As a result, the Society of Obstetricians and Gynecologists of Canada has revised its position, saying physicians should not automatically perform C-sections for breech births, but, under the right circumstances, should allow women choice.

The new guidelines were announced last June, but change has been slow.

The problem is that many doctors have never delivered a breech baby and others have limited experience. It had become a lost art.

Ottawa obstetrician Glenn Posner began practising after the
controversial breech birth study and, as a result, had no practical
experience delivering breech babies. He is anxious to change that. On
Monday night he helped deliver Lily Luck-Henderson. He says watching a
video about how it is done in Germany, with women in an upright position or on their hands and knees rather than lying down, helped.

It is time women were given the choice about attempting to deliver
breech babies without surgery, he added. "Aren't we supposed to let
people make their own choices? It's not the 1950s when you tell people
what to do and they say, 'OK, doctor.' "

Daviss, a midwife and researcher has traveled around the world
collecting and dispersing knowledge about breech birth deliveries. She
was recently in Israel where she taught techniques to help mothers
deliver breech babies without surgery. She conducts weekly sessions for mothers and care providers in Ottawa. And she is instrumental in the formation of a "breech birth squad" in Ottawa of physicians comfortable with and experienced in vaginal breech deliveries.

Last year, Daviss was involved in a conference sponsored by the
Ottawa-based Coalition for Breech Birth, aimed at bringing breech birth delivery back to Canada. The coalition was started by an Ottawa mother, Robin Guy, who had a breech baby by C-section.

The issue can be emotional for some. Guy has said her surgery was
unnecessary, except for the lack of skilled care providers to help her. She has lobbied to improve breech skills in Canada.

Daviss calls the return of vaginal breech birth "only a microcosm of
what else might change in obstetrics."

Since the 1960s, probably before, women have talked about taking back
control of birth. Still, with each decade, it has become more a medical procedure and less a natural event.

In the 1960s, about five per cent of Canadian women delivered by
C-section. Today, more than 27 per cent of babies are delivered
surgically and there is a national debate about whether women should
have the option of C-sections on demand.

Some will argue that if women want them and if they reduce risk, then
they should have them. But Daviss and others counter that C-sections are far from risk-free, something women are often not aware of.
Complications, even death, can result. What is more, reliance on
C-sections results in a loss of medical expertise, as has happened with breech deliveries. And "you never know when you are going to be in a place where you don't have a C-section available," Daviss says.

Lily's birth turned out to be problem free. "It went very easily," said Lily's mother Jennifer Luck. "If this helps make things easier for women along the way, I think that's fantastic."

Elizabeth Payne is a member of the Citizen's editorial board.
E-mail: epayne@thecitizen.
C Copyright (c) The Ottawa Citizen

The Best of All in a Day April 13, 2010 "Breech Births"

The Society of Obstetricians and Gynecologists reversed its position on breech deliveries last year. They now say that it's safe to deliver breech births naturally in most cases. But a lot of obstetricians aren't trained in delivering breeches, because for years doctors have been directed to do C-sections instead. Well, this is all slowly changing at Ottawa Hospitals. Dr. Glenn Posner is an ob-gyn who's been trying out natural breech delivery. Robin Guy is from the Coalition for Breech Birth.

Listen to Dr. Posner talk about receiving a breech

Way to go Dr. Posner & Canada! Now we just have to get the U.S. OBs on board!


1 comment:

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