Women in Canada and abroad are requesting the option of breech vaginal delivery. Will it be obstetricians and gynaecologists offering this, or, since many hospitals are not offering breech vaginal delivery, will women rely on midwives to do so? Some women with a breech presentation elect to deliver at home because they believe they will be refused a breech vaginal delivery at the hospital. It is urgent that we take on this responsibility and that every hospital in Canada offer safe breech vaginal delivery. We need to meet with our colleagues in midwifery to support their request for breech vaginal delivery in hospital and access to consultation with their obstetrician colleagues.
The other article of interest is Evolving Evidence Since the Term Breech Trial: Canadian Response, European Dissent, and Potential Solutions (full text PDF). Written by Betty-Anne Daviss, Kenneth C. Johnson, and André B. Lalonde, this article also appeared in the JOGC. The authors surveyed the 30 largest maternity hospitals in Canada to see how their breech policies changed after the initial Hannah findings and then again after the two-year followup. They found that "Hospitals were almost five times more likely to adopt a policy of requiring Caesarean section for breech delivery when current evidence suggested that it decreased risk for the neonate than they were to reintroduce the option of vaginal breech delivery when it did not." They concluded: "The weight of epidemiologic evidence does not support the practice developed in Canadian hospitals since the Term Breech Trial that recommends delivery by Caesarean section for all breech presentations. Obstetric and midwifery bodies will require creative strategies to make clinical practice consistent with current national and international evidence."
And if you're new to this blog, please visit these earlier posts addressing breech birth, mostly in chronological order:
- A hands-off breech birth (link to birth story & video)
- Interview with Dr. Stuart J. Fischbein
- A simple breech birth criteria
- Canada does a 180!
- Breech: what to do next? by Robin Guy
- More on breech & the SOGC
- Unassisted footling breech video
- Musings on breech
- The dance of breech
- Review of 2 books on breech birth: Breech Birth Woman-Wise by Maggie Banks and Breech Birth by Benna Waites
- International Breech Conference: Day 1
- International Breech Conference: Day 2 (The Germans)
- International Breech Conference: Day 2, continued
- Why breech matters
- A Breech Birth in Ottawa
- Transcript of CBC Radio Program on Breech Birth
- Review of the documentary "A Breech in the System"
- Confidence, Competence, and Preserving Breech Birth at Home