Sunday, November 11, 2012
It was an exhausting, exhilarating three days at the 3rd International Breech Conference in D.C., sponsored by the Coalition for Breech Birth. Our schedule was packed from early morning until late in the evening.
It's amazing to see the developments since the last breech conference in Ottawa in 2009. Three years ago, Dr. Frank Louwen and Dr. Anke Reitter had just introduced their pioneering work doing upright breech birth in a hospital setting. Today, they presented the results of 900+ breech presentations at their clinic from 2004-2011. They've done a preliminary analysis of the data and hope to publish it soon.
Three years ago, obstetrician Michael Hall of Colorado first learned about hands & knees positioning and said, "That sounds really interesting; I'd like to give it a try." Now he's doing lots of upright breeches and has found that they require much fewer maneuvers.
Three years ago, Ottawa midwives were required to transfer care for a planned breech birth, even though doing breeches was within their scope of practice. This meant that some very experienced midwives had to transfer care to less experienced physicians; they could stay in the room but could not assist with the birth in any way. This also meant that some women ended up with cesareans if no physician willing or experienced enough was on call. Just this week, Montfort Hospital agreed to waive the mandatory transfer of care policy, becoming the first hospital in North America to allow midwives to attend breech births as the primary care provider.
One of my favorite things about this conference was seeing experts in breech birth from around the world hammering out the intricacies of how a breech baby navigates through the maternal pelvis, asking questions and challenging each other on their research and outcomes, and collaboratively building a new body of knowledge.
I'll continue to post my summaries of each conference session that I attended. Keep in mind that some of them will be less coherent than my usual posts; I was trying to capture as much information as possible. I also have some selected videos I hope to share: Dr. Michael Hall sharing tips & techniques, UK midwife Jane Evans demonstrating the cardinal movements of the breech, and more.
I met some amazing obstetricians, some of whom I'll introduce later in my conference notes. They're doing vaginal breech births, VBAMCs, water births, opening birth centers, and fighting to get midwives hospital privileges. They're working to re-train other obstetricians in how to attend breech births and gradually overcoming resistance from their colleagues. I've invited some to write guest posts and hope to share those with you soon!
And of course I can't forget to mention all of the other fantastic people I met or reconnected with. There are too many to name here, but please keep in touch.
Best of all, I came back to my hotel room before heading to the airport...and there was a woman in labor! (I was rooming with Canadian midwife Gloria Lemay, and she generously offered our room to the birthing family.) I packed as quietly as I could and whispered good luck wishes on my way out. Only at a conference like this...