Friday, November 09, 2012

Opening Remarks of the Heads Up! Breech Conference

I'll be posting each session of the 3rd International Breech Conference separately. Please pardon any typos or awkward wording; I'm trying to get these session summaries up quickly!

Day 1: 
Opening Remarks by Robin Guy

Robin Guy, one of the founders of the Coalition for Breech Birth (CBB), welcomed us all and told the stories of her two children’s births. Her first was an easy homebirth. During her 2nd pregnancy, her daughter was breech and she looked desperately to find a care provider after trying everything to get her to turn. She even did ECV 4 times with 2 different care providers. This was before the 2009 SOGC guidelines reopening vaginal breech birth as an option. There were 2 “closeted” OBs in all of Ottawa that would catch a breech if she walked in late in labor and refused a cesarean. They were on call on different days and she had the misfortune of going into labor at the wrong time. The OB on call did not feel she could safely provide a vaginal breech, so she was forced to consent to a cesarean.

Our care providers need to know that women exist after their 6-week visit. 6+ years later, Robin still can’t get through her birth story. This long-term trauma is not unusual for women who experience violations of their autonomy. She still flashbacks, not to the surgery, but to the fighting beforehand. The problem wasn’t the surgery; the problem was the removal of her rights and of her bodily autonomy. She experienced this as assault. Legally, women aren’t protected from assault in a hospital, and there is no legal ground for recourse.

After this birth, Robin got angry and wrote lots of letters, sending them to every hospital in Ottawa. She and two other women got together in a park and came up with the idea of the CBB. They said nobody is fixing this; I guess it’s up to us! They communicated their concerns via a petition to the Society of Obstetricians & Gynaecologists of Canada (SOGC), which helped influence the 2009 protocols. Now, the CBB has 8 formal chapters in 5 countries and over 1,500 members. They have a two-pronged approach: exerting pressure from consumers and training providers.

In Ottawa, 3 of the 4 hospitals now support vaginal breech birth (VBB) attended by obstetricians. It still isn't offered; women have to tell their OB they want a VBB. What about the midwives? In Ontario, it’s within their scope of practice but is discouraged from taking place at home. However, the hospitals don’t tend to respect that scope of practice and mandate a transfer of care from the midwife to the hospital physicians. In other words, you can go in with someone like Betty-Anne Daviss, who has extensive experience in VBB, and you’re still obliged to transfer to someone of lesser skill. They’re still working on getting hospitals to allow experienced midwives to attend VBB.

There’s a private breech catcher group at LinkedIn that Robin moderates. It’s a safe space for breech-friendly birth professionals to talk to each other. Please join if you’re a midwife or physician interested in or currently catching breech babies.

Other ways to contact CBB:
Twitter: @breechconf


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