All day today I’ve received emails, telephone messages and Facebook notes letting me know that the Society of Obstetricians and Gynecologists of Canada have had a change of heart about vaginal breech birth. The article in the Globe and Mail lets us know that the 30,000 Canadian women who undergo major abdominal surgery to have their breech babies have been given a raw deal.
There is an obstetrician in Ontario, Mary Hannah, who has been the source of much of the wrong headed “research” that has led to the out of control rate of cesareans world wide. Ms. Hannah was behind the study that said babies should be induced at 41 weeks gestational age. That study was found to have major methodology flaws. Now, we know that the breech study by the same woman is also bad science. I would like to see the S.O.G.C. issue a press release that Ms. Hannah will not be allowed to publish in a scientific journal ever again. She’s got a great deal of karmic debt load for causing so much unnecessary suffering in the world with her two multi centre controlled trials.
In obstetrics, the first rule has to be “Mother Nature is probably right”. After all, Mother Nature has been doing birth for a very long time and doctors have only come into it relatively recently. When these studies are so counter to what Mother Nature has been doing for millenia, they have to be suspected of being flawed in the methodology. The fact that doctors and midwives march blindly along righteously cloaked in “evidence based practise” without questioning the wholesale surgical nightmare is hard to believe.
I cannot get excited about this latest epiphany of the medical profession. The fact is that doctors feel good about being aggressive with birth. They don’t like the unknown and they don’t like things wild. The context of hospital treatment is to “control” the birth. A controlled breech vaginal delivery is not a pretty thing to watch. Through the 1980’s, I had a friendly obstetrician who would “allow” breech deliveries. He would bring the woman in to be induced with a foley catheter placed into her cervix (a balloon at the end of the catheter would be inflated with saline solution to provide an irritant to the cervix). The induction was done because he didn’t want the breech baby to get too big. When the woman started to have sensations, he would get an I.V. into her arm so that he could get Pitocin running when she was pushing (didn’t want an arrest of contractions once the body was out). Most of those breech births involved him cutting a “generous” episiotomy and introducing Piper’s forceps into the vagina and onto the baby’s head to pull the head down. Just recalling it all makes me sick to my stomach. Those poor babies would usually come out with the placenta on top of their heads like a tam. One little boy was resuscitated for over an hour and has severe cerebral palsy. The mother, too, would have to recover from the episiotomy and that was brutal.
What was the alternative? I had no experience with breech birth and I didn’t want my client to have a cesarean and have her childbearing future tainted forever. Breech cesareans are not a pretty sight either. The head can be trapped and forceps are needed to extract it from the abdominal incision. Another boy has cerebral palsy after a cesarean done by a resident who had a terrible time getting the babe’s head out. We didn’t have the internet back then, either, so I didn’t have access to all the great midwives who have published their ideas and photos of breech births.
It’s different now. I now have experience with breech birth and I’ve gathered really good information and tricks of the trade. A home birth with a breech baby is a whole different kettle of fish than a hospital “breech delivery”. Not every breech baby can be born safely by the vaginal route and, if a hospital is truly needed, a cesarean is a good option at those times. The majority of healthy women with a breech presenting baby, however, will fare better staying away from hospital procedures.
If the S. O. G. C. is serious that it wants Canadian women giving birth vaginally to their breech babies, they’d be wise to hire an international team of midwives to show the doctors how it’s really done in the home setting. Mary Cronk (England), Lisa Barrett (Australia), Ina May Gaskin (U.S.A.), Maggie Banks (New Zealand) and Patti Blomme (B.C., Canada) are the ones I’d like to see heading up that team. When I see those women on the ground in Canada, I’ll get excited about the chances of Canadian women having vaginal breech births.