Yes it was Brenda who wrote that, but I have also been a midwife long enough
to have seen many breech births - back in the UK, and delivered a few
myself. Not all good, mostly quite 'managed' but at least they were mostly
seen as being manageable vaginally! My own elective C/S (nearly 21 years old
now!) was for primip breech, although I was given the choice of vaginal
birth, I knew just what that would entail within the large unit that I was
obliged to attend - epidural, forceps, episiotomy, and I chose not to go
there, however at that time there was no question that I would not be able
to have VBAC with the next - nowadays that is not so.
A year or so back we had a multi with a breech who was lucky enough to see a
less interventionist OB (as you so rightly guessed Melissa :-)) and she
chose to have a vaginal birth. Of course it had to be induced on the 'right'
day, but was very straight forward. Apart from that we really don't see
them anymore, and at least one of the few docs who does do them does such a
horrendous job that I would personally prefer a C/S rather than submit to
his handling.( you can probably guess that one too Mel!)
It is sad that student midwives today will not learn these essential skills
within the hospital system. Personally I feel confident that I can handle
an unexpected breech, but cannot see how the next generation are going to
cope with this, there is so much fear of what is really only a different
variety of birth, in the same way that any 'different' presentation is.
Anyone who has had the pleasure of hearing Maggie Banks speak, watched her
video, or that of Michel Odent's work in Pithiers will know that this is
true
Rachel, I totally empathise with how you are feeling having just come to
Australia from the UK (been here 15 years myself). It was a real shock to
me to see how much all births are seen as being the doctor's property. One
of my first births here was in a small hospital and I called the GP as per
protocol. He arrived as I had the head in my hands and proceeded to rush
in, without even washing his hands and virtually pushed me out of the way!
I looked at him with horror and said quietly " I think I may as well finish
the job now don't you?" He did step back and let me finish. Some years
later he admitted that he had learned a few things from me - one of which
was to wait for restitution before trying to deliver the shoulders! They
were always in such a goddamn hurry to drag the baby out, it drove me mad.
When they are faced with an 'expert' obstetrician (often a male authority
figure) telling them their baby is in danger - they will chose to protect
their child because as a mother that is their instinct.
An example of this happened to me just this week - the head was well and
truly crowned (primip, long labour, NO fetal distress) but OB insisted on
listening to FH immediately ctx ended - it was about 100, and he took over
from me to apply forceps. I was not concerned for the baby as I knew there
had been no compromise throughout and that he would be born within minutes,
but within the system I am obliged to defer to the doctor's judgement,
whether or not I agree with it. Believe me, I know well what happens when
one tries to argue!!
I hope you maintain your own integrity and autonomy - it is very different
here to what we knew in UK, but we do need to keep pushing for midwifery led
care. I feel that much of the problem lies with how we are percieved and
presented within this system. We are seen as being secondary and forced
into a 'waitress' role, while doctors are glorified as being all-knowing
experts. I have spent ages discussing things with couples only to have
everything overturned by a 5 minute doctor appointment.
Nice to have your input on the list
Sue
"The only thing necessary for the triumph of evil is for good men to do
nothing"
Edmund Burke
----- Original Message -----
From: "brendamanning" <[EMAIL PROTECTED]>
To: <ozmidwifery@acegraphics.com.au>
Sent: Thursday, September 01, 2005 10:26 AM
Subject: Re: [ozmidwifery] Re:
Rachel,
Actually that was me (Brenda)not Sue, who wrote about the physiological
breeches, and I do realise now that experience is rare.
When you speak about choice & what you'd do if you had a breech baby
yourself you are really limited because there are not many of us in PP who
have experience with breeches.
I would definitely not alter plans to birth at home if my baby was breech
(but I have had 4 children) finding a MW to attend would be a difficult
task though!
There is no way on earth I'd consent to surgery to remove my healthy baby
just because he was upside down !
The next best option here would be to go to our local private hospital
with my own MW & the OB who supports us (he was the OB who had enough
belief in women 10 years ago to be present for their breech births but now
is 'not allowed' to do them because of the breech trial).
I would just insist, but then I can be very determined !!
BM
----- Original Message -----
From: "wump fish" <[EMAIL PROTECTED]>
To: <ozmidwifery@acegraphics.com.au>
Sent: Thursday, September 01, 2005 10:55 AM
Subject: Re: [ozmidwifery] Re:
Sue, you are so lucky to have cared for women having a physiological
breech. I have only seen one vaginal breech - and it was far from
physiological (epidural, stirrups, fiddling about etc).
Unfortunately it doesn't matter what we teach women about saying 'no'.
When they are faced with an 'expert' obstetrician (often a male authority
figure) telling them their baby is in danger - they will chose to protect
their child because as a mother that is their instinct.
Women need to be making decisions such as c-section within a partnership
relationship with a known midwife. They should be given honest,
evidence-based info by someone who truely believes in the body's ability
to birth (ie. not a dr) and will support their decision whatever it is
(including c-section). Women would then be able to make choices which are
right for them as individuals - not right for the system.
As for breech birth. The Term-Breech Trial is often used by the obs as
evidence that breech birth is unsafe for the baby. However, this is not
what it shows. It can only tell us what happens in large hospitals with
obs management of breech birth. It does not compare physiological birth
with c-secion. Based on the findings - if I was planning a breech birth I
would have two options. A planned c-section in a good hospital. Or, a
homebirth with an experienced independent mw.
Rachel
From: "brendamanning" <[EMAIL PROTECTED]>
Reply-To: ozmidwifery@acegraphics.com.au
To: <ozmidwifery@acegraphics.com.au>
Subject: Re: [ozmidwifery] Re: Date: Thu, 1 Sep 2005 07:33:26 +1000
Sue,
I wish we could teach women that they can say NO to C/S.
No consent, no surgery.
What can we do to enable them to just have faith? I know it's the old
education, education, education but it's just so wrong !
Very distressing, makes me want to cry!
We used to have beautiful standing breech births 10 years ago in our
little hospital,not one with a problem, but no longer allowed as we
practice "safe" obstetrics now !!!!!
There are only 1 or 2 of us who remember & believe it can happen.
SO SAD!
BM
----- Original Message -----
From: Susan Cudlipp
To: ozmidwifery@acegraphics.com.au
Sent: Wednesday, August 31, 2005 10:38 PM
Subject: [ozmidwifery] Re:
Hi Melissa (only just worked out the surname :-))
Yes, happened today - how sad.
Also today we saw a multi 10 wks post partum with RPOC post emergency
C/S for breech at 36 weeks. This particular lady had vaginal breech with
no.1, I delivered no 2 (SVD), and then, as you say - came into labour on
'the wrong day' with no 3!
There have been several incidents of what would 5 years ago been
considered to be 'good' breech presentations in multis, being rushed off
to theatre in established labour, ( I remember one who was at least
7cms) justified by that accursed so-called breech trial! Really sad how
the skills to deliver well positioned breech births are no longer taught
or used.
Did anyone else catch the 7 news last night? A small story on a 23
week bub who had done very well, however they did state that she had
been one of twins, the other having died (or been terminated?? due to
complications - sorry, a bit vague on that bit, kids making noise at the
time)
BUT the bit I did catch was that she had had to have a C/S at 23 weeks
because the 'placenta was growing through a previous C/S scar'
I find it very interesting to read the recent VBAC recommendations and
guidelines given to women - states clearly that VBAC is in many cases
preferable to repeat C/S - so why are they so keen to do the C/S in the
first place????
Sue
"The only thing necessary for the triumph of evil is for good men to
do nothing"
Edmund Burke
----- Original Message -----
From: Melissa Singer
To: ozmidwifery@acegraphics.com.au
Sent: Wednesday, August 31, 2005 5:22 PM
Hi all,
I thought I'd share with you a ridiculous scenerio which happened at
my work today. A woman who was having her fourth baby, three previous
being vaginal births and one of which was a uncomplicated vaginal breech
birth was booked for her first ELUSC for breech at 38 weeks. Upon
looking through the notes the only options that were documented as being
offered to her were C/S or "risky ECV".
This baby was previously cephalic until 33/40, with only her last
two visits showing a non engaged breech presentation. I surely hope
they palpated her before performing the C/S today.
Whats even more ridiculous is that she had her previous babies at
our hospital under the same obstetricians as today. Our obstetricians
are very experienced and in the past routinely did vaginal breech
births, with a couple still doing them. This poor lady had simply gone
to the wrong clinic day and seen the wrong obstetrician for her!
Her other three babies were all born within the last five years!
Times are changing fast!
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