Breech Of Trust
|by Lisa Bobrow|
If your doctor has recently told you that your baby is breech, you have likely been told that you will need to have a cesarean section. If your midwife has recently told you that your baby is breech, she may have informed you that she no longer feels comfortable attending your homebirth, and asked you to consider going to a doctor. If your goal is a natural childbirth, you probably have a lot of questions that your birth professional cannot answer. The reason? They have probably never seen one.
Doctors overwhelmingly prefer to perform cesarean sections on breech babies, and midwives overwhelmingly prefer to hand over their unborn breech clients to the care of doctors. Doctors and midwives claim safety as their motivation. In fact, neither cesarean section nor vaginal hospital delivery are particularly safe. The hospital setting does, however, protect the professional interests of doctors and midwives.
Between 3-4% of all babies are born breech, that is, with something other than the head coming first. There are three types of breeches, according to what part presents. "Frank breech" babies are in the "pike" position, with legs extended over the head. This is the most common type, describing 50-70% of all breeches. "Complete breech" babies (5-10%) are in the "cannonball" position, with both hips and knees flexed. "Footling" or "incomplete" breech babies (10-30%) emerge with one or both feet first (Fischer, 2002).
While many babies assume a breech position at some point, the chances of a baby being born breech decreases the closer the baby comes to full term. 25% of babies born before 28 weeks' gestation are breech. That number decreases to 7% at 32 weeks' gestation, and again to 1-3% at full term (Fischer, 2002).
Today in the United States, the rate of cesarean section for breech babies is 94%, up from 80% in 1985 and only 10% in 1970. The sharp increase in recent years is part of a larger trend toward surgical birth (almost 1 in 4 babies are delivered by cesarean section in the US, with similar rates in Canada and Australia). Since 1959, when a doctor by the name of Wright proposed that all breech babies be delivered by cesarean section, a mythology has grown up around the perceived dangers of vaginal breech birth to the point where Wright's proposition is accepted as a fact of birth: if the baby is breech, a cesarean section is required.
Thankfully, many doctors, midwives and birth researchers are now questioning Wright's wisdom.