In a nutshell, the Canadian version of ACOG (the SOGC) has reviewed the literature on breech birth and determined that there is insufficient evidence to say that all breeches must be born vaginally. Many vaginal birth and vaginal breech birth advocates have been saying that there were problems with some of the breech trials that seemed to show a problem for years, so it is nice to see that the SOGC seemingly confirms that.
This does not mean that it is 100% safe for all breech babies to be born vaginally — if you do an internet search, I’m sure you’ll find numerous stories in which it did not work out. But I think the worst statistics the pro-C-section people had to offer was 6% of breech babies being serious injured or killed (I don’t remember the study for sure, but it seems like that has been the number bandied about — Pinky, do you have anything more certain on that?). Which means that 94% will do just fine. And trying to figure out which breech babies will be in the “6%” category and which will be in the “94%” category will be the subject of much discussion, I’m sure. There are some definite contraindications, but a whole lot of middle ground to study. [Update -- Pinky corrected me to say that it's 6/1000, so that means it's 0.6% of breech babies possibly harmed by vaginal birth and 99.4% that will do just fine.]
Apparently, one of the factors in the SOGC’s decision was that some women have chosen out-of-hospital births as an alternative to automatic C-section, since that was their only “choice” in a hospital. Since a lot of U.S. hospitals and/or doctors will no longer allow VBACs, regardless of the reason for the initial C-section, many women have found the “automatic C-section for a breech” to have the unfortunate negative consequences of morphing into “automatic C-sections for all babies.”
Now the question becomes, what will ACOG do?
For more information, check out Science and Sensibility‘s post on this topic.
Filed under: breech Tagged: | acog, baby, birth, breech, breech birth, canada, home birth, hospital birth, pregnancy, pregnant, society of obstetricians and gynecologists in canada, sogc, unassisted birth, vaginal breech birth, vbb