Labor & Birth

Reteach Breech

Options for breech birth are slim. Despite knowing that it may not be the best option for women, cesareans are often scheduled for women when their babies are breech at term. Providers are no longer trained in safely attending a breech birth. 

In his Reteach Breech Campaign, Dr. Stu reminds us,

The bond between a woman, her body and her baby lasts a lifetime. The way we are born is incredibly consequential. A woman's right to choose how and where she gives birth has been under attack for 40 years in the U.S. This unethical restriction on reasonable birth options has contributed to a cesarean epidemic.
The option of vaginal breech birthing has all but disappeared. Dr. Stu is one of the few practitioners left who not only assists women with this choice by action but actively educates through his speaking and writing. He has been teaching live breech birth to the local midwives in Los Angeles but wishes to reach a larger audience than the intimacy of a single birth can possibly achieve. This year Dr. Stu has been invited to begin teaching hands on training sessions.

- Via Dr. Stu's Reteach Breech Campaign

What has happened to breech birth?

Options for breech birth are slim. Despite knowing that it may not be the best option for women, cesareans are often scheduled for women when their babies are breech at term. Providers are no longer trained in safely attending a breech birth. 

Dr. Stu says

Selected term breech vaginal delivery is an evidenced based and reasonable option for many women. When attended by a skilled practitioner and when properly screened a woman and her family can expect a safe outcome for her baby and, when compared to cesarean section, a better outcome for herself and for her future pregnancies. I am confident in saying that laboring with a vaginal breech birth succeeds or fails for the same reasons that a head first baby succeeds or fails. 

This is a problem that needs to be addressed. 

I am often asked if properly selected vaginal breech delivery is supported by the research then why are there so few doctors willing to assist women in the reasonable choice. And, further, why would I do it. First, I do it because I was well trained, have years of experience and have the patience and understanding of normal mammalian birth to trust the process. I also respect the right of true informed consent and refusal and the autonomy of the individual to make her own decisions without coercion.

Most practicing physicians no longer have the training and skill, or the will to learn, how to assist women with a breech delivery. Those that do know often prefer the more expedient route of cesarean section and cling to the false belief that it is safer. The current economics and legal aspects of medicine do not favor the ethical duty to alter this trend and return to respecting all reasonable choices and common sense.

- Dr. Stuart James Fischbein

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Why does it matter?

The norm for a woman carrying a breech baby at term, is a scheduled cesarean section. There is little information, and lots of litigation surrounding breech birth. This fear based approach is a disservice to families, and a violation of human rights in childbirth.


Maryn Green of Indie Birth talked on breech birth back in 2015 in her podcast "Beautiful Breech: Opening the Doors to an Option Many Women Are Told Isn't Possible." She addressed the issue of options, or the lack thereof, women have when faced with breech babies. 

 
You know, birth is not without risk; any sort of birth. We could talk all day about the different ways that a birth could look. That could mean a head down baby, that could a butt first baby, that could mean a woman that's had cesarean sections(s) and is planning a vaginal birth, that could mean multiples, absolutely anything, including a total text book situation with none of those "risk factors" is without risk. Birth just is not that way. There is no such thing as perfection in birth. 

- Maryn Green, Indie Birth

Is breech a variation of normal?

Under what circumstances might a baby be breech? For example in mothers who have had more than one pregnancy (multips), or in a woman with a bicornate uterus? The latter of those often does mean a necessary cesarean, but for a woman who's uterus simply allows a baby that freedom of movement, and that baby chooses to sit breech, or even rotate at term, ......

options for breech babies, spinning babies

Just because your baby is sitting breech one day, doesn't mean it will be the next

In her talk on breech, Maryn says,

We don't know.... we don't know how that baby is different a lot of the time.... Is this the kind of different that's more personality? Or is this the kind of different where maybe there is a legitimate concern or physical anomaly that would make vaginal birth not a good idea for this baby?

She goes on to address,

Breech birth, [according] to the studies is more risky than [vertex] vaginal birth.
10% of the time, there is an anomaly. It's also because the studies include babies that are preterm. We're including these groups that are already risky [with full term, healthy babies].
Is it really the presentation of the baby?

The "Term Breech Trial" study, which has since been refuted, caused a lot of damage, placing a lot of fear and litigation surrounding breech birth. As a result, we are in this situation where women are left with few options and even less support.

A vaginal breech birth may be more risky than a head-down baby vaginally, but a c-section is not safer for breech babies. 
- Maryn
options for breech birth, colorado springs childbirth education

Beautiful Breech

Opening the Doors To An Option Many Women Are Told Isn't Possible

Listen to the complete podcast to learn more about Maryn's thoughts, and criteria used, to determine if breech birth might be right for you.

Families have the right to options when their babies are breech at term. A woman deserves the right of true informed consent and refusal, and the autonomy of the individual to make her own decisions without coercion. 

Will you consider supporting Dr. Stu's campaign to #ReteachBreech