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The OB who was interviewed said that the American College of Obstetricians and Gynecologists (ACOG’s) bans OBs from delivering breech-presenting babies vaginally.  It doesn’t

A 2001 study concluded that cesarean deliveries are safer than vaginal births for babies in breech position based on short-term assessment of the babies.  When the babies were reassessed at age three, there was no significant difference in their neurological status based on how they were delivered.  In 2006 ACOG revised it policy on Mode of Term Singleton Breech Delivery:  "In light of recent studies that further clarify the long-term risks of vaginal breech delivery, the American College of Obstetricians and Gynecologists recommends that the decision regarding mode of delivery should depend on the experience of the health care provider.  Cesarean delivery will be the preferred mode for most physicians because of the diminishing expertise in vaginal breech delivery. Planned vaginal delivery of a term singleton breech fetus may be reasonable under hospital-specific protocol guidelines for both eligibility and labor management. Before a vaginal breech delivery is planned, women should be informed that the risk of perinatal or neonatal mortality or short-term serious neonatal morbidity may be higher than if a cesarean delivery is planned, and the patient's informed consent should be documented."

Many young OBs aren’t learning how to conduct safe vaginal births of twins or breech-presenting babies.  As cesareans have gotten safer, OBs are more likely to suggest a cesarean as the best way to deliver a baby when complications are suspected, such as a "big" baby (hugely overestimated fetal weights are extremely common).

One–third of US babies are delivered surgically.  Cesareans are safer than before but not safer than vaginal birth for a healthy mother and fetus.  More cesareans have led to increases in preterm births, more babies in Neonatal Intensive Care Units, mothers readmitted to hospitals with infections or bleeding, and serious complications and deaths during the mother's subsequent births due to the big scar in her uterus.  Pregnant women need full information on all risks associated with cesareans for the mother and baby during future pregnancies as well the current one.  There are benefits and risks: if it wasn’t necessary, all you get is risks.

posted 4 years ago
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