This is a topic that I feel quite strongly about. I feel so lucky that with the birth of my daughter, that I was not pressured to have a c-section after I stalled for nine hours at 6 centimeters dilated. Without my amazing midwife and the team I had, I really don’t know what would have happened. Thankfully, it was never even mentioned. But for how many women is it? And how many of those women end up feeling pressured to have one? And lastly, how often is it really necessary?? This will always be one of those things that I will learn as I go. This, obviously, does not have anything to do with times in which a c-section would be appropriate.
The following link will take you to an article written by an OB regarding the top ten signs he/she may be planning a c-section. I agree with most of the points, however #6 regarding a breech baby and performing an external cephalic version (ECV) as the “remedy”. I work in a hospital and in my experience, these are not super successful. Seems that about half the time they work and the other half, they don’t. Then there is a small percentage of the babies who do flip from the ECV but then go back breech before labor begins. Then what? AND not to mention that every woman I have talked to has said that this is so incredibly painful. If you are under the care of a midwife, the on-call OB is the one to perform the ECV. You have to be hooked up to an IV for a number of reasons because it is risky. Placental abruption, cord twisting, and labor onset (which could be as early as 36 weeks) are just a few and really, these are not very common, but something to be aware of. My thoughts are: why not just deliver a breech baby? It seems that many facilities still shy away from allowing healthy moms and babies to deliver in the breech presentation. Transverse breech would be the only time in which I would see a c-section necessary. The hospital I work in and where I delivered both my babies does not yet allow breech or water births unless delivery is imminent (as in-within minutes of arrival). It does happen. I remember when a mother delivered a footling breech baby in front of the ER in her car. Then there was the mama who rode into the birth center backwards on a wheel chair with a tiny little foot ready to come out. There are risks with breech deliveries too. The baby who was born outside the ER did suffer a broken clavicle.
Anyway, this is not the most educationally driven post. I just wanted to write out some thoughts on the subject. Please share your experience with both breech and an ECV, especially if you are already a student or working midwife.