I just read an article at Science and Sensibility, written by Amy Romano, about how Canada’s Society of Obstetricians and Gynecologists (SOGC) has changed its position on breech delivery protocol. I believe strongly that minimal intervention is best when it comes to childbirth, and I was heartened by Amy’s article. She discusses the Term Breech Trial, and how it had set the standard for routine c-sections of breech babies. Turns out that there were plenty of flaws in the TBT, and SOGC has determined that c-sections should no longer be routinely performed when babies are breech. This will give women more control over their own bodies and births, and will likely help to lower the total number of c-sections performed.
Now we just have to get ACOG on board too. C-section rates in the US are far higher than the World Health Organization recommends, and women here who have a breech baby are routinely herded into the OR, with little choice in the matter. Jay was born breech, and so was his sister. Neither was a c-section, and both turned out great (you can pay me later, Jay). Obviously those are just two incidents (and we all know that anecdotes are not data) but had Jay and his sister been born 30 years later than they were, Jay’s mother would have been subjected to two major abdominal surgeries – which also involve risk – that she didn’t really need.
In the current quest to reform health care, everyone is talking about controlling costs. Lowering the rate of c-sections would have a significant impact on the cost of maternity care, since vaginal births are much less expensive than surgical births. Maternity care is something that most women eventually use, and lowered costs would translate to lowered health insurance premiums for all of us. I have friends here in Colorado who have been subjected to routine c-sections because their babies were breech, and in one case the parents ended up paying several thousand dollars out of pocket for the birth, since the surgery was done at an out-of-network hospital. A change in protocol for breech births seems like it would benefit mothers, babies, and health insurance companies (and all of us who pay premiums for insurance). Let’s hope that ACOG follows in SOGC’s footsteps.
I found Amy’s article in Grand Rounds last week, hosted at Florence dot com.