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Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA

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One Midwife's Collection of Breech Turning Techniques

Practice Variation in Cesarean Rates: Not Due to Maternal Complications
This brief but well-referenced post analyzes cesarean rates relative to differences in maternal diagnoses or pregnancy complexity. On average, the likelihood of cesarean delivery for an individual woman varied between 19 and 48 percent across hospitals.”

Birth attendants often claim that their high cesarean rate is due to their clientele - that they provide care for a lot of high-risk clients.  This analysis shows that:

    Among lower risk women, likelihood of cesarean delivery varied between 8 and 32 percent across hospitals.
    Among higher risk women, likelihood of cesarean delivery varied between 56 and 92 percent across hospitals.
    Hospital variability did not decrease after adjusting for patient diagnoses, socio-demographics, and hospital characteristics.

This shows that practice variation in cesarean rates is real, substantive, and not just a reflection of the mother’s risk level.

Tips for Choosing a Care Provider - great overview! from Henci Goer

Here are the suggestions that I received in response to my request for help turning a breech. I have included the whole post as opposed to deleting duplicate suggestions. (sorry, I'm due any time now and couldn't get it together enough to be creative and organized!!!)


Has she tried all the ways to try to turn a breech baby? Here's a list:

  1. Laying on her back on a board or using pillows so that her head is about 40 degrees lower than her feet.
  2. Play music, preferably with headphones, placing them low down on her uterus.
  3. Shine a very bright light low down on her uterus, or even between her legs.
  4. Have someone (preferably the father) talk loudly but soothingly to the baby, low on the belly, close to the skin, telling the baby to turn around, to come towards the voice (have also heard that commanding works).
  5. If all else fails, how about external version? This is where the mother is given drugs to relax her uterus, then the dr uses his hands externally to turn the baby around. This, of course, has it's pros and cons, which should be weighed. It also can be very painful for the mother (but not as much pain as she'll have after a c-section, I would think!).

Acupuncture usually entails the use of moxibustion instead of needles. I've heard people have great success with this.


Find every picture of a head-down baby you can find and plaster them all over your house/work, in your purse, and anywhere else you can think of and keep the faith. Your baby will turn! Also, talk to the baby about its motivation for turning around. There is also a birth guardian in charge of your baby who you can communicate with about this. Sometimes this is the only way unborn babies have of getting through to us. Try to listen.


Hypnotherapy is supposed to work really well because of the relaxation it induces more than anything else.


One that I heard was to do 100 pelvic rocks an hour along with everything else... Also chiropractic, a technique called Webster's technique. Some others are music & light (mag flashlight) near the crotch area especially while sleeping, music on lower abdomen also may work during the day (classical or very soothing)....


Sometimes doing somersaults yourself in the water and turn a baby. And don't forget the power of communicating with your baby.... Release that tension and the baby will turn when he feels you relax.


Something I have seen work with several of my moms and myself is having the Daddy put his mouth down where the babies head should be, then Daddy should talk to his baby and tell him/her to turn around and put its head where it should be. My last baby always responded to Daddy's voice and did whatever he ask! Another thing I've seen work is playing music to the baby using headphones and placing them where the baby's head should be. Sometimes babies will turn to hear the tunes!!


What about your thoughts and/or fears? For example, I was considering doing my birth unassisted a few weeks back and my baby turned breech. I wouldn't do a breech unassisted so I suggested an agreement with the baby that I would make every effort to have the midwife there if she would turn vertex. She did a few hours later. BTW, the idea of doing an external version didn't intuitively feel right at the time, partly because I was only 32 weeks but ... trust in yourself!


Have you ever heard of elephant walking? It has worked well for my students who carry breech near term. Elephant walking is walking on hands and feet instead of knees. As soon as you try it, you will see why it would work! It's very difficult to do, but it definitely helps loosen the baby up and out of the pelvic ring. Some people feel the baby turn as soon as they start doing it.


Did anyone suggest diving into a pool several times? Midwives around here recommend it all the time.


Breech and transverse positions symbolize comfort for the mother and baby, as the position places the head nearer the mother's heart. Relax mothers, relax babies, easy to turn baby to vertex.


Other methods that have worked:


(RE: a Transverse lie) Get her into a warm pool. She walks into the water until up to her shoulders. Then have her dive down to the bottom of the pool. As she is deweighted so is the baby and the heavy part of the baby (the head) will go into the pelvis. She may have to do this three times but I have never had it fail.



This Web page is referenced from another page containing related information about Prenatal Breech Issues

 




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