No more automatic C-section for breech births, says Ob/Gyn Society



    HALIFAX, June 17 /CNW Telbec/ - Physicians should no longer automatically
opt for caesarean sections in the event of breech birth, according to new
guidelines for Canadian health professionals released today by the Society of
Obstetricians and Gynaecologists of Canada.
    The guidelines are based on a comprehensive review of research and
clinical evidence regarding the safety and outcomes of vaginal breech births
compared with that of caesarean sections. In the final weeks of pregnancy,
most babies will align themselves in the womb into a head down position, in
preparation for birth. However, in approximately 3-4% percent of pregnancies,
the baby will not align into this birthing position, and instead will present
as a breech pregnancy, with its feet or buttocks positioned downwards towards
the birthing canal.
    "Breech pregnancies are almost always delivered using a caesarean
section, to the point where the practice has become somewhat automatic," said
Dr. Robert Gagnon, a principal author of the new guidelines and Chair of the
Society's Maternal Fetal Medicine Committee. "What we've found is that, in
some cases, vaginal breech birth is a safe option, and obstetricians should be
able to offer women the choice to attempt a traditional delivery."

    Lack of Training

    Canadian women carrying breech babies are typically not considered as
candidates for a vaginal childbirth, and instead are recommended for a
caesarean section. As such, there exists a significant cohort of Canadian
obstetricians who lack training in vaginal breech birth.
    "The evidence is clear that attempting a vaginal delivery is a legitimate
option in some breech pregnancies," said Dr. André Lalonde, Executive
Vice-President of the Society of Obstetricians and Gynaecologists of Canada.
"The onus is now on us as a profession to ensure that Canadian obstetricians
have the necessary training to offer women the choice to deliver vaginally
when possible."
    In light of the lack of training, health professionals, universities, and
hospitals will need to work together to help ensure that Canadian health
centres are prepared to accommodate women who choose to attempt a trial of
breech vaginal delivery.
    The society is also cautioning that many breech deliveries will still
require a caesarean section, and that a vaginal birth is not recommended for
some types of breech positions. In situations where a vaginal delivery is an
option, the delivery should take place in a hospital setting. An experienced
obstetrician should be present to attend the delivery and to offer a caesarean
section if the labour does not progress smoothly or if complications arise.



    For More Information
    --------------------

    Guideline
    Vaginal Delivery of Breech Presentation
    (http://www.sogc.org/media/pdf/advisories/CpgBreechJune09_e.pdf)

    Editorial
    Vaginal Breech Delivery Guideline: The Time Has Come
    (<a href="http://www.sogc.org/media/pdf/advisories/LalondeBreechEditorialJune09_e.pdf">http://www.sogc.org/media/pdf/advisories/LalondeBreechEditorialJune09_e.
pdf</a>)
    Dr. André Lalonde

    Commentary
    Breech Birth Can Be Safe, But is it Worth the Effort?
    (<a href="http://www.sogc.org/media/pdf/advisories/KotaskaCommentBreechJune09_e.pdf">http://www.sogc.org/media/pdf/advisories/KotaskaCommentBreechJune09_e.pd
f</a>)
    Dr. Andrew Kotaska

    SOGC Backgrounder
    About Breech Birth
    (http://www.sogc.org/media/advisories-20090617b_e.asp)

    SOGC Public Education Brochure
    (http://www.sogc.org/media/pdf/advisories/BrochureBreech_e.pdf)
    Breech Childbirth

    About the SOGC
    --------------

    The Society of Obstetricians and Gynaecologists of Canada (SOGC) is one
of Canada's oldest national specialty organizations. Established in 1944, the
Society's mission is to promote excellence in the practice of obstetrics and
gynaecology and to advance the health of women through leadership, advocacy,
collaboration, outreach and education. The SOGC represents
obstetricians/gynaecologists, family physicians, nurses, midwives and allied
health professionals working in the field of sexual reproductive health. For
more information, visit www.sogc.org




For further information:

For further information: Media Contact: Mike Haymes, Media Relations
Officer, SOGC (902) 440-3263; Natalie Wright, Director of Communications and
Public Education, SOGC, (613) 240-0169

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Society of Obstetricians and Gynaecologists of Canada

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