I recently came across Oregon Health & Science University’s website where they support vaginal breech birth! The Portland, OR based facility says,
OHSU hospital offers breech vaginal birth for mothers who qualify based on Ultrasound and other testing. Please talk to your doctor or midwife about breech delivery.
What is a breech birth?
Babies may be in any position in early pregnancy, but most settle into a headfirst position near the end of the pregnancy. Occasionally, babies do not turn and are expected to be born bottom-first or feet-first in a breech position. As you get closer to your due date, your doctor or midwife will be able to tell (by physical exam, ultrasound or both) if your baby is breech.
Can my baby be delivered vaginally breech if he/she does not turn?
OHSU hospital is supportive of breech vaginal birth for mothers who qualify. Babies must be not be in footling breech and ultrasound and other testing is required. There are risks to both breech delivery and cesarean delivery which your doctor will explain so you can decide what is best, and safest, for you and your bab(ies).
Please talk to your doctor or midwife about breech delivery.
They also state:
OHSU effort aims to reduce the number of cesarean section births
OHSU hospital is one of a handful nationwide that allows planned vaginal breech births, encourages VBACs and has implemented practices it hopes will result in fewer surgical deliveries. [As featured in a July 2011 Oregon Live news article.]
UPDATE 1/5/12: Seattle ICAN member Elisabeth had a breech birth consult with OHSU and provided this information:
To qualify these are the requirements:
- estimated fetal weight by us of 2500-4000 at time of delivery
- gestational age of 36+ weeks
- frank or complete breech
- flexed fetal head
- no major fetal anomalies
- pelvimetry by MRI
- pelvic examination: outlet, fibroids, pubic arch, ability to flex legs
Labor
- 1st stage – normal rate of progression once in active phase
- 2nd stage – passive descent for up to 2 hours, active pushing with documented progress each hour
- continuous EFM and IV access
- Induction considered for post termThey recommend, but do not require, an epidural
Their success rate is about 70-75%
Below is the criteria you must meet to quailfy for a breech birth at OHSU.
Comment from ICAN member: They were really positive about the whole thing and seemed pretty willing to be flexible about their requirements (at least if one is in the ball park) and seem to take into account individual situations.
To qualify these are the requirements:
- estimated fetal weight by us of 2500-4000 at time of delivery
- gestational age of 36+ weeks
- frank or complete breech
- flexed fetal head
- no major fetal anomalies
- pelvimetry by MRI
- pelvic examination: outlet, fibroids, pubic arch, ability to flex legs
Labor
- 1st stage – normal rate of progression once in active phase
- 2nd stage – passive descent for up to 2 hours, active pushing with documented progress each hour
- continuous EFM and IV access
- Induction considered for post term
They recommend, but do not require, an epidural
Their success rate is about 70-75%
I’m sure we all have an opinion of this. It’s defenitally not ideal, but at least there is a possible choice for moms who would never consider out-of-hospital birth.