A ‘normal’ breech baby – well-flexed, with lots of room to move
The Royal College of Obstetricians and Gynaecologists is consulting the public on the proposed new breech guideline, until 2 May, which is Monday. They accept one peer review per organisation, so I will collate any comments sent to me personally or posted here on Monday afternoon, and submit them for Breech Birth Network. – Shawn
Hi Shawn, I don’t see a huge change in the recommendations but planned vaginal breeches seem to have good outcomes. The most important factor is having skilled people to offer a choice. In the absence of this in most units, elective CSections are going to be the norm.
Hi, Logan. I see the recognition of upright positioning and the very simple pro forma they suggest requiring balancing counselling as significant changes. But I also agree with you. Recent ACOG guideline changes have the same weakness — they rely on ‘experience’ as the basis upon which someone is safe to offer to facilitate breech birth or not. Without a definition, or at least a framework, of what ‘experienced’ means, support of breech birth will remain largely a matter of personal preference (eg. Do you consider yourself experienced, or not?). Professionals who do support breech births will be vulnerable of accusations that their self-judgement was incorrect when adverse outcomes occur. Others have expressed similar reservations to me, and Breech Birth Network feedback will include a recommendation that all Trusts maintain a list of who they consider ‘experienced’ to support breech birth, under supervision and autonomously.