According to new guidelines by the Society of Obstetricians and Gynecologists of Canada physicians should no longer automatically opt to perform a cesarean section in the case of a breech birth.

The guidelines, which were released yesterday, are in response to new evidence that shows many women are safely able to vaginally deliver babies who enter the birth canal with the buttocks or feet first. Normally, the infant descends head first.

“Our primary purpose is to offer choice to women,” said André Lalonde, executive vice-president of the SOGC.

“More women are feeling disappointed when there is no one who is trained to assist in breech vaginal delivery,” he adds.

Since 2000, C-sections have been the preferred method of delivery in breech births. Studies suggested that breached births were associated with an increased rate of complication when performed vaginally.

As a result, many medical schools have stopped training their physicians in breech vaginal delivery.

The problem now, according to Dr. Lalonde, is that there is a serious shortage of doctors to teach and perform these deliveries.

With the release of the new guidelines, the SOGC will launch a nationwide training program to ensure that doctors will be adequately prepared to offer vaginal breech births .

New research shows there is no difference in complication rates between vaginal and cesarean section deliveries in the case of breech births.

The SOGC stresses that because of complications that may arise, many breech deliveries will still require a cesarean section.

Breech presentations occur in 3-4 per cent of pregnant women who reach term, which translates to approximately 11,000 to 14,500 breech deliveries a year in Canada.

The new decision to offer vaginal breech birth aligns with the SOGC promotion of normal childbirth – spontaneous labour, followed by a delivery that is not assisted by forceps, vacuum or cesarean section. In December of 2008, the society release a policy statement that included its recommendation for a development of national practice guidelines on normal childbirth.

“The safest way to deliver has always been the natural way,” said Dr. Lalonde.

“Vaginal birth is the preferred method of having a baby because a C-section in itself has complications.”

Cesarean sections, in which incisions are made through a mother’s abdomen and uterus to deliver the baby, can lead to increased chance of bleeding and infections and can cause further complications for pregnancies later on.

The SOGC believes that if a woman is well-prepared during pregnancy, she has the innate ability to deliver vaginally.

The national average for babies delivered via cesarean section in Canada is 25 per cent.

The causes of breech presentations are not fully known. However, a breech birth is more common :

• In subsequent pregnancies
• In pregnancies of multiples
• When there is history of premature delivery
• When the uterus has too much or too little amniotic fluid
• In an abnormal shaped uterus or a uterus with abnormal growths, such as fibroids.
• For women with placenta previa

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Doctors in Miami worked quickly minutes after Jordan Jamal Smith was born in March, to remove a 1.8-pound mound of liquid and tissue protruding from the newborn’s mouth that covered his eyes and nose, his cheeks and forehead.

During a routine 17 week ultrasound the technician noticed something odd on the screen. The growing fetus inside Kimberly Robinson had an abnormal shape on its face.

”I thought he was sucking his thumb,” she recalled.

Doctors soon discovered it was a rapidly-growing tumor, which sprouted out of the baby’s mouth like a large, inflated balloon. It would soon prevent him from swallowing amniotic fluid, which could cause the expectant mom’s uterus to swell and give birth prematurely.

She was told the tumor, an epignathus teratoma, would likely suffocate the baby after birth. If the child was lucky enough to survive — and he would probably not — he would likely be mentally disabled. Abortion, doctors told her, would only expedite the inevitable.

Instead, the hopeful mom returned to the hospital, where doctors would insert a six-inch-long needle into her belly to drain a liter of amniotic fluid building up inside her.

On March 25 Dr. Elvire Jacques, a UM obstetrician/gynecologist at Holtz Children’s Hospital and her 20-person team of doctors and nurses performed the Caesarean and kept the baby connected to his mother’s placenta after birth, while they found a way to get the baby to start breathing, despite the tumor covering the baby’s face.

In the last 50 years there have only been 70 similar cases of the rare condition. Of those, most of the babies had suffocated soon after birth.

Seconds after baby Jordan left the womb, he was whisked off by hospital staff. Robinson didn’t even catch a glimpse of her son. The baby had no visible face, only a red mound the size of two adult fists.

”Thirty-five percent of his own weight was sitting on his face,” Younis recalled.

When the doctor lifted the heavy tumor, he found what he was looking for: a mouth. The tumor, growing out of the child’s mouth, had left a small opening large enough to insert a breathing tube. Doctors wrapped the baby’s head and tumor in a large mask.

The amazing part is that beneath the heavy red mass Jordan’s face was untouched and unaffected.

Although Jordan’s facial bones and jaw had been pushed back and out of place, they were perfectly healthy. And like most babies, his bones were malleable. During the following weeks, his face slowly readjusted.

Now 2 months later, there is little evidence of this baby’s amazing journey.

His mom hopes that he will be well enough to come home next week.

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PHOTOCREDIT:AP Photo/Lynne Sladky

Last year when Camila Alves delivered her first baby, new daddy Matthew McConaughey told OK Magazine that she danced through labor saying,

“Contractions started kicking in, and we found a great rhythm. We had a 14-hour session, her and I did. I sat there with her, right between her legs. We got tribal on it. We danced to it. I was DJing this native Brazilian music.”

Dancing through labor has become increasingly popular as moms try to find natural ways to deal with contractions.

Many of the movements in belly dance are similar to movements and techniques taught in childbirth class. For instance, the belly roll in typical belly dancing is similar to the pattern of breathing progression women are taught to practice during labor: lower abdominal breaths, to more shallow chest breathing, and to the popular panting breath.

The pelvic rock that most childbirth preparation classes teach is to stretch and strengthen the pelvic muscles; allow the baby to attain a better position in the pelvis; and to ease the strain on the laboring mother’s back. These hip and pelvic movements are synonymous with the hip circles, figure eights, and hip lifts of belly dancing.

When I had my son dancing was the last thing on mind. Heck the pain was so intense I couldn’t even speak let alone dance…

How do these women do it?

The woman in the video below is 9cm dilated and dancing like she is at a Caribbean resort…

A New York woman who almost made it to the hospital on time instead ended up giving birth on Fifth Avenue with a view of Central Park.

Hospital staff ran out to help deliver the baby girl after mom-to-be Elisabeth Brew’s screams could be heard a woman from inside Mount Sinai Medical Center today.

When they arrived they found Elizabeth sprawled across the front seat of her SUV with the baby’s head already crowning

The new baby joined her twin brother, after he was delivered a few minutes later indoors. Both babies are healthy, but will stay hospitalized for a few weeks because they’re premature.

Wow this mom is a trooper!

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A surprised Michigan dad helped deliver his wife’s baby boy despite not knowing she was pregnant.

The man called 911 early this morning because his wife was in labor. He told the dispatcher that he didn’t know his 27-year-old wife was pregnant. He thought her recent weight gain because they had just quit smoking.

The baby was successfully delivered and then transferred to the hospital for observation.

The new baby joins the couple’s two children, and an another child from a previous relationship.

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In an attempt to turn one of the world’s most common operations into an experience closer to vaginal birth, a UK doctor has made some changes to the how Caesarean sections are done, which has made the procedure more intimate for expectant families.

“It struck me that all the effort was going into changing normal childbirth but that Caesarean section was still steeped in old surgical rituals,” says Professor Nicholas Fisk, a former obstetrician at Queen Charlotte’s Hospital in London, “In some cases I was horrified; the baby would be dragged out like a tumour and passed to several medical staff before the mother. It was ripe for reform.”

His team focused on three areas.

First, parental involvement: this meant dropping the drape that “divorced” the mother from her abdomen, to allow her to see her baby’s head emerge; the baby itself blocks the mother’s view of the operation.

The second point was physiological: Fisk showed that when a Caesarean is performed slowly the baby is able to “autoresuscitate” – start breathing unaided – while still attached to the placenta, as in normal birth. The baby is “half-delivered” and a combination of the naturally contracting uterus and the baby’s vigorous wriggles allow the lungs to expel fluid in a similar way to a vaginal birth. This reduces the risk of the baby needing help to breathe; a common occurrence after a Caesarean.

Finally, Fisk wanted to see newborns handed immediately to their mother for skin-to-skin bonding.

“There are now official standards for skin-to-skin bonding in childbirth, but these are almost never met with Caesareans,” he says. One obstruction is that the monitoring equipment needed for patients in surgery is routinely attached to the mother’s chest. “In a natural Caesarean we attach the ECG wires to the back of the chest so that the baby can be placed on the mother after birth,” Dr Felicity Plaat, consultant anaesthetist explains. The anaesthetic dose is lowered so that there is no “heaviness in the arms” to prevent holding the baby, and a clip that measures oxygen in the blood is attached to the toe.

Plaat knows from experience how important it is for a mother to be given her child as quickly as possible:

“My son was passed around, measured, weighed, dressed and even had his hair washed before being given to me. A crucial player, therefore, is the midwife . She has to be enthusiastic and involved. It’s not just ‘dumping baby on mum’ and writing up notes; it’s making sure that the baby is safe, is not going to slip off, and is warm. We put towels over the baby and even bubble-wrap – the kind you buy in big rolls in Ryman.”

Camilla Fisher had one last summer, after an emergency Caesarean two years before.

“It was the most relaxing environment: calm and reassuring,” she recalls. “The staff and my husband were all in green surgical gowns, but it didn’t feel like an operation. When you’ve had a natural Caesarean you wonder why it was ever different. I’ve never felt that I was deprived of a ‘natural birth’.”

It would be interesting to see if doctors in other countries adopt this procedure. It makes sense.

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After already delivering 4 children, Catherine was well aware of what was going to happen when she arrived at Rush University Medical Center in March. However, nothing could have prepared her for the horrible ordeal she was about to face.

According to a civil suit filed Monday, Skol arrived at the hospital at about 4 a.m. Her usual doctor was out of town, so Dr. Scott Pierce filled in. The lawsuit alleged that Pierce showed up at Rush four hours later, and when he did, he allegedly reprimanded Skol for not calling before coming in. The lawsuit claims he said there was not enough time to administer pain medication.

The suit also accuses Pierce of telling a nurse that Skol got the pain she deserved because she had not called ahead.

“Sometimes pain is the best teacher,” he allegedly said.

Skol says the doctor gave her an excruciating vaginal exam in the middle of a contraction. Then, although she was not fully dilated, she claims Pierce instructed her to start pushing.

When Skol or the staff questioned his methods, Pierce told Skol, “Shut up, close your mouth, and push,” according to the suit.

Skol accuses the doctor of giving her unnecessary stitches after the birth, using an excessively large needle.

A spokesperson for Rush said Pierce is in private practice and is not employed by the hospital, and that the hospital in no way condones the actions described in the civil suit.

Wow, I hope that this guy doesn’t get pulled over for speeding any time soon…

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But Amber Hartnell of Hawaii says her birth experience was different. The mom of 2 says she experienced an orgasm during labor when she gave birth to her son in September 2005.

“All of a sudden the orgasm just started rolling through and rolling through, and it just kept coming, and my whole body was spiraling and rolling, and I was laughing and crying,” she said.

Amber’s husband was amazed – and also relieved – to see his wife experience such pleasure.

“It made me feel like everything was gonna be all right,” he said. “The experience didn’t have to be a traumatic, painful experience. It could be an experience of ecstatic joy.”

The couple even allowed the birth of her second child to be filmed as part of a documentary titled “Orgasmic Birth.”

Debra Pascali-Bonaro, a childbirth educator for 26 years says,

“It is, as we say, the best-kept secret. I believe by women having such terrible fear. … Women aren’t getting the choices they need, to make the experience as easy as possible.”

The secret? Intimacy. Another couple, who also experienced the same thing spent much of their labor kissing and caressing.

“The physical touch and the nurturing was just really comforting to me,” Tamra Larter said, adding that she ultimately experienced an orgasmic birth. “It was happening, and I could hardly breathe, and it was like, ‘oh, that feels good.’ That’s all I could say really.”

Dr. Christiane Northrup, a board-certified OB-GYN said orgasms during labor are caused by basic science.

“When the baby’s coming down the birth canal, remember, it’s going through the exact same positions as something going in, the penis going into the vagina, to cause an orgasm,” Northrup said. “And labor itself is associated with a huge hormonal change in the body, way more prolactin, way more oxytocin, way more beta-endorphins — these are the molecules of ecstasy.”

Number 2 is coming in a couple of weeks – sign me up!

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While in labor and rushing to the hospital in the breakdown lane, Jennifer Davis and her husband pulled up behind a state trooper to ask for his help.

Instead of getting a warm reception, they were issued a ticket for $100, after having to wait for him to finish writing the ticket he was already writing for someone else.

And if that’s not enough – the trooper tops it off by asking the laboring woman to prove she is pregnant.

According to Jennifer Davis, the trooper said, “what’s under your jacket?” She said, “my belly.” To which the trooper responded, “okay, let’s see it.” She was wearing a jacket, it seems, and so perhaps this intrepid law enforcer thought she and her husband were stealing a very large beach ball or something.

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This is not because I don’t like being pregnant, but because I would like all of the pregnancy horror stories to end.

Even though I already have a son, I didn’t get to do the whole pregnancy thing – getting ripped off 16 weeks early. This makes me a target for those who have delivered full term babies to tell me their horror stories of 48 hour labors and ripping from one end to the other.

In the last few weeks I have heard about:

• someone losing their baby at 36 weeks (that’s where I am)
• someone who had a botched c-section
• someone who’s hubby cheated 4 days before baby #2 arrived

This on top of multiple inquiries about if I am going to bust soon…

For all of you who have had nightmare deliveries, crummy pregnancies or unfortunate things happen after, it may be nice to keep them private until others have their babies safely in their arms.

I have no control over what my little monkey is doing inside right now, how incompetent the doctor is going to be or how my body is going to react to childbirth. But I do deserve the right to enter into this with faith, which is hard when you hear negative stories.

So…if you see a pregnant woman today, resist the urge to tell her about all the bad things you have heard and say something nice!