A steady decline in the rate of vaginal term breech birth over the past three decades has led to a resurgence of vaginal breech birth in many parts of the world. The dedication of researchers, teachers, providers, and non-profit organizations has fostered on- going studies, published research, and provided hands-on training. Within that dedicated group of professionals there is a controversy surrounding using water for second stage. There are strong opinions on either side. Dr. Herman Ponette, the head obstetrician at the H. Surreys Hospital in Ostend, Belgium, was the first obstetrician to detail his experience using water immersion for term breech vaginal birth in the early 1980s. Using water as a comfort measure for early labor is not currently in question. Most experienced breech providers have limited experience using water for the actual birth.
This session will examine the pros and cons of facilitating breech birth in water from a provider perspective. A brief discussion of fetal reflexes and newborn transitional physiology will be included as well as a summary of the current research. Using photos, video of breech waterbirths, and video demonstration on models of hand positions and techniques to assist with a breech birth will introduce the participant to this topic and create an interest for further research and investigation.
Learning Objectives:
1. Demonstrate suggested hand maneuvers used during a frank breech birth.
2. Discuss the current trends in breech literature.
3. Describe the sequence of fetal reflexes as they apply to breech birth.
4. Explain how to decide when to proceed in water and when to leave the water.
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