$Unique_ID{BRK01612}
$Pretitle{Pregnancy and Childbirth}
$Title{Cesarean Delivery for a Breech Positioned Baby}
$Subject{C-section delivery}
$Volume{K-14}
$Log{}

Copyright (c) 1991   Tribune Media Services, Inc.


Cesarean Delivery for a Breech Positioned Baby


------------------------------------------------------------------------------

QUESTION:  I am expecting a baby in about two months, but they have found that
it is in a breech position and I have been advised to have a cesarean
delivery.  I've read that too many cesareans are performed in this country
anyway.  Do you think I need another doctor, who might have another opinion?
I've never had surgery before.  Can you tell me if this is serious?

------------------------------------------------------------------------------

ANSWER:  It would seem that you are anxious and worried, but maybe I can
provide some information to help you.  A cesarean is considered major surgery,
involving a series of separate incisions in the mother.  The skin, the muscles
underneath and abdomen must be opened.  Then an opening must be made in the
uterus for the baby to be removed.  A breech positioned baby is a legitimate
reason for performing a Cesarean, if other factors are involved.  When the
baby that is breech is 8 pounds or larger, when the mother's pelvic dimensions
are considered too small for vaginal passage, or if the baby is positioned
with a hyperextended head, then, most doctors feel a cesarean presents less of
a risk than vaginal delivery.  It may be wise for you discuss these factors
with your physician.  If your doctor has determined that your baby is indeed
breech and one of the complicating factors are present, chances are you will
have to have the C-section.
     Fortunately, modern medicine and its advances have made the cesarean a
generally "safe" procedure, and maternal deaths are very rare.
     If it is decided that you must have the C-section, there are some other
things to be discussed ahead of time.  Find out what type of incision will be
made.  In the past, (and sometimes still in the case of breech babies), a
vertical incision was often used.  This is referred to as the classical
operation, allowing a greater opening.  This operation is used when fetal size
or position is a problem and in some emergency situations.
     Nowadays, however, a horizontal incision in the lower uterus is used most
exclusively.  The procedure is called the low transverse cervical, (also known
as the Pfannenstiel or "bikini" incision) and it has the lowest incidence of
hemorrhage as well as the least chance of rupturing during a later pregnancy.
     Don't be afraid to discuss all of this with your doctor.  This is a very
special time for you, and your anxiety is understandable.  The best medicine
for this, however, is knowledge, and you have a right and responsibility to
know all there is to know about your condition.  Its the best way to make this
period of preparation one that is fun and joyous.
ÿ
----------------

The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
