The Globe and Mail has the headline "C-section not best option for breech birth" and everyone cheered. Everyone, but a few people maybe. I mean, I cheered and then I said "Don't get too excited."
Here is the thing; there are some pretty unclear things with the news story about the Society of Obstetricians and Gynecologists of Canada releasing the new guideline that doctors should no longer automatically opt to perform a cesarean section in the case of a breech birth. The forget that for nearly 20 years in birth, c-sections have been performed for breech babies and therefor this idea is "new" to a lot of care providers.
These care providers have been taught to be afraid of breech birth. So this guideline changes nothing until training is offered and more than just offered, demanded and expected. Without training and practice a guideline is useless. Until then we are still going to see doctors recommending c-sections because it is their comfort zone. To speak some honest truth the matter is that things will be more risky if a doctor isn't comfortable.
Women are going to continue to be disappointed. Maybe even more so disappointed because they will know this is a guideline now yet their care provider is not up to par of the expectation. Sounds like training will be coming but in what capacity, it doesn't say. Who is responsible for that? Who will enforce the need for training? How soon do they expect to have people trained? What expectation are we setting for mothers showing up to deliver? Will a doctor who is trained be there or be called in, if the doctor on call is not trained?
There was also this quote: "If a woman is well-prepared during pregnancy, she has the innate ability to deliver vaginally." As a doula I know this statement to be true, but then I also ask, who is responsible for this preparation? Who is providing with this preparation? Where is the over worked system going to begin to even start preparing women for birth? Shouldn't that already be happening, breech aside? If this isn't already happening, why would we expect to see that change in regards to breech birth? This is a large part of what doula's do! It almost reads to me like the SOGC is recommending doulas. And childbirth education that focuses on a woman strength and ability. These are wins, to me.
Today I celebrate the SOCG and their new guideline but I also feel the sighs of the women walking into the hospital in the near future who are told they will not be supported in their choice to deliver vaginally.
I will continue to watch how things progress locally on this front and will update the information as I can.