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Tuesday, February 26, 2013

Episode 74 (Epilogue): What's Up with Breech Birth

Tonight’s show focused on breech birth. In particular, Laura and Cheryl focused on the subject of vaginal breech birth. The show began with statements from our local physicians about stances and policies related to breech birth delivery method in our area and a discussion of the lack of educational standards for medical students involve vaginal breech birth. Cheryl then shared with us her experience at the Spinning Babies workshop. Spinning babies is a project of CPM Gail Tully to help babies get into the optimal position for labor, before that labor ever starts.
Our guests tonight were Dr. Stuart Fischbein and Dr. Whitney Gonsoulin. Dr. Fischbein is a Fellow of the American College of Obstetrics & Gynecology and a practicing obstetrician in Southern California. While well trained at Cedars-Sinai in the standard medical model of obstetrics he had the respect and vision to support the midwifery model of care and served as a backup consultant to many home and birthing center midwives for 25 years. He co-authored “Fearless Pregnancy, Wisdom & Reassurance from a Doctor, a Midwife and a Mom.” Dr. Gonsoulin received his residency training at LSU School of Medicine in New Orleans from 1979 to 1983. He completed a maternal fetal medicine fellowship at Baylor in Houston, Tx from 1988 to 1990 in hospital doing 18000 births per year. Since then Dr. Gonsoulin has practiced Maternal Fetal Medicine in Texas and Louisiana supporting women's option of place of birth and birth attendant.  

The doctors shared with us information about the different forms of breech presentation, theories about what might cause breech birth, and reasons why breech vaginal delivery has been shied away from. The doctors also discussed some of the risk and risks factors for vaginal breech delivery, and compared the safety of vaginal breech delivery and Cesarean breech deliver.  We also continued our discussion about what factors have led to the decline in vaginal breech births and relevant training for doctors (especially experience with live vaginal breech birth) on assisting a vaginal breech delivery.  

We then moved to a discussion of what could be done in the future to change policies related to hospital policy, problems which research which has influenced the decline in vaginal breech birth assistance in the hospital setting, and what women who find out they have a breech presentation and want to attempt a vaginal delivery can do. The importance of doctors who practice informed consent and knowledge on the part of the patient involving current research on breech delivery methods.
Our next guest was Dr. Simion Tsinker. Dr. Tsinker completed his OB GYN Internship & Residency at Brooklyn Jewish Hospital in New York in 1982. He then began private practice in Fort Lauderdale, Florida. He has been chief of the Department of Ob. Gyn. at Florida Medical Center South, vice chairman of the Ob. Gyn. Department at Plantation General Hospital, and featured in articles in Miami Herald and Vogue Magazine. Dr. Tsinker shared with us how he came to specialize in breech birth, and discussed the importance of skill of the OB/GYN and selection criteria relating to women who wish to attempt vaginal breech delivery. He also discussed his colleagues' reactions to vaginal breech delivery, and the added work on the part of the physician to assist a breech birth vaginally.  Dr. Tsinker also discussed issues with the research which has led to the decline in vaginal breech birth and training in assisting vaginally breech birth.

Dr. Fischbein 
Dr. Tsinker 
Tonight’s Right for Childbearing Women: Every woman and infant has the right to receive care that is consistent with current scientific evidence about benefits and risks. Practices that have been found to be safe and beneficial should be used when indicated. Harmful, ineffective or unnecessary practices should be avoided. Unproven interventions should be used only in the context of research to evaluate their effects. To learn more about your rights, please visit Childbirth Connection

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