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Old 06-30-2013, 10:19 AM   #1
Ellasundies
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Breech extraction

A friend of mine recently had twins . Her twins were vertex/breech. They allowed her to have a vaginal delivery but they insisted on a breech extraction for twin B. This friend was fine and so were her babies but my DH has a coworker who's baby B twin had a broken leg and arm thanks to this procedure. So I've been reading up on it (because I'm a dork like that ) and it makes me wonder why it's done???

I've read some research that shows it's safer then doing an external version after delivering twin A but nothing comparing an extraction to just letting baby B deliver naturally. It also seems as though there really aren't any OB's who will just allow Baby B to deliver. It seems like your options for a hospital birth with vertex/nonvertex twins are either a c-section or a breech extraction.

When they deliver baby b through a breech extraction they reach in, grab the baby's feet and then pull them out. It seems to me that you are then forcing the baby to deliver as a footling breech which is the most dangerous type of breech. So why not just let the baby deliver and if they happen to be footling then manipulate things if you have to.

I also don't get how it's common knowledge to be hands off for breech deliveries and yet they are doing this to the easiest type of breech to deliver (a twin B). I just don't get it and haven't been able to find anything on the web about it.

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Old 06-30-2013, 10:38 AM   #2
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Re: Breech extraction

omg, I would have never allowed this!! my new baby with a broken arm and leg. Im for all natural and would have chosen a c section before harm to my baby makes me want to cry

I have attended 3 sets of twins births and one was a breech, the baby just fell out. super easy.
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Old 06-30-2013, 10:45 AM   #3
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Re: Breech extraction

I was pretty shocked too when it happened. If I remember right though the research does favor breech extraction over c section. Still I just can't help but wonder what the Ob's reasoning is for this.
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Old 06-30-2013, 10:52 AM   #4
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Re: Breech extraction

The reasoning for extraction is that since the uterus is used to fitting two babies, now that there's only one, baby b could turn transverse. An alternative that I've heard done is to place two pairs of hands at the top of uterus immediately after twin a is born, putting a medium amount of pressure so that baby b stays further down in the uterus and can't turn.
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Old 06-30-2013, 12:03 PM   #5
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Re: Breech extraction

Which could also be helped with an extraction so why not just wait and see what happens and helping if its needed?
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Old 06-30-2013, 01:32 PM   #6
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Re: Breech extraction

I am not an expert by any means but I do remember reading a story about a twin that died because the placenta detatched and they were waiting for baby to be born. It seems like they were saying that this is the fear with waiting for baby b to be born. Probably others can chime in and set the record straight. It does seem very confusing. I can't imagine having a nb with broken bones.
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Old 06-30-2013, 01:38 PM   #7
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Re: Breech extraction

Goodness ladies, you're all making the possibility of a c/s look downright good Especially after I asked Dr. Google. In any case, the most desirable outcome is 2 healthy babies, period. But, from what I can tell, following a vaginal delivery of Baby A, the extraction of B is associated w/ a lower c/s & fetal distress rate. The outcomes for the extraction don't look that bad when extraction is performed by a clinician experienced in breech deliveries...and I think most people generally & doctors in this case overestimate their experience & facility with specific work-related skills.

I can only assume about the other factors, but PP's thoughts about Baby B turning into an even less desirable position makes sense, as does the idea that, b/c Baby B is not engaged, mom is more likely to see a protracted labor, delay any direct contact w/ Baby A, etc. I know that, once Baby A is out, getting Baby B out ASAP is a huge priority; letting that little bugger creep back up & descend naturally may make sense to you & me, but I suspect it leaves things too out-of-control for a doctor. I'll tell you what...I think one of my biggest fears as I look at the prospect of (my first) birth is to push a baby out, then still have to be cut open, especially after trying to push the 2nd out
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