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Babies with hyperextended necks (with their heads tipped back) should be born via cesarean section due to the high risk of entrapment of their aft-presenting head.
Note: Shortly before a planned cesarean birth it is recommended an ultrasound be done to confirm breech presentation and to rule out congenital anomalies incompatible with life. If baby is found in a vertex position, a cesarean section is then not needed.
Finding an experienced vaginal breech caregiver
Having a skilled and gently caregiver will greatly enhance your chance of a vaginal breech delivery. Unfortunately, the experience needed or desired to support a woman with a vaginal breech delivery is becoming harder to find as doctors and obstetricians rely on cesarean sections to be the only option available for breech babies. Interview potential caregivers, ask about their complication rates and find out what they recommend to minimize the chance of problems. Start looking and inquiring as soon as you find out baby is breech.
If you are unable to find a caregiver who will attend you, the midwives at The Farm in Tennessee headed by senior midwife Ina May Gaskin, the renowned author of Spiritual Midwifery, are very skilled at vaginal breech birth.
Vaginal breech birth protocols
Having a first baby should not disqualify a woman from a vaginal breech birth.
The jury is out on the routine use of epidurals during a vaginal breech birth. Though it prevents the premature urge to push and allows the use of forceps and manipulation of the baby without causing pain, it also hinders pushing, which is essential when a woman must rapidly and effectively push out the baby's head.