Heads Up! Breech Conference

November 9-11, 2012

Betty-Anne Daviss: The Evolution of Breech Birth

November 9, 2012

Betty-Anne Daviss is interested in breech birth from an anthropological perspective. Her presentation covered 3 main topics:

1. The history of breech birth: sorting through the myths and realities
2. The Noble Lie & human rights: why practitioners need to stop pretending and women need to become less gullible
3. Boundary crossing and elements that create change

Playing "make believe" allows children to deal with fears in a safe setting. Plato referred to a concept of "the Noble Lie"--that politicians need to lie to create myths that comfort and cohere a population. This is an adult form of "make believe." What is the greatest Noble Lie our culture tells about Childbirth? Women need to be saved most of the time.

Betty-Anne trained with traditional midwives in Guatemala several decades ago. She keeps going back to what they taught her, finding their insights to keep proving true. She also strongly reveres the black Granny Midwives, whom she worked with in the 1980s.

Next, Betty-Anne gave a brief overview of the history of obstetrics in its cultural and historical context. Some of the things she touched on:

  • The work of Eric Bracht, known for the Bracht maneuver. She tried to mimic what would naturally happen in a gravity-positive position and created obstetrical maneuvers to simulate those movements with the mother on her back.
  • Reduction of maternal mortality fell drastically in the 1930s and 40s due to antibiotics, safe anesthetics, and blood transfusion. Starting in the 1950s, cesarean sections became increasingly safer.
  • Overview of cesarean rates in the last several decades.
  • Why is Bracht so important? He began making...but failed..to complete the link between gravity & breech birth.
  • Final interpretation of the Term Breech Trial (TBT) found that the risk is very minimized if: the baby is not IUGR, labor is spontaneous, good labor progress, shorter second stage, & experienced practitioner present.
  • Recent discoveries on importance of vaginal birth in colonizing the baby with the mother's gut bacteria
  • Referred to economist Daniel H. Pink's book A Whole New Mind.
  • European observational studies of breech that we'll be looking at during this conference: Scandinavia, PREMODA, 2006 French study.
  • Agnes Gereb and human rights issues in childbirth

Betty-Anne just had a meeting this week with Montfort Hospital in Ottawa. They just waived the requirement to have an obstetrician present at all breech births. It's now the first hospital in North America to allow midwives to attend breech births as the primary caregiver!

She lamented that ACOG is not present at this conference, despite intensive efforts from many organizers and physicians. In contrast, the SOGC has been involved in breech activism for several years now.

We need to carefully study women and contemplate what they need, what they know, and what they are capable of. "I don't believe in compromise; I never have," she commented. She ended her presentation with this observation: We need collaboration, not compromise or co-optation.