Woman Suffers Permanent Reproductive Damage After Breech Birth

I have extensive experience with similar patients. I trained in an era when breech vaginal deliveries were the accepted norm. Consequently, I know how to do them, and actually perform the occasional vaginal breech today, when the circumstances are optimal. However, for most breeches, I recommend either external cephalic version or cesarean section in accord with current standards. Under normal circumstances, I would do an ultrasound to determine the type of breech (frank, complete, or footling), and the degree of flexion of the head, as labor and delivery has different implications for each. I would assess the likelihood of success of external cephalic version and attempt it as quickly as possible, if I thought it might work. If the patient was not an ideal candidate for vaginal birth, I would schedule a cesarean section for as soon as possible, or even do one right then and there at the first admission, to prevent just such a disaster. The extent to which this patient was dilated suggests either that she was in early labor or is likely to go into labor soon, which is what apparently happened. The patient should have received closer care than she was given in this case, and should not have been sent home in her condition.