In a message dated 99-12-09 09:49:03 EST, you write:

<< The way I have seen and learned about breech delivery is that one really
 needs to let gravity and the uterus move the baby, never to "grab the feet
 and pull him down hard". Otherwise there can be damage to the neck. Or if the
 hands are placed on the body to pull, there can be adrenal damage. >>

The breech delivery of a second twin (or 3rd of triplets) is not always the
same as for a single breech. A singleton (or 1st twin) breech generally is
engaged in the pelvis prior to labor. Waiting for gravity and the uterus to
move twin # 2 often is not an option. This little guy/gal (who generally is a
smaller size than a singleton) is more likely to get into a footling breech
situation since this babe can't engage in the pelvis until babe # 1 exits it.
Or twin # 2 may have been in a transverse lie, so the doc goes to get him and
the feet are easier to bring down than his head. (Research evidence indicates
that going in to get him by the feet is no more traumatic for him--and less
traumatic for mother--than doing an emergency surgical birth!) In either
case, there is concern about where his cord is while he's getting into
position. (I should note, that if twin # 1 is breech but twin # 2 is vertex,
most docs will want to deliver the babies surgically. And many/most will
suggest the same for double breech or breech/transverse positioning.)

Also, a mother's perception that the doc had to "grab the feet and pull him
down hard" may not be what actually occurred in terms of the baby's body
mechanics.

Karen

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