I believe the injection you refer to was a pudental nerve block. This intervention (injection of a local anesthetic) targets the pudendal nerve trunk as it enters the lesser sciatic foramen, about 1 cm inferior and medial to the attachment of the sacrospinous ligament to the ischial spine, where the pudental nerve is medial to the internal pudendal vessels. Your friend might have a very skilled doctor. You see, ,the pudendal nerve has 3 branches: dorsal nerve of clitoris, perineal branch, and inferior hemorrhoidal nerve. He or she has specifically blocked the second branch, to numb the muscles of the perineum (transversus perinei superficialis, bulbospongiosus, ischiocavernosus), the skin of the labia majora and labia minora, to ensure an autraumatic breech delivery.

As for your daughter in law, if she is in the 35th week, there is no chance that the fetal position will change. The choice of a delivery method is based on the fetal weight, fetal condition, position of the umbilical cord, age of the woman, prior obstetric history, and some other factors.

how was this baby delivered - out of curiosity since the baby should have delivered by now

As has been suggested by others the injection likely was a pudendal nerve block for pain control at the time of delivery. Today, vaginal breech deliveries, aside from a second twin are not common. Options for someone at 35 weeks with a breech would be 1) expectant management (still a small chance of version to head down), 2) External cephalic version at 37 weeks by an obstetricians experienced with the procedure. Success rates are around 50% depending on the babies size, fluid, placental position, type of breech etc. If successful, a vaginal delivery of the baby in a head down position is possible 3) Use of moxibustion (Chinese herbal burned by the toes - JAMA randomized trial demonstrated efficacy), and 4) Cesarean. There are probably a few experienced OB/GYNs that might offer vaginal breech delivery to an excellent candidate but would be dependent on your overall assessment and the providers level of experience. These people may be challenging to find but likely will be at academic centers.

When I was in my Residency at Tulane Medical School the Chairman of our Obstetrical department was doubly board certified in Maternal fetal medicine and Internal Medicine and had written volumes on High risk Obstetrics and breech deliveries.

Due to the high risk of possible neurological complications to the fetus....all of our breech pregnancies were delivered by C-section! Unless when the patient came in and the feet or the breech were already exposed at the introitus! Then it was necessary to deliver vaginally since the baby could not be "pushed back up"!

The risk is that the biggest part of a new born is the head and not the breech.!

If the feet or the buttocks were presenting...which by definition are much smaller in diameter than the head.. then the head could get entrapped in the cervix. The "pointy"part of the baby's head ( the soft spot) is what dilated the cervix during labor and the chin is "tucked in" against the baby's chest....in a breech presentation the head may extend as it passes through the cervix in "military" position i.e.having the baby's chin pointing "up" instead of being tucked onto the baby,chest...this causes that the widest part of the baby's head as the presenting part instead of the narrowest part called the Vertex ( soft spot) and this can and does get trapped in the vaginal canal !!

This is mayor Obstetrical emergency and can cause fetal death and or permanent neurological injury to the baby!!!

It was for this reason that in our training program any breech that delivered vaginally we had to be in our Chairman's office to discuss the "why" and "where for" of the delivery and the out come. This is the reason most Obstetricians proceed with a Cesarean section....especially if this is the patient's FIRST pregnancy !!

First time pregnancies have what we refer to as "an unproven pelvis"....i.e. there is no documentation as to how big a baby she can safely have vaginally....no documentation if her pelvis is of an adequate size to have a vaginal delivery...and many other important criteria that have not been documented by the patient not having had a prior pregnancy and vaginal birth.

For these reasons it is my opinion that if this is her first pregnancy and the baby is breech she should have a Primary Cesarean section.

A pudendal block is NO guarantee that she will have a safe and healthy baby at the end!!

The reason that since the 1970's cesarean section has been recommended for breech presentation is that overall the chance of the baby experiencing a permanent neurologic injury is 3 times greater with vaginal breech delivery compared to cesarean delivery. That means the baby could have one arm that doesn't move or be asphyxiated during the delivery and end up with Cerebral Palsy. The potential risks and complications from cesarean delivery are less than ever before and therefore very few obstetricians have performed vaginal breech deliveries since the 70's, which means there are very few OB's left with enough experience to safely delivery a vaginal breech or for that matter to provide todays OB's with adequate training. I would advise that your daughter in law to cross her fingers and hope that the baby reverts to head first presentation but if not, don't put the baby at risk. The injection was probably either an analgesic which helped the mother relax or a local anesthetic to help with the actual delivery.

In 2015 most OB/Gyns would not do a breech delivery because of medical legal concerns. Personally I do breech deliveries on the trailing twin in a twin gestation because I have 22 years of experience and "back in the day" that is how we were trained. Unfortunately most younger OB/Gyn's have not even seen a breech delivered let alone performed one. I think it is important that your daughter-in-law understands that you never want a doctor in any specialty to do a procedure that he/she is not trained to do or comfortable doing. I suspect the injection you are asking about is a pudendal block that numbs the distal vagina and labia and perineum. Another possible option is to try an external cephalic version (try to turn the baby so it will not be breech).This procedure is also not performed by all OB/Gyn's and there are certain contraindications to not wanting to try to do it. Finally a word should be said about the complications of a planned c-section, they are extremely low and your daughter-in-law and grandchild will both do well and be healthy. Good luck and congratulations.

I agree with Dr. Matevosyan that the injection you a re describing is most likely a pudendal nerve block. This is a method of local anesthesia that works well in unmedicated deliveries but only near the end which tells me that the friend arrived to the hospital almost ready to deliver. In this circumstance a breech delivery is essentially inevitable and often successful however the safer route in the average patient would be via cesarean.

An option to avoid surgery for your daughter in law may be attempting an external cephalic version, a procedure in which an obstetrician may attempt to position the baby out of breech. There are certain risks that may be involved however it may be worth a discussion with her obstetrician.

For a breech,probably the safest delivery is C-section. The obstetrician should be able to evaluate the specific situation as far as best outcome

I think that major abdominal surgery is not the best way to have a baby. C-section was developed actually in Roman times to get a live baby out of a dead woman. It was never meant for live mothers, and in addition to lack of bonding right when the baby is born because you are drugged and in surgery, there can be some lung troubles because the baby isn't forced to breathe coming out of the birth canal. C-section babies catch up much more slowly with their immune systems than normal birth babies because they don't get the good flora/bacteria of the vaginal canal.

Breeches can be born just fine, as your friend had, injection or not. That being said, if your doctor said that C section is the best solution, you NEED a better doctor. This doctor doesn't know what she is doing. I'd get a midwife ASAP who is an expert in normal (not surgical) births.

Get to an acupuncturist ASAP as there are certain points to be used to turn the baby. I did a lot of this as a medical student. THere are also homeopathic remedies to help turn the baby. Homeopathic remedies stimulate your healthy body! The most common homeopathic remedy for breech babies is PULSATILLA. You can get this fromwww.1800homeopathy.com. Order a 30C and take 3 pellets 3 times daily. There are no side effects or interactions with medications, and yes, it's safe in preg because it helps you be healthier. For more reading, see:http://www.midwiferytoday.com/articles/turnbaby.asp

Keep in mind that C-sections make hospitals a LOT of money. Here is a video of an obviously new, nervous mom with her baby being born breech. Honestly it happened so fast I can't tell if it is breech or not! See for yourself: https://www.youtube.com/watch?v=oFabMR4sg5g

Try this: https://www.youtube.com/watch?v=bF50hTziZ74