Some fear vaginal breech deliveries may become obsolete. (Disagreement with ACOG).

SEA ISLAND, GA. -- The art of delivering breech fetuses vaginally is likely to be lost within the next decade, given the stance taken by the American College of Obstetricians and Gynecologists in a committee opinion issued in 2001.

With its statement that "planned vaginal delivery of a term singleton breech may no longer be appropriate," ACOG has "put handcuffs on those of us who still want to do breech deliveries," Dr. James B. Ferguson said at an ob.gyn. meeting sponsored by the Medical College of Georgia.

"I hope ACOG will consider rescinding their publication," Dr. Ferguson told this newspaper.

The loss of this skill will result in a further elevation in already high cesarean delivery rates, according to Dr. Ferguson, who is the John M. Nokes Professor of Obstetrics and Gynecology and director of the division of maternal-fetal medicine at the University of Virginia, Charlottesville.

Moreover, "there may be times when doing a cesarean section in a timely fashion or safely will not be possible," said Dr. Lawrence D. Devoe, Brooks Professor and chairman of the department of obstetrics and gynecology and director of maternal-fetal medicine at the Medical College of Georgia, Augusta.

"I would submit that those who don't know the mechanisms of breech delivery vaginally also may have a difficult time doing it ...