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Would you attempt HB with a footling breech? - Page 2

post #21 of 31

no I would not plan a footling breech at home. but what I would do is a moot point b/c I believe midwives are not licensed to attend breech births at home here anyway. I did ask in the interview if they had delivered breech babies and they said yes, surprise breech, and the wouldn't transfer a mom if they discover that baby is breech at the last moment, 

 

post #22 of 31

I would not knowingly deliver a vaginal breech at home, regardless of the specifics of the presentation. The possibility of vaginal breech is only an option in my comfort zone because I do have a proven pelvis, and would assume no other problems were detected.

 

I certainly would endeavor to seek out the remaining care providers who will attend vaginal breech.

 

I try not to make decisions based on anecdotes, but I'm human, and I've read of some horrific outcomes in footling breech.

post #23 of 31

I would attempt a full or frank breech home birth but not a footling :)

post #24 of 31

I would attempt vaginal delivery of breech in a hospital, but not at home.

 

I would not attempt vaginal delivery of known footling breach because of the increased risk of cord prolapse.  I would have a c-section.

post #25 of 31

Breech would worry me. I was just looking at the 2008 prospective homebirth study. The overall mortality rate was 1.7 per 1000 for low-risk babies, on par with hospital mortality, but in that study, there were 80 breech babies and 2 death in that group. One out of 40 is really damn high. I don't know if they were frank or footling, but it's still scary. I'd like to know more of the details of those deaths.

I think one problem is that breech often goes hand-in-hand with other issues. I might consider a frank breech at home with a really good team of midwives with breech experience, especially since I'm about four minutes from the NICU. But then again, I might not. I hope that's not a choice I have to make.

The other thing is that for most OBs, breech = C-section, and breech sections are a lot riskier than head-down sections. If I could find a hospital-based midwifery practice that did vaginal breech births, I might do that. But if my choice was homebirth or C-section, it would be a tough call.

post #26 of 31

I would unquestionably have a c-section with a footling breech.  I've had three uncomplicated vertex vaginal births with good-sized babies, two at home.

 

I would need to think carefully about frank breech.  I would only want to attempt it in the hospital, but the problem there is finding a practitioner who will support breech birth and has the necessary experience.  I might travel to a different area to find a provider who would support a breech birth (in a hospital).  I don't think I would attempt breech birth at home.  I'd think about it, but I don't think I'd ultimately be comfortable with that, just like I personally would want to VBAC (if I had a c-section) in a hospital with continuous monitoring.  There are some good hospital-based midwives working with OBs around here that support VBAC.

post #27 of 31

I across this forum and thread in google. I think it's a little sad that breech births are talked about as thing of myth because the medical profession doesn't trust women and their birthing bodies and babies. Research suggests now that it is no more dangerous to birth a breech vaginally (hands off) than it is to section. Fewer dOB's know what to do in a surprise breech situation these days because they really have no experience and i think that's dangerous. Yes breech birth can go wrong but more often it is due to complications that are already there causing the breech or mismanagement of the breech. 

 

I don't consider myself a reckless or careless mother but one that is in touch with her baby and body. I had my 3rd in transverse/breech lie for the last part of my pregnancy with his head under my right ribs and bum under left with feet dangling into my pelvis. I tried a few things to turn him but I knew my babe was comfortable and not going to move. S I emotionally prepared myself to continue with my freebirth of my babe. I had 2 previous quick deliveries 2 pushes and 5 mins of pushing so i knew for the most dangerous part (having only 8 minutes to birth the shoulders and head after umbilicus) I would be ok. I also believe i have a strong instinct that has never been wrong and I trusted it this time and if I felt at any point it was dangerous would have gone to hosp.

 

I gave birth to a 9.2 pound double footling posterior breech at home after a relatively pain free 4 hour labour. He had his arms up and a deflexed head so had to be gently freed as well as the cord removed from his neck once he was born. However my beautiful babe was and is still healthy and i had on small 1/8 inch tear and that's it. Nothing is mythical or impossible if our bodies tell us so and we trust them enough. My out come in hospital would have been much much worse and I am glad I birthed my breech belly babe at home, wouldn't change a thing.

post #28 of 31

We had a surprise breech baby at home. Midwives are not licensed for homebirths here PERIOD, so having one at my breech birth was no different. My midwife had a breech birth 5 year prior to mine and she brought all of the European knowledge that she studied and researched for her own birth into mine. I labored for 10 hours, painfully, but none the less...At 10 cm's my water still had not broken and the baby had not descended into the birth canal yet. So I pushed real hard through two contractions and broke my own water and then he dropped down into my pelvis. She checked me and said, "So, he's definitely a boy and he's definitely breech!" She gave us the option of ding it at home or transferring. We decided to stay home and 10 minutes later, he was born without being touched, AT ALL!!!! Cord wrapped twice, but still had beautiful color. Needed no resusitation. He was actually asleep when he was born and we had to wake him to assess him. :*)  The worst part of everything was the bruising on his little bottom from my pelvic bones. That went away with arnica cream after a couple days. He had a perfect shaped head and was perfect all around. The closest hospital is 20 minutes away and had we transported, I would have had him in the car, which to me would be more compromising than staying home. I knew we were in good hands. I knew the risk, I had peace about our choice.

 

I feel like a common mismanagement of labor and delivery among the medical profession causes this unfounded fear in women that we incapable of doing what women have been doing since the beginning of time. No Dr. in the country would allow a breech birth in a hospital, simply because they lack the training and experience to properly attend to mothers of breech babies. I would deliver a breech at home again without hesitation. Ina May Gaskin just did a conference here in NC on breech birth that I missed as my babe was too young to leave home. I wish I had been there but she is a huge advocate for it in skilled environments with tried pelvises. I love listening to her speak. Birth is natural and normal. We commonly misconceive this because we are told by other women, as especially health care professionals, that we are inadequate. When really, our babies are just as unique in birth as they are in personality.

post #29 of 31

Based on what I know about breech (and that's not a lot), I'd consider homebirth frank breech but not footling breech.

 

I'm VERY curious to know where this 1 in 20 figure comes from.  I've never heard that before.  Would the OP of that statistic please provide a source?

 

Oh, and breech is not part of the SOP of midwives or OBs in my town, so if babe presents breech (which is a possibility), then I'd be on my own.

post #30 of 31
Quote:
Originally Posted by loveneverfails View Post

Under no circumstances would I give birth to a footling breech child vaginally in home or at hospital, because there is a 1 in 20 chance of death.  Not 1 in 100.  Not 1 in 1000.  1 in 20, and that does not count babies with hypoxic brain injury.  I would consider planned home birth of a footling breech baby to be reckless, negligent parenting and no midwife should be taking on that client profile.  



Please share the source of your statistic!

post #31 of 31

It's hard for me to speculate what I would do, not having been in that position.  I believe I would plan a homebirth for a breech baby, but I don't get ultrasounds so I wouldn't necessarily know if it was footling or not.  

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