I'm sure she'll have answers for you, but if she has any fault she won't admit it.
agreed. She has probably had lots of time to think up the perfect answers because knows she is going to be asked. By you, by other clients, and possibly even involved in some sort of malpractice suit. Getting good answers from her wouldn't be enough for me to feel comfortable.
It's kind of shocking to read some of these responses on a supposedly homebirth board.
For many, breech is considered a version of normal.
I have more to say on this topic, but since it's off topic, I'll refrain.
OP please keep us posted. I'm sure you'll get it all sorted out in time.
So, no, normally, healthy babies of healthy mothers do not die in childbirth unless the practitioner was incompetent.
If only that were true. Hemorrhage, uterine atony, cord accidents, amniotic fluid embolism, placenta problems, infection, unexplained fetal deaths, an a long list of other things often strike without risk and without warning and sometimes cannot be controlled.
Is breech a normally occurring phenomenon? Yes.
Does it increase risk? Yes.
Are all "positive" homebirth studies (assuming that you accept their validity) predicated on the assumption of low-risk mothers? Yes.
For a mother who is concerned about risk and is relying on the aforesaid studies as part of her comfort level for homebirth, breech homebirth delivery should be concerning.
If only that were true. Hemorrhage, uterine atony, cord accidents, amniotic fluid embolism, placenta problems, infection, unexplained fetal deaths, an a long list of other things often strike without risk and without warning and sometimes cannot be controlled.
A breech delivery does not fit into the rare unforseen event though. This is an area that has been extensively (by the standards of childbirth) studied. And as a PP pointed out, the studies that demonstrate homebirth to be equivalent in safety for low-risk mothers have occured in areas where breech risks you out.
Just because things can happen that we can't foresee or control, doesn't mean that you then ignore the ones you can.
As someone who lost a child to an unforeseen event who was not saved due to incompetence, I can say that "babies just die" is often - of COURSE not always - the cry of those who don't want to take responsibility for their poor judgement, and mothers should be cautious about taking that as the final word.
Is it possible that this baby had some other 1:10,000 event occur while being breech? Sure. But it does raise the question, especially since so many areas of the world risk women out for breech.
It is also really easy to say until it's your baby.
But if this midwife is a real professional, she will be able to address some of the concerns, and the OP also has renewed reason - sometimes it takes something concrete to really engage our minds and intuition - to take stock of her choices and options. There is never anything wrong with asking questions and getting information and revisiting our tolerance for loss.
This is an interesting conversation. I'm not sure what I would do, but I would talk to midwife and if possible look into her history...does she have other baby deaths, what is her transfer rate, etc..
Yes, babies do die anywhere...at home, in hospitals, etc. With birth can come death, and all mothers take that risk once they become pregnant. However, while all baby deaths are tragic, in my mind there is a difference between an unforeseen, unpredictable, unpreventable occurrence causing death, and a death caused by taking a greater risk which COULD have been prevented. Because, if we are being totally honest, this baby's death most likely could have been prevented. If this baby had been born in the hospital via c-section, like 95% of all other breech babies, then likely that mother would be cuddling that baby today. Yes, things can wrong in c-sections. Yes, things can go wrong in hospitals. We don't know that things would have been fine in the hospital, but they likely would have.
For some people, that may have been an acceptable risk to take. For others, it may not have been. I know *for me*, (as a mother, and if I were a birth professional), I would not want to have any death on my shoulders that most likely *could* have been prevented if different choices had been made. Other people would make different decisions.
It's kind of shocking to read some of these responses on a supposedly homebirth board.
For many, breech is considered a version of normal.
I have more to say on this topic, but since it's off topic, I'll refrain.
OP please keep us posted. I'm sure you'll get it all sorted out in time.
:(
, calling it negligence for midwives to attend breech birth makes my heart sad 
Interesting opinion. Why do you say that hands off midwives specifically should be handling breech vaginal births? Is this somehow less dangerous?
And I perceived people to be saying a hospital is a better option because a mama can labor for a while and then easily switch to an emergency C-section if it is necessary, not that they should be forced.
A breech delivery does not fit into the rare unforseen event though. This is an area that has been extensively (by the standards of childbirth) studied. And as a PP pointed out, the studies that demonstrate homebirth to be equivalent in safety for low-risk mothers have occured in areas where breech risks you out.
Just because things can happen that we can't foresee or control, doesn't mean that you then ignore the ones you can.
As someone who lost a child to an unforeseen event who was not saved due to incompetence, I can say that "babies just die" is often - of COURSE not always - the cry of those who don't want to take responsibility for their poor judgement, and mothers should be cautious about taking that as the final word.
Is it possible that this baby had some other 1:10,000 event occur while being breech? Sure. But it does raise the question, especially since so many areas of the world risk women out for breech.
It is also really easy to say until it's your baby.
But if this midwife is a real professional, she will be able to address some of the concerns, and the OP also has renewed reason - sometimes it takes something concrete to really engage our minds and intuition - to take stock of her choices and options. There is never anything wrong with asking questions and getting information and revisiting our tolerance for loss.
I was responding to the poster who said healthy babies/healthy moms only die if the practitioner is incompetent. That is completely untrue. Certainly an incompetent provider is a problem but competent providers lose babies and moms.
In much of the developed world, attitudes on vaginal breech are changing. The results of the term breech trial have never been replicated. In fact evidence shows that for a complete of frank breech, perinatal mortality is equivalent. Both England and Canada are now training providers for vaginal breech deliveries. Many of the providers in the term breech trial were not competent in breech deliveries and that is a concern.
Breech delivery is often an unforeseen event. Either it was missed in prenatal care, some does not have prenatal care and shows up pushing, baby turns, etc. So it is important for providers to have the skills.
I recently attended a very interesting lecture by a Canadian MD who attends breech birth. Basically he discussed the fact that we provider informed coercion to women in maternity care "you must have a c-section for breech" "homebirth is too dangerous" "we do not allow waterbirth" When the woman is not allowed a choice we are not fulfilling our obligation to patient autonomy. Whether I agree with the decision or not the patient has the right to self determination. The cancer patient can opt for no treatment, the diabetic patient can continue to eat sweets, the pregnant woman with the breech can opt for vaginal delivery.
I'm really sorry for your loss, and I don't believe babies "just die." I believe that in many cases a competent provider has the ability to save babies that would die without intervention. I also believe that we will always lose some babies, not matter what we do.
If only that were true. Hemorrhage, uterine atony, cord accidents, amniotic fluid embolism, placenta problems, infection, unexplained fetal deaths, an a long list of other things often strike without risk and without warning and sometimes cannot be controlled.
Thank you for this. I'm shocked at this attitude. Babies only die if the attending was incompetent!? Please! I researched the causes for my daughter's brain injury (which very often results in death) extensively and it appears about 50% of incidences have no known cause and CANNOT be prevented (the other 50% are caused by unnecessary intervention). The cord is just in the wrong place at the wrong time, or the placenta suddenly abrupts, with the mother having no risk factors. Things like that.
I'm wondering what that poster thinks my midwife did wrong, seeing as how my DD didn't even have a single heart decel to give us a head's up that she was in distress. Guess since she isn't psychic, she's negligent.
People with this attitude simply don't want to admit it's something that could happen to them. They think with the right midwife they are *guaranteed* a healthy baby.
I don't know how I feel about breech births. I haven't really researched them. So I don't have anything to add to the OP. Just thought I'd throw in there that not all deaths/injuries are the result of incompetence.
But it's not disrespecting anyone's choice to state the fact that breech vaginal births are riskier than cephalic vaginal births.
Obviously, as previously stated, it will depend on the baby's position, but SOGC supports the option for both frank and footlings. A 2003 statement from them voiced support for midwifery, but I'm not sure of their official position on vaginal breech birth at home...
Everything I have read has suggested that vaginal breech is only recommended with immediate access to a c-section if an emergent situation arises.
Everything I have read has suggested that vaginal breech is only recommended with immediate access to a c-section if an emergent situation arises.
Sounds logical, but then you have that decision-to-incision factor, which multiple studies have indicated can range from 30-60 minutes. (It isn't like what Tinseltown portrays, when doctors get going within three minutes). Proximity to a hospital should be a factor in any birth at home or in a freestanding birthing center.
Sounds logical, but then you have that decision-to-incision factor, which multiple studies have indicated can range from 30-60 minutes. (It isn't like what Tinseltown portrays, when doctors get going within three minutes). Proximity to a hospital should be a factor in any birth at home or in a freestanding birthing center.
In a hospital, an emergency c-section can be performed within 4 minutes. I inquired about this when I was hospitalized for severe preeclampsia and had daily fetal monitoring, and wondered what would happen if it was evident that baby was in distress.
My non-emergent, but fairly urgent, c-sections took longer to start because of OR conflicts, but in an emergency, a baby CAN be delivered within minutes.
I don't think they would do a c-section if a baby were breach and the head got stuck. The baby would already be mostly out. I think they would do an episiotomy-type surgery or maybe use a vacuum or forceps. It wouldn't be a c-section though.
I think in truly dire circumstances, they perform a maneuver (Zanelli?) to push the baby back up the birth canal, and then perform the C.
Alternatively there are some kinds of cuts that that ob can perform that may allow for the head to be released.
Or maybe I am getting mixed up with S-D?
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