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It's Possibly Going to be a Breech Homebirth

post #1 of 61
Thread Starter 

For the past few months we've been focusing on our plan for our upcoming homebirth.  At the last visit, we've discovered that lo is sitting breech.  While I am doing inversions, exercises, relaxation, etc to get this little one to turn, we now have to consider the possibility that we will be birthing breech (and also planning a different hospital transfer plan, should we need it).  I'm looking for different birth stories, things we should consider, and of course support.  Most everything I find in the mainstream is 'breech is scary, awful and you should just schedule your c-section'.  This is our third child, so I have a 'proven pelvis', placenta isn't in a scary position, and my past births have been shorter labors with less than 45 minutes of push time (honestly, once we've hit the point that baby is ready,it's been very quick).  TIA. :)

post #2 of 61

I came across this just a few days ago and found it fascinating.  It CAN be done, especially with prior knowledge and planning! Good luck to you!

http://www.birthingway.com/footling_breech.htm

post #3 of 61
Although I believe the opportunity for a vaginal birth with a frank breech baby should be an option for moms who want it, please know that all breech positions are not equal. The chances for something going terribly wrong with a footling breech are so much higher.

I fully support home birthing and vaginal birth of breech babes when the benefits outweigh the risks, but being careful with breech babes is on my mind right now as just last week a homebirther in my area lost her footling breech baby during delivery.

I'm sorry to share another scary story. Im honestly not trying to fear-monger. I'm just so sad for the family who lost their precious little one. Her religion precluded her from delivering at the hospital. I can't stop thinking about it.
post #4 of 61
My first baby was born breech. He was in a frank position according to all the ultrasounds right until birth. During labor he kicked both his feet down and decided to come out footling! I didn't have time to even worry about it in the moment--it was a very fast, easy, straightforward birth. I remember my midwives saying that fast labors tend to go smoothly. smile.gif

My story is very happy! Now, I am just one person and one story. I was healthy and in great shape, I had done my research and was informed about breech birth, and I was attended by 2 awesome, experienced midwives, one of whom was particularly experienced with breech births. I know I made the right choice having my baby at home. I can't imagine how awful it would have been had I gone to the hospital. But, that's just me. I am NOT saying it's the right choice for everyone.

Sad things happen, babies die. greensad.gif Breech birth, statistically, is more dangerous than vertex birth. But having an experienced midwife, a full term baby, and a mother in good shape reduce the risk. Breech is a variation of normal!

My son's birth story: http://www.mothering.com/community/t/1158462/the-double-footling-breech-home-birth-of-zander-blaze
post #5 of 61

That's a great story, radicaleel, and I'm so glad that turned out so well for you.  I think it's important to realize that your health, your research, and your midwives' experience had little to do with that outcome - they didn't mess it up for you, but they couldn't have helped much if anything had gone wrong.  To me, the photo-essay on the birthingway site is terrifying.  Babies CAN be born feet-first safely at home, but no care provider can guarantee that will happen.  Babies die in hospitals too, but not of head entrapment with a known breech.  

 

listipton, I hope your baby turns.  There are some very encouraging stories on MDC of moms whose babies turn at the last minute.  You have a couple weeks.  He could still flip.  

 

 

post #6 of 61
OP, I really encourage you to do your research, read the studies and decide what you feel is right for you. There is no evidence anywhere that says vaginal breech birth with a full-term baby (provided nobody impedes the process) is more risky than a breech c-section. Both are riskier than vertex birth, so you should definitely try to get baby to turn.

Breech Birth by Benna Waites is a good book. Also Breech Birth Woman Wise by Maggie Banks.

ETA: My midwife mentioned to me in passing that there is new research that indicates women with a certain pelvis shape are more suited to breech birth than others, and it is easy to check-- but I don't know the details. PM me if you would like my midwife's contact info!
post #7 of 61


 

Quote:
Originally Posted by radicaleel View Post

My first baby was born breech. He was in a frank position according to all the ultrasounds right until birth. During labor he kicked both his feet down and decided to come out footling! I didn't have time to even worry about it in the moment--it was a very fast, easy, straightforward birth. I remember my midwives saying that fast labors tend to go smoothly. smile.gif

My story is very happy! Now, I am just one person and one story. I was healthy and in great shape, I had done my research and was informed about breech birth, and I was attended by 2 awesome, experienced midwives, one of whom was particularly experienced with breech births. I know I made the right choice having my baby at home. I can't imagine how awful it would have been had I gone to the hospital. But, that's just me. I am NOT saying it's the right choice for everyone.

Sad things happen, babies die. greensad.gif Breech birth, statistically, is more dangerous than vertex birth. But having an experienced midwife, a full term baby, and a mother in good shape reduce the risk. Breech is a variation of normal!

My son's birth story: http://www.mothering.com/community/t/1158462/the-double-footling-breech-home-birth-of-zander-blaze

Breech is not just a variation of normal. It is a position, esp footling, that puts a baby at elevated risk. Yes, things can go wrong with both hospital and home births, but in the case of a footling breech, the risk is much lower that it will end in death. To say that sad things happen and babies die is not the right answer when a different birthing choice would greatly change the chances of that happening. 

 

OP, I hope that the baby turns and you get to have your homebirth. If not, please understand the risk factors before choosing where/how to birth. 
 

 

 

post #8 of 61
Quote:
Originally Posted by radicaleel View Post

OP, I really encourage you to do your research, read the studies and decide what you feel is right for you. There is no evidence anywhere that says vaginal breech birth with a full-term baby (provided nobody impedes the process) is more risky than a breech c-section. Both are riskier than vertex birth, so you should definitely try to get baby to turn.
Breech Birth by Benna Waites is a good book. Also Breech Birth Woman Wise by Maggie Banks.
ETA: My midwife mentioned to me in passing that there is new research that indicates women with a certain pelvis shape are more suited to breech birth than others, and it is easy to check-- but I don't know the details. PM me if you would like my midwife's contact info!


What about the Term Breech Trial?http://www.ncbi.nlm.nih.gov/pubmed/11052579

post #9 of 61
Warning: Spoiler! (Click to show)
The "term breech trial" by Hannah is a flawed study. I have performed, written and spoken on this topic for 25 years. Just last week I wrote a short history of breech birthing in America. See www.supportdrfischbein.blogspot.com for that essay. Breech is just a variation of normal and careful selection of clients with term breech babies can be delivered safely from below. Trouble is finding willing practitioner and supportive hospital these days in the united states. Home breech birthing is possible but may be difficult to find a willing midwife or obstetrician. To "Listipton",where do you live? Please keep seeking your options and get an opinion on whether you meet the criteria for vaginal trial from a knowledgeable doctor. The informed choice should be yours.
post #10 of 61
Quote:
Originally Posted by stik View Post

That's a great story, radicaleel, and I'm so glad that turned out so well for you.  I think it's important to realize that your health, your research, and your midwives' experience had little to do with that outcome - they didn't mess it up for you, but they couldn't have helped much if anything had gone wrong.  To me, the photo-essay on the birthingway site is terrifying.  Babies CAN be born feet-first safely at home, but no care provider can guarantee that will happen.  Babies die in hospitals too, but not of head entrapment with a known breech.  

 

listipton, I hope your baby turns.  There are some very encouraging stories on MDC of moms whose babies turn at the last minute.  You have a couple weeks.  He could still flip.  

 

 

 

 

Wow, just taking a moment to marvel at this quietly vicious statement. You could have just come out and called her silly, or stupid, or ignorant, you know. You could have just come out and said "the only reason your baby didn't die or have a terrible injury was because of luck....all of the choices you made that you thought were making breech birth safe for your baby at home, were really just stupid and could have killed your baby".

 

As for your comment:


 

Quote:

 

Babies die in hospitals too, but not of head entrapment with a known breech. 

 

Yeah...just like babies born at home die too, but not of drug resist bacterial infections or due to complications from drug reactions or c/s or any number of the other things that happen exclusively at the hospital.

The OP asked for helpful information, positive birth stories and words that do not form the sentiment "breech birth is scary, dangerous and you should just schedule a c/s" - thanks for treating Listipton and Radicaleel like idiots.

 

Oh and FTR, I consider breech birth a variation of normal. My research, personal experience with anecdotal evidence and gut tell me that breech is a normal birthing variation and I wouldn;t blink twice at birthing breech at home. So I guess that makes me an idiot too....just a moment of bad luck away from killing my own baby, huh?? Nice.


 

 

post #11 of 61
[quote name="amma_mama" To say that sad things happen and babies die is not the right answer when a different birthing choice would greatly change the chances of that happening.[/quote]

It wouldn't, necessarily.

I obviously was not implying that it's okay to put yourself or your baby in danger. Sheesh. Quite the opposite.

What I meant when I said that babies sometimes die is this: in order to have good risk assessment skills, you have to first acknowledge that all life involves a degree of risk. You cannot ever get the risk down to zero. There are no guarantees in life.

OP, your job is to gather as much information as possible, take all foreseeable factors into account, and make the best choice available to you.

Ignore the fear mongers, be positive and simply look at the facts. I am not telling you which choice to make, only sharing my awesome experience. There are LOTS of stories like mine!

Breech birth IS a variation of normal. When something happens 3% of the time and almost always ends well (yes, even in the absence of c sections) that's a variation of normal.
post #12 of 61
Quote:
Originally Posted by radicaleel View Post

<snip>
Breech birth IS a variation of normal. When something happens 3% of the time and almost always ends well (yes, even in the absence of c sections) that's a variation of normal.


Thank you.

 

 

post #13 of 61

Listiptin, I wonder why you're not considering letting a doctor or midwife turn your baby by external cephalic version?  I'm a home birth midwife with 12 years experience in home birth and another 10 as a nurse in the hospital.  I do breech births at home, but not footling.  I'm becoming less comfortable planning a breech birth without first trying to turn the baby.  I usually confirm position by 30-32 weeks (many say this is too early).  If it is breech I request the woman start inversion exercises and chiropractic if she's agreeable.  If it hasn't turned by 34-36 weeks, I try to turn it (again, many say this is too early--ECV can cause premature labor).  If all else fails, we discuss our options, one of which is having a home breech birth.  IMO the number one factor in the safety of the birth is the experience of the birth attendant.  On many sites, when there is a question whether a new study that says breech birth is unsafe, I always say, I want to know how experienced the birth attendants were in this study.   Unfortunately, I don't believe this is a consideration in ANY of the breech birth studies I've seen.  

post #14 of 61
Thread Starter 

@Dr. Stu, I am in a rural area in Illinois.  Practices are limited to three home birth midwives (who you do have to track down to find, but aren't necessarily 'underground'), and two hospitals that deliver (one being 15-20 minutes from my door, the other 45). Both of these hospitals work with larger care practices that have 'on call' docs, and a few remaining doctors can deliver, but they are few and none deliver breech. So basically, the chances of having a specific person attending the birth are small unless we go to a specific practice and have an induction on the day that the particular doc is 'on call'. A good friend of mine did deliver a breech child three months ago, but it was under very specific circumstances.  She had to be induced at 39 weeks 4 days, had to have an epi, and had to deliver in the OR.  I have another midwife appointment tomorrow to talk further about whether or not we should attempt a home breech birth.  This little person moves all. the. time.  I think we have at least one foot down, which is frustrating for obvious reasons. I feel like my midwife is more experienced with breech birth than the doctors that are available to me.  I'm aware of the risk involved.  It weighs heavily on me and is why I posted for positive experiences and reassurance. In a perfect world, my midwife could just attend me at the hospital and then if complications arose, we would be in a place that was designed for emergency care situations.  But therein lies the rub in this whole situation.  

post #15 of 61

Just as anecdote, I heard a story about a woman who gave birth last week at home... she was carrying twins. Her midwife did not arrive in time to be present for Twin A who was vertex, but did arrive shortly before the birth of Twin B who was breech.  She was very hands off, and the mother felt extremely empowered by not only delivering twins at home largely by herself, but also being allowed by her midwife to be very self-directive of the birth of Twin B.  I do realize how unusual her story is, and how her risks were higher, and terrible things *do* happen, but there are also positive stories out there as well.  Unfortunately her story did not include any information on how much in advance or if they knew in advance what her specific situation was.  I would be very interested in knowing that as to how it played into the success of her birth.

post #16 of 61
Quote:
Originally Posted by stik View Post

That's a great story, radicaleel, and I'm so glad that turned out so well for you.  I think it's important to realize that your health, your research, and your midwives' experience had little to do with that outcome - they didn't mess it up for you, but they couldn't have helped much if anything had gone wrong.  To me, the photo-essay on the birthingway site is terrifying.  Babies CAN be born feet-first safely at home, but no care provider can guarantee that will happen.  Babies die in hospitals too, but not of head entrapment with a known breech.  

 

listipton, I hope your baby turns.  There are some very encouraging stories on MDC of moms whose babies turn at the last minute.  You have a couple weeks.  He could still flip.  

 

 


 

I do hope that you read the commentary that went along with the photo's.  There were THREE midwives on hand, all of whom were very experienced and skilled in breech delivery.  That was a large deciding factor for the mother - their experience and skill.  The 3rd was 'extra' if an extra pair of hands was needed, but she wasn't so she took pictures.  I think the advance planning and preparation that this mother and her team did in advance of her birth probably had quite a lot to do with her successful outcome.

post #17 of 61

I read the commentary. I noticed how many midwives were present. I don't judge the situation as many of you did. In my opinion, the chances of birth injury with a footling breech and the baby's grayish color and floppy tone in many of those pictures are an argument in favor of cesearian delivery of babies who are footling breech.  

 

Fewer and fewer clinicians have experience with breech birth, which increases the risks associated with them for many women. Breech may be a variation of normal, but normal is not a synonym for fine, safe, or desirable. 

 

I think it would be awesome if the baby turned. 

post #18 of 61
Quote:
Originally Posted by stik View Post

I read the commentary. I noticed how many midwives were present. I don't judge the situation as many of you did. In my opinion, the chances of birth injury with a footling breech and the baby's grayish color and floppy tone in many of those pictures are an argument in favor of cesearian delivery of babies who are footling breech.  

 

Fewer and fewer clinicians have experience with breech birth, which increases the risks associated with them for many women. Breech may be a variation of normal, but normal is not a synonym for fine, safe, or desirable. 

 

I think it would be awesome if the baby turned. 


Really? You're going to bring gray and floppy into this? We should take a poll and ask MDC mamas how many of them gave birth to floppy gray babies.

 

As for this comment:

 

Quote:
Fewer and fewer clinicians have experience with breech birth, which increases the risks associated with them for many women. Breech may be a variation of normal, but normal is not a synonym for fine, safe, or desirable.

 

Two things:

 

1. The first sentence feels like backtracking. That is not at all what you said in your first post. You didn't say "having an experienced clinician is KEY to safety" - you said "...your midwives' experience had little to do with that outcome".

 

2. So, are you a believer in c-sections for posterior babies? What about twins...automatic section? What else can you come up with? I mean, things get murky when you start talking about the "risks" associated with any number of things...ooo, vbacs, I bet you are a believer in automatic sectioning for anyone who has already had one, right? I mean, the risks...anyone who would take that kind of risk is crazy...and better be lucky, right? Since no amount of preparation, choosing an experienced provider or research can make any difference in outcome.

 

 

 

 

 

post #19 of 61

When I looked at my babies right after they were born, I was relieved to see that they weren't grey and floppy.  Maybe color and muscle tone aren't issues that are important to you when looking at a newborn, but to me, they're important indicators that the baby is OK.  Quite a few grey, floppy babies are OK later, but I personally feel like a birth is better and safer if the baby has good O2 sats and muscle tone asap.  

 

I think an experienced practitioner can make a difference when a baby is frank breech (and in a number of other situations), but footling deliveries, to me, seem to be all about luck.  

 

 

 

Quote:

2. So, are you a believer in c-sections for posterior babies? What about twins...automatic section? What else can you come up with? I mean, things get murky when you start talking about the "risks" associated with any number of things...ooo, vbacs, I bet you are a believer in automatic sectioning for anyone who has already had one, right? I mean, the risks...anyone who would take that kind of risk is crazy...and better be lucky, right? Since no amount of preparation, choosing an experienced provider or research can make any difference in outcome.

 

I'm not a betting woman.  I see that you strongly disagree with my concerns about footling breech deliveries.  You're misinterpreting my statements about the value of experienced practitioners.  My views on other situations in which c-section is appropriate are complex and interesting, but a distraction from the OP's question.  

 

I'm a little surprised that no one has mentioned spinningbabies.com yet.  There's a ton of ideas there about how to get babies to turn.

post #20 of 61
Quote:

Originally Posted by stik View Post

 

<snip>
I think an experienced practitioner can make a difference when a baby is frank breech (and in a number of other situations), but footling deliveries, to me, seem to be all about luck.  


<snip>


Exactly. They SEEM. To YOU. <----- This is the exact reason I'm being so persnickety with you. The OP asked for information worth considering, positive birth stories...you know, a departure from the "regular" on the internet, when it comes to a lady expressing a desire to deliver breech at home. Instead, you gave her exactly what she could expect to get if she went anywhere on the internet: your negative feedback, based on a personal feeling that footling breech deliveries are "all about luck".

 

You even went so far as to tell a lady who, in keeping with the original request by the thread starter, shared her positive PERSONAL experience....that while you are happy that she had a positive outcome, it was sheer dumb luck that delivered her child safely and, you know, NOT DEAD, to her and not her own preparation and birthing, her skilled team of midwives and her research on the subject. Basically, you said "had luck blown a different way that day, your MW and preparation couldn't have spared you from tragedy." You attribute her living, healthy child not to the presence of skill and commitment to preparation at her birth....but rather, the absence of bad luck.

 

Sorry, but I'm sick of the number of women who come to the online community of birthers for encouragement and support in preparing for variation from the "norm" only to find harsh fear mongering and shouts of "you're going to kill your baby" that are based on personal feeling and not new information or interesting studies that shed new light on birth issues.

 

If you have compelling new evidence that we're all in the dark about, please, share it. I would LOVE to see it...not even being sarcastic. But the information I've seen thus far, in all the preparation I've done and all the research I've thrown myself into, has only supported my feeling that the prepared, educated mother with skilled and experienced MWs by her side can safely and joyfully welcome a breech baby in the comfort of her own home.

 

There is no risk free birth. It doesn't matter where you go, great position, crappy position...whatever. It's up to all of us to judge risk and go the road that feels best to us. This mother has heard what you've had to say....she's heard it a hundred times. It's all over the internet, in real life, everywhere....she came here and asked for something different, a balance to that wasteland of fear out on the interwebs when it comes to this issue. She has a right to that.

 

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