Vaginal Breech Birth

[jmmsunshine]

My DS was found to be frank breech at 39 weeks we had an unsucsessful version followed by an uncomplicated (by medical standards) C/S.

I'm now 30 weeks with baby #2 and although she was vertex 3 1/2 weeks ago at my last exam, she's breech today. I'm receiving chiropractic care, and have been doing my pelvic rocks, inversions, and laying on my ironing board hoping for baby girl to change positions as I know we still have a little time left. I definitely would like to avoid a repeat C/S.

First, does anyone have any good research resources about the incidence of complications with vaginal breech births? I'm starting to look online, but I'm finding everything to be somewhat overwhelming (might have something to do with my emotional state though...).

I live in SE MI (about 30 min south of Flint) and have been told that no hospitals in SE MI will do a breech vaginal delivery. Does anyone know of any hospitals in SE or Mid MI that might do a vaginal breech delivery? I understand The Birth Place in Taylor, MI will do them, and I've contacted them for some preliminary information, but I'm just trying to uncover all my options.

Lastly, when I'm laying on my ironing board upside down, should I be on my left side, or on my back??

THANKS!!

[fruitful womb]

I really wish I could help you, so I'm giving it a shot. A breech vaginal delivery is very possible. My MW has done a few, that I know of. I'm sure she has done more. I'm not a professional (I am thinking about becoming a MW one day). But I do go to conferences. A few years ago I saw Barbra Harper speak at a convention and I'll never forget the video clip she showed us from the documentary, Water Babies. In it has a baby being born breech underwater. Apparently babies do not take their first breath until they've reached air. And of course, they're getting plenty of oxygen from the attached umbilical cord. I'll be checking in on this thread periodically hoping with you for the answers to your other questions. Good Luck!

[CMcC]

s

I don't have any resources on hand to answer your questions on vaginal breech birth.

However, I also have had 2 breech babies. First I decided not to turn, so he was a "scheduled" cesarean birth. My second was a "successful" ECV, but after laboring a long time, she was also born via cesarean birth. So here is a link to one of my other post where I posted links about different home remedies to try. I think they explain the ironing board position in more detail in one of those links. (Sorry I'm not more detailed, I'm suppose to be getting my son to swim practice.)

30 weeks still gives the baby at least 10 weeks to turn! Don't give up hope! Relax those muscles and I'll be praying that this little one turns on her own.

[Defenestrator]

I have heard that Dr. Zaidan at St. Joe's in Pontiac will do vaginal breech births with established patients (meaning that you couldn't just come to him at 40 weeks and switch care, you would have to do it soon.

I have attended a breech birth with Dr. Kathy Kleinert in Livonia. She does homebirths -- she trained as a midwife before going to medical school and now practices as a general practitioner and midwife. She does not attend births in the hospital.

The best resource I have found for understanding breech births is Breech Birth Woman Wise by Maggie Banks. The information on safety is really dependent on the baby's position, with frank breech being the safest (in many studies as safe as a vertex baby) and footling breech being the most challenging, with complete breech or other varients somewhere in the middle.

Good luck!

[DoomaYula]

I had a vaginal breech birth with Dr. Nugent at Mott in Ann Arbor. However, he was a second twin, so I don't know if that "counts"

The birth was fine, no complications, and I feel a lot of confidence that I could birth a breech vaginally again.

[CawMama]

:

Cross Posted Here

[pamamidwife]

I agree with Defenestrator about the book by Maggie Banks...it is awesome and has TONS of info on breech during pregnancy and birth.

It's still SUPER early for you to worry about position, though. The fact that your baby was vertex just awhile back is a good sign - she's likely to turn again before labor.

[jmmsunshine]

Thanks so much for your encouragement and resources. I'm working through all of them and have even found a couple more non-invasive things to try... swimming, handstands in pools, diving, and "elephant walking" that I'll add to my list.

In the interim, I'm working very hard at being positive and relaxing. Most of all I recognize that being "stressed" will release stress hormones into my body that will affect my baby girl, and I don't want that. I also don't want to spend so much time obsessing about HOW she will come out, that I miss this amazing opportunity to enjoy the sensation of her moving inside me.

Thanks again!!

[Isaac'sMa]

You could try acupressure/acupuncture and/or moxibustion too.

[isaoma]

I don't have time to write much now b/c my dd is a restless sleeper lately. I gave birth to a frank breech baby just last Aug. (vaginally, labor was less than 4 hours total) to my first baby. I was scared at first, but talked to another woman in town who had THREE VBAC breech babes - all without any meds. So, it can be done.

You are lucky that you are in Michigan, there is a famous video called "Normalizing Breech deliveries" done by two very well respected mid-wives from Michigan, Valerie El Halta and Rahima Baldwin Dancy. Check it out here: http://www.midwiferytoday.com/videos/breech.asp

I am not sure where there are in Michigan, but I am sure you can find out. Watching there video and the one from "the Farm", I much rather have given birth with one of them!

30 weeks as you know is still very early though.

Mariann

[isaoma]

oh darn I was going to add, that there was a badly designed research study called "the breech trial" in 2001 that lots of OG/GYNS site as the reason why breech births are not safe. To make a long story short, several research articles have come out since then refuting this article. "The Breech trial revisited" I believe was one of them. THe academy of OB/GYN actually put out a statement in spring 2006 stating that breech births were indeed safe (which was a reveral of some sorts) if they followed certain guidelines (not suprisingly, the guidelines are uber conservative). If you are considering giving vaginally birth, I truely believe that trusting your own instincts/body is most important, and secondly, find a practioner that has experience in assisting with breech births.

[Jane]

I know that you can't un-ring the bell, and I would also be concerned if I'd had a c-section for breech, but 30 weeks is not a time to worry about breech. Do your exercises, but know that your baby will likely turn on her/his own no matter what you do now.

[nimblemama]

I know that breech babies can be tricky and I don't know what I would decide if I was having a breech, but here is some encouragement. I know a lady who gave birth to breech twins at home a few weeks ago. They were big twins, too (8 1/2 lbs and 6 1/2 lbs). The babies and mama all were okay and everything seems to be going well. Now, how often would that happen in a hospital, NEVER??!!!!

[jmmsunshine]

Thanks everyone for your encouraging comments and good information! I think she's turned again (vertex now) and will have that confirmed next week when I go see my midwife. In the interim... pls continue to send me good thoughts!!!

[mwherbs]

here is a recent abstract--

Acta Med Croatica. 2007 Apr;61(2):177-84.

[Dillema about the method of delivery for the fetus in breech presentation]

[Article in ]

Vasilj O, Matijević R, Grgić O.

Klinika za ginekologiju i porodnistvo, Opća bolnica Sveti Duh, Zagreb, Hrvatska.
[e-mail]

The management of preterm and term delivery of fetus in breech presentation is one of the most disputable issues in modern obstetric practice. Several years ago, one of the biggest randomized controlled studies in obstetrics, Term Breech Trial (TBT), tried to set up guidelines and resolve the question of the best method to deliver the fetus at term in breech presentation. The results of this study have shown that the policy of planned cesarean section reduces the risk of short-term adverse perinatal outcome, compared with the policy of planned vaginal birth. Many perinatal centers have accepted the recommendations from this study and different obstetric associations have implemented these results in their guidelines. On the other hand, TBT had some limitations, especially those connected with the impossibility of regular and objective comparison of these two
methods of delivery. In addition, the same group of authors did not find
differences in long-term outcomes between the planned cesarean section and
vaginal delivery. Although the rate of planned cesarean section has increased
following the publication of TBT, selective vaginal breech delivery is still very
successfully used in the centers where doctors have the possibility to obtain
experience in vaginal breech deliveries. The most common method of reduce the noncephalic presentation is external cephalic version at term. It reduces the incidence of noncephalic presentations at labor, thus reducing the number of cesarean sections as well. At this moment, there is not enough evidence to
support cesarean section as the method of choice for delivery of preterm and term breech, having in mind obstetric indications and criteria. The decision whether to deliver vaginally or by cesarean section should be individual for each pregnant woman.

Publication Types:
English Abstract

PMID: 17585474 [PubMed - in process]

[bryonyvaughn]

Originally Posted by isaoma

...You are lucky that you are in Michigan, there is a famous video called "Normalizing Breech deliveries" done by two very well respected mid-wives from Michigan, Valerie El Halta and Rahima Baldwin Dancy. Check it out here: http://www.midwiferytoday.com/videos/breech.asp

I am not sure where there are in Michigan, but I am sure you can find out. Watching there video and the one from "the Farm", I much rather have given birth with one of them!

Rahima went on to California from Michigan and I don't know where she is now.

NARM has weighed in on Valerie's practice. In the 90s Laurie Morgan wrote extensively about UC and googling "Laurie Morgan" + midwife could give you insight into NARM's stance.

~BV