Can we talk about breech babies?

[ann_of_loxley]

My son was breech. Because of this and his large size (10lbs 4.5oz) and him being my first pregnancy - it ended in a section. I was very scared. I pictured him getting stuck and dying. The things I was told about breech births did not help with this imagine in my mind and is what led to the section. However, as many of you on here can guess - its still hard for me to come to terms with that. I did not want a section. I am still not happy about the section. It feels like a loss to me. The loss of something I had a right to. Those who have gone through childbirth and cant understand this tell me I am lucky I have not had to go through contractions and labour, etc... But I dont feel that. I feel like something was taken from me that I had a right to and am dealing with the loss of that. I want to feel a contraction. I want to feel what its like for the urge to push. I want that. I want to become a mother through that I have lost.

I do not want to be told I was wrong or really that I was right in the final decision that was made. That is all past us. Because my son is here now and healthy and fine and we make a great family. But I do want to filter through what is fact and what is fiction regarding breech births. I want to try and get my head around it. If I can make the horrible image of my son getting stuck and dying out of my head that will be a good thing. Even just thinking about what could have been different regarding my sons birth might help as well. And I know subsequent breech births are very rare - but its also a way I can help myself move on when its time for us to TTC. I feel if I know the facts from the fiction I can be more confident and better prepared and positive next time around!

My son was complete breech.

So lets talk breech births. Lets talk fact and lets talk fiction! Will a baby get stuck and really die? Did you deliver breech? How was it? Would you do it again?

[cappuccinosmom]

Wow. Sorry mama.

I totally understand the pressures you were under and the fears you had. My last baby was all over the place even past 40 weeks and i was under huge pressure to induce whenever they found him vertex, and the backup doctor told me that there was a high probability of him getting stuck and dying or being permanently injured, and of me being torn wide open.

Now, my baby did go vertex at the last minute, so the pressure didn't continue into labor. I was planning to just show up pushing if he was breech, but I don't know, I may still have caved at that point.

I believe that there is a slightly higher risk associated with breech birth, but I am quite sure that much of that risk comes from interventions and babies being messed with. One thing I hadn't thought about until I read it after that birth is that nucal hand or hands can cause a breech baby's head to get stuck, *but* it is possible, even likely, that a doctor manhandling the baby trying to "extract" him is what causes the nucal hand in the first place, by stimulating that reflex to fling their hands up. Interesting thought.

[mbelisle2]

I had a vaginal breech birth (a lovely girl!) one week ago. I consider myself very lucky to have had an opportunity to even try, considering even my homebirth midwife said herself that it was beyond her "scope of practice" to help deliver vs. going to the hospital for a c-section.
I don't know many of the facts, only the risks she mentioned when we discovered a little bum coming out instead of a little head: that the cord may get pinched for more than a moment or 2 (it has to come out the same time the head does), the cord needs to be long to extend from the placenta inside to the body outside, the cervix may retract a bit around the head after the body comes out. For me, the cord was very long, the heartbeat was consistently monitored and was strong- especially when I took deeeeeep breaths, my cervix was fairly pliable and didn't retract (this was also my 3rd child), and my midwife knew how to shift the baby's body down and then somersault her to get the head past my pubic bone. The baby needed a little oxygen but was fine, and I was fine. I did have to push harder than with my 2 other births, but if I can do it, I think anyone can.
I think back to times when breech births were consistently delivered vaginally in the hospital, often with a "specialist". My mom delivered me breech 33 years ago, and she said it seemed considered a different birth, not such a risky one. It's just that doctors aren't even trained to help women deliver that way anymore. I feel that if you have an assistant who knows what they're doing, then that can make all the difference. Would I do it again? Absolutely, and that may be in part because this one was so empowering and successful.
Everyone's experience is different, and I think getting beyond fear is a huge step in experiencing peace with birth. "Ina May Gaskin's Guide to Childbirth" might be a good read for you if you haven't come across it already. I like what you said about there being no right or wrong about your experience. You experienced what was perfect for you and you also have every right to grieve what you expected to have happen. I wish you the opportunity to experience labor and vaginal birth, and because you want that so much you may just manifest it for yourself!
HTH!

[hapersmion]

I'm sorry that happened to you. I would have felt the same way about a c-section.

My first child was frank breech, born naturally at the Farm - the story's in my sig. It was the best thing I've ever done, and I would definitely do it again. In fact, it's quite likely that I will. If you look at my and my husband's family history, about one child in three is breech. I don't know why it runs in our families like that, maybe we have big heads (my DS certainly did!) or differently-shaped uteri, but it's nothing that shows up on ultrasound. *shrug* Just to give you some statistics, out of the seven or so breeches in the three generations I have talked to, my husband was the only c-section. He was also the only one with any complications I've heard of, since they cut his bottom. Everyone else is just fine; no one got stuck or died.

I actually remember reading a news story that someone linked several months ago, about a baby who was born unexpectedly, breech, on a fishing boat out at sea. That baby's head did get stuck for a few minutes (and it might have come out on its own if nothing had been done), but one of the fishermen just reached in and scooped it out. I figure if a fisherman who's never seen a birth can get a breech baby unstuck, a trained and experienced midwife should be able to handle it.

Next time I TTC, I want to have a homebirth midwife with breech experience all lined up beforehand. The Farm was wonderful, but I don't want to have to scramble and change providers like last time.

I really believe that vaginal breech (uninterfered-with by uneducated health care providers) is safer than c-section for the baby. There is really no argument that it's safer for the mom and any future children, but doctors often don't seem to consider that. I hope you heal from your previous c-section, and go on to have a triumphant VBAC in the future, breech or not!

[danotoyou2]

I haven't had a breech baby, but the medical practice in this country that touts the dangers of breech delivery is really pissing me off. That's why I wrote this article:

a-breech-of-trust-the-acog-on-vaginal-breech-delivery/

Because what's not really talked about, is that cesareans for babies in a breech position are also more difficult. Of course, they don't tell you that when they have you signing the paperwork to get cut.

Doctors are making a fortune off of cutting for breech. And yet foreign countries (Europe) are able to deliver vaginal births safely. Seems to me that American doctors don't know how to keep their hands to themselves with any birth, and end up screwing things up and causing harm. THEN they blame it on the baby being in a breech position.

Now I'm ranting... <sigh> Just read the article, and you'll see why I'm upset.

[DoomaYula]

I have twins who were both born vaginally, and the second one was a feet-first breech. He was almost twice as big as his brother -- 5lbs 10oz vs 3lbs 11oz. They were born in the hospital -- my water broke with him and his foot slid out, and there was no going back after that. I didn't think much of it at the time (all of a sudden, I heard someone say, "There's a foot! Push! Push!") but I'm SOOOOOOOOOOO glad his foot came out and he was born vaginally. It has given me the confidence that I could birth another breech, although my other three were all vertex.

[fireweed]

I'm finally delurking to tell my ongoing breech story! My baby was discovered breech last week (at 38 weeks) after being vertex for 6 weeks, and my whole birth plan went head over heels, so to speak. I had planned a beautiful waterbirth with a midwife, but because midwives aren't allowed to attend breech births here, she had to transfer my care to an Ob.

So, this past week (after many tears were shed) has been spent trying every possible method to turn the baby, as well as searching out an Ob who would let me go through a trial of labour. No luck on turning the baby- I've finally accepted that she might just want to stay head up. I did manage to find the only Ob in the city who has the experience and willingness to deliver my baby, and seems to have a fairly hands off approach to the delivery- I can labour and push in any position I want, and he does not like to do episiotomies. He did need some convincing because this is my first, that I might not know how to push effectively. But basically, he said that if I deal with the 1st stage well enough and progress steadily, and the baby is not footlong, he will let me push the baby out.

Of course there's a catch, and that is that he's going to be on holidays over the Easter long weekend!! I'm due on the 19th, and he'll be out of town from the 21st to the 26th. So if I go into labour then, a c-section will be unavoidable. I don't know whether to extend my efforts in natural induction(EPO, sex, homeopathic black & blue cohosh etc etc), in the hopes that I will be early, or whether I should stop them all and sit tight with my legs crossed. lol He checked me yesterday, and said no signs of baby for this next week at least.

So, I'm not sure what will happen here. I would be very grateful for a chance to deliver her vaginally, but I'm (slowly)coming to terms with the fact that the situation might not allow for that, and that a c-section would be safer.
I guess this is my first lesson that having children means learning how to relinquish control in certain situations!!

[momtogeorge]

I did not have a breech birth, but was brought into this world frank breech 39 years ago.

When I was pregnant with my son, my midwife and I were talking and she mentioned that one of the cases in which she would have an OB intervene was in the case of a breech presentation. I told her about my mother and said I was not afraid of having a breech birth since she and I both came out of it fine and she had two other children after me ( I was her first). Her response was that because of all the medical interventions performed now, doctors have LOST THE KNOWLEDGE ABOUT THIS TYPE OF BIRTH. It floors me to know that an old man educated in the 1930's knew more about vaginal birth than almost any obstetrician today.

[kltroy]

My son was breech and I could not find anyone who would deliver a breech baby vaginally - especially to a mom who had never vaginally delivered a child before (the whole "unproven pelvis" argument). I ended up with a c-section. This time around (I'm due with #2 in june) if my baby is breech I will be more agressive about finding someone (though I may be out of luck - who would do a breech VBAC?) Yes, bad things *can* happen. Most of the time they don't if the care provider is skilled and the baby is a frank breech. Cord prolapse, which can be life-thretening, is more likely to happen with a footlong breech. With frank, the butt usually will stop that from happening.

[NatureMama3]

here are some informational articles on breech.

http://www.gentlebirth.org/archives/breechrf.html

http://www.gentlebirth.org/archives/breechbr.html

http://www.aims.org.uk/Journal/Vol10...CSvsNormal.htm

from the above article:

Estimates of the perinatal mortality attributable to vaginal delivery of breech presentation have varied, but it is generally accepted to be four times that for cephalic presentation when corrected for abnormalities. However, in a review of over 10,000 breech births in eighty-six hospitals world-wide, Fortney et al (1986)(2) found that the neonatal mortality rate in breech births was about twice the overall neonatal mortality rate.

The sad fact is that babies in the breech position are at higher risk than cephalic babies. Unfortunately widespread use of caesarean delivery for breech babies has not demonstrated an improvement in the outcome statistics.

Caesarean operations do not guarantee delivery of healthy babies, breech or otherwise. Neither are all the 'hazards' of vaginal delivery always avoided. Breech presenting babies are still born bottom first even when delivered operatively.

"It is incorrect to assume . . . that caesarean breech delivery is never traumatic for the fetus. Several retrospective studies have shown that brachial plexus injury, damage to soft tissues, fractures, lacerations, and entrapment of the fetal head behind the uterine incision followed by intracranial hemorrhage occur in caesarean breech deliveries as well."(3)

FWIW, my little one keeps getting himself breech so I am expecting it may be during labor too. I found a midwife with 20 years experience including many breech deliveries. Just as with the "classical c-section VBAC" issues, I'm finding that the statistics on poor breech outcomes are very low, especially when it is done correctly (no pulling baby, not in lithotomy position, no forceps, etc).