Wednesday, February 6, 2008

Bring Breech Birth Back

Giving birth vaginally to a breech baby almost never happens anymore. Especially not in hospitals. Its one of default reasons for a "necessary C-section." And since C-sections are the obstetrics bread and butter, the more the better. As result, its become archaic for OBs to know how to assist in the vaginal birth of a breech baby.

Some midwifes make it their business to know how to assist in breech births. Ina May Gaskin writes in her book about learning how to do it. However, many midwives will not attempt to assist in the process because of increased liability to their practice.

It is true that there is a small degree of increased risk in giving birth vaginally to a breech baby, but it can be done and it can be done safely with proper skill and training. Is it really necessary to cut a woman open if her baby is going out coming into the world a little differently than most? Have we really become a society where no one can be unique anymore?

As my friends will tell you, I am proud that I am unique and different. I strive to be an individual and do things differently as a matter of course. I am a person to dance to a beat of a different drummer. So is it any surprise, that I was a breech baby? Why wouldn't I start my descent into the world being a little different?

And how many OBs inform their patients with breech babies of techniques to turn a baby into proper position? The website provides techniques to move a baby into optimal positioning to birth. Meditation, talking to the baby and even patiently waiting a few days is often enough to turn a baby. There is also a chiropractic technique that uses spinal adjustments to get a baby to move. Most invasively (short of surgery) is a procedure called an external cephalic version where an OB or midwife uses external force to manually move the baby into proper position. This technique does not have a great success rate (65%) and can be painful for the mother, but it is an option to be considered.

And last but not least, there's the possibility of allowing a baby to choose her own way into the world. Amy of Crunchy Domestic Goddess fame shares the story of the surprise footling breech birth of her son. Sarah J. Buckley, author of Gentle Birth, Gentle Mothering, also shares the story of the breech birth of one of her children.

So it can be done! And I'm suggesting it should be done more often. I firmly advocate that women be given the information regarding breech birth without being pressured into a C-section that is also fraught with risks (see my blog What they don't tell you about C-sections). We might find more babies dancing feet first into this world!


Leigh said...

You go, breech baby, you!

I love your vigor and conviction in this post. I hope it inspires others to be cognizant that 1) babies can turn 2) sometimes babies want to be born breech 3) breech births can be safe.

Indeed, sometimes babies choose to be born this way. Both of my girls
did; both of 'em Frank breeches that didn't want to turn even through moxa, webster, positioning, swimming, the whole gamut!

My first was a homebirth transport (surprise Breech) that ultimately ended in C-section. Her birth started a 2 year long journey of healing, hope, and advocacy.

For girl #2, I found out early on she was Breech and decided to trust the method she would choose to be born. I tried gentle persuasion, the above mentioned techniques, and lots of late night conversations with her.

Ultimately, she danced forth from my womb feet (er, bum) first, in the morning light of the desert. In my own home. Into the hands of her daddy. In an extremely non-interventive birth.

Beautiful, glorious, intense.
She was healthy and perfect.
My journey had come full circle. And she was allowed her own special entry.

And after all the hulabaloo, I still feel as if I didn't do anything special; nothing any other birthing woman hasn't done. Just trusted my baby and my body.


FYI: I'm not sure if this link to her birth story will work, but I'll try. It's called "Birth Story: Indigo Sol".

Juniper said...

I have just come across your blog now, and am enjoying reading it.

I had my 3rd baby at home (the other two were at birth centers) in August last year. He ended up being an undiagnosed Frank breech - undiagnosed until I was pushing him out!

I was *so* glad that my care providers (a midwife and a GP who specialises in homebirths) were experienced in vaginal breech birth.

What really concerns me so much now, is that so few care providers/OBs/Midwives have experience in natural vaginal breech births. IMO, this in itself makes vaginal breech births more risky.

I worry that the day will come that *noone* will have knowledge of natural vaginal breech birth. What then?

alyson said...

thanks for your advocacy for vaginal breech births.

i gave birth to my daughter, my first child, at home three months ago--and nobody (not our midwife, not our family doctor, not me) suspected that she was breech until we saw her butt emerging. in fact, we were relieved, because all that meconium had scared us!

our midwife had never delivered a breech baby before, but she radiated so much calm confidence that the room felt charged with excitement, not fear. cole, who weighed 7 lb 6 oz, is an utterly happy baby, and has been a knockout beauty from the start.

it can be done.