Last minute home breech birth to avoid C-section.
I had been going to the local birthing center for prenatal care. Around month 5 I had an unpleasant experience with the director of the center which fortunately led to getting a great counselor to support me emotionally through the rest of the pregnancy as the father was overseas at school.
A few weeks before the expected delivery (week 36) the midwife examining me remarked Is that the head up there? There was an intern in the room and they quickly devolved into a discussion leading nowhere in particular and nothing else was said, however later I saw on the chart that the experienced midwife had written a symbol for breech with question mark in the chart.
The next week I was told by another midwife that the baby was breech. This midwife was cold and brusque. She handed me a photocopy of some rudimentary advice and sent me off. I wasn't convinced the baby was breech and spent the next week reading the SpinningBabies website and trying to feel for the head and other body parts. I had about convinced myself that the baby was head down, but on my next visit they disabused me of that notion. This time I was told, at 38 weeks, that for liability reasons the center would not be assisting me with the birth as long as the baby remained breech. I would have to go to the hospital and have a C-section.
When I was a girl I spent a lot of time climbing around in the tops of trees. I was the fastest runner in the neighborhood until the boys hit puberty. Currently I enjoy a vigorous ashtanga yoga practice and love to walk, jog and bicycle. I have a lot of confidence in my physical self. Even as a first-time mom in my late thirties, NO WAY did I think I needed a C-section!
At this visit they found a more illustrative handout to guide me and encouraged me to try to turn the baby. So I launched into a regimen that included frozen peas on the belly, music by the pubis, lying head down on a slanted ironing board, a session of hypnotherapy, ligament massage with a chiropractor, handstands at the swimming pool, burning Chinese herbs by my little toe, and lots of massaging the baby around with my hands. I could feel the occipital notch at the back of her head and I would pull and coax it around, hauling on her little bottom at the same time, till her head would pass under my belly button from 10 o'clock over to 3 o'clock and then it always slipped back and away. Over and over again. It was truly frustrating. On the next visit the director talked to me and I told her I didn't want a C-section. My husband was there and she basically intimated to him that he should try to convince me. I asked every permutation of every question I could think of to find a way but the bottom line was the center's insurance didn't cover so-called “high risk” deliveries which they considered included breech. She did offer to go with me to the hospital and have the doctors try to turn the baby, so I agreed to that.
The hospital visit was fruitless. I was doing shoulder stands in the bed waiting for the doctor to get there (this is said to give the baby more room to turn). He and the center director and an intern gave it a couple of good tries and gave up. I asked the doctor to try again and he refused, saying that if the baby wasn't turning there might be a good reason for it, and he didn't want to risk the baby's well-being. He said they could schedule me for a C-section. I asked, would they let me go into labor first and then have the C-section? I had heard that labor was beneficial to mother and baby. He said No. I had a long list of questions and issues I had written up beforehand to discuss. The director told me later that she knew there in the hospital that I wasn't going to agree to a C-section. It must have been nerve-wracking for her! I was not in any great conflict. I just kept trying to find a way that meshed with my own sense of what was right.
So after that, my focus shifted. I started reading online about breech babies and breech birth. I looked up the scientific literature and read about some studies assessing the risks. I became convinced that vaginal breech birth was no riskier than a head down birth as long as the birth assistant was familiar and experienced with breech birth. A full 5% of babies are breech. It is a normal condition, just different from the head down type. So I started looking for a midwife to help me at home.
At first I was having no luck. All the midwives in my state were leery as they were hoping for some favorable legislation in the state house and senate and didn't want to jeopardize their possibilities in case anything went wrong. Especially with my being a first-time mom at first I found little faith, but I had plenty of faith in myself. I knew I would be fine with the right kind of support. I kept looking. I read on the ICAN website about women who had gone through an initial C-section or two and now wanted to try a vaginal birth, called VBAC. Reading their stories I realized even more strongly just how motivated I was to avoid a C-section. I asked for advice and called up any lead I could find. I called The Farm in Tennessee and almost begged for help but that facility was in decline and they politely refused. Finally someone told me about a lady in Boston and when I called her she said she couldn't do it, but she gave me the name of someone else she recommended highly out west. Someone experienced in breech birth. Finally!
When I talked with “Melody” she asked me some questions. How tall was the father? How tall was I? She seemed encouraged to hear that I am slightly taller than my husband. Apparently the father's size compared to the mom has an effect on the ease of delivery. She said she wanted to get back before Easter which was coming up in about 10 days, that we would have to pay her fee and buy her a plane ticket. I told my husband and he said okay. He'd been discouraging me, laboring under the impression the birthing center director had made in him that it was his duty to do so, but now seeing how determined I was he came around. “Melody” wanted an oxygen tank present just in case, could we rustle one up? In the end she hung back but I pressured her. This was our best option yet. Surely she would help us! And she said yes!
It was such a great feeling to have a competent midwife on the way. The next few days we spent pinning down the details in that typical frenzy of activity of getting things ready. To make a long story just a little shorter, the birth went beautifully. I would say more about the midwife and her background but I don't want to present even the slightest risk of getting her into trouble by making the information public, even in a forum like this. I will just say that she was completely knowledgeable and competent. She demonstrated the basics of how to do a breech birth for my husband using a teddy bear, as he would be present and helping.
The next morning after the midwife's arrival I was in the early stages of labor all day, still very active, going to the bank, taking a walk, making bread and soy sausage (my pet project back then). So around 9:30 at night I started feeling a little weird and was hoping my father-in-law, who was chatting with the midwife a bit after kindly dropping off an oxygen tank from his dentistry practice, would go away soon. He did so, shortly thereafter. “Melody” had taken a nap earlier in the afternoon expecting a long night of it. Just before 10 pm I went into the bedroom and suddenly felt the bottom of my belly fall out in one dramatic motion as my water broke and I swooned to my knees, propping myself up with the end of the bed. Wow! We were off and running.
We sat in my kitchen for a while surrounded by the pretty walls that I had painted pink and mauve a year earlier. My contractions were manageable. I was pretty vocal since I knew from my reading that it's supposed to help. I was experimenting and babbling with words and bits of poetry, even “bee bee boddy boddy” from a story from my childhood. The story is about a little bird who is awake when the other animals are asleep and asleep when they are awake, and wakes them all up with her song. There's another nonconformist for you, determined to do things her way! After a while when things got more intense I settled on the mantra “baby”. I didn't bother with music or some of the other things I had planned for the birth, mostly because the labor ended up being so short and there was no need for distraction.
In fact FOCUS was my number one concern. At one point after a particularly intense contraction my midwife, clearly empathizing and ill-at-ease, leaned back and crossed her legs. Immediately I asked her to please uncross her legs! I had heard about cultures where nothing is allowed to be crossed, closed or tied up in the vicinity of a laboring woman for fear of sending the wrong idea and slowing things down. Cabinets, doors, shoe laces…everything has to be open and untied. And I did feel better when she, surprised by my request, nonetheless complied. Another time my husband got up and went to open the refrigerator door right beside me, sending a strong shaft of light right into my field of vision in the semi-dark room! I told him sternly to stop that as well. Being in my own home, after all the preparations, I felt in my element. They were my team and I had to lead them. “Melody” offered to massage my lower back at one point but I didn't need or want it. All I needed to do was focus.
It was not long before “Melody” said, quite startled, Are the contractions really that close together? So she gets me to go void my bladder and we head down the hall to the bedroom. She felt my cervix and said You're dilated to four centimeters. I felt quietly triumphant when I heard that. Things were proceeding at full tilt.
It might have been half an hour. I was sitting up some and then on my back and the contractions were intense. I was singing loudly, operatic style “Baaay beeeee! Baaaay beeee!” 🙂 (My daughter loves to hear about that part!) At one point I started talking to her inside of me and giving her a pep talk for what was coming up. After a while “Melody” told me to stop pushing but I didn't feel as though I were pushing. She thought it was happening too fast and had me lie on my side. With breech birth especially it's important to make sure the mom is completely dilated before the baby starts coming out. I had a few minutes of rest, it seemed like a short time. Finally I was back on my back. I started rocking my hips from side to side but I stopped when “Melody” told me to stop. That was my one dissatisfaction with the entire experience. I think I knew instinctively that I needed to loosen things up a little more, and in fact I ended up with a small tear at the bottom of the perineum, I believe because I listened to her telling me to stop rocking. Even now, five years later, when I'm having sex and the site of the tear affects my sensation a little, I think, If only I hadn't been so polite and stopped rocking my hips!
So the baby came. David said “Margaret, it's a girl! It's Fiona!” They rotated her and let her dangle a little according to plan. Then her head and face were gently rotated forward and under and then she was totally born. “Melody” said later that after the buttocks emerged she next saw a little hand and momentarily worried that we had a deformed baby on our hands, but then came the legs and feet and it was all okay. I think she was just waving “hello!”, ready and eager to meet us. In fact I remembered a lot of scrabbling sensations in the latter part of my pregnancy down around where her bottom was, so I bet she had her hand down there a lot before she was born, trying things out.
It was just after midnight. “Melody” marveled at how healthy she was, pink hands and feet, and gave her a nine and a ten on her apgar scores. She was awake, alert, rolling her big brown baby eyes left and right and “tasting” the air with the broad surface of her little tongue. My sister Katie showed up just moments later. At first she thought we were joking when we told her the baby had just been born, and then she was upset. She had really wanted to be there but it happened so fast and we hadn't called her right away. She got over it though and proceeded to take pictures of the placenta emerging and some other amazing shots.
It turns out Katie had been delayed at the doorway because the neighbor in our duplex, an EMT, had heard all my robust singing and got worried. Instead of coming over, he called the police! So Katie was standing on the front doorstop chatting with the cops, letting them know everything was okay, before coming in! I will always be grateful to her for coming to the rescue that way. Can you imagine having cops in the house???!!!!!! Uh!
It's too bad that I feel a bit like an outlaw for doing something so natural. The birthing center's response and all those scared midwives from my state made me feel I was doing something outside the pale. Yet I have no doubt at all that it was the right decision for us. My daughter stayed awake for FOUR HOURS after birth, bonding and beaming at my entire family and being a darling. The experience was not traumatic to her at all. The only mark she bears of this whole ordeal which I noticed a day or two after her birth is a rather large strawberry mark just above her hairline at the nape of her neck. That was an injury she sustained during all those obsessive massage sessions when I was still hoping to get on the “good side” of the medical establishment by getting her to turn. And every now and then when I'm brushing her hair or something else is pestering her physically, she'll arch her back and rear back strongly, as if bucking those persistent hands once again!
While I'm here I will put in a big shout-out for home birth and for vaginal breech birth. Only a few decades ago breech birth was not “medicalized” the way it is now. Plenty of people were safely born breech vaginally, I have a cousin my age who was and I know plenty of other stories. Unfortunately it's not being taught to the new doctors anymore, which is very shortsighted because even if they manage somehow to pressure all the women like me who know the baby is breech to get a C-section, there are always going to be surprise breech births. With twins often one is breech, and they don't always know ahead of time. It is completely manageable if you know the right techniques.
One other comment to other pregnant women out there who might be approaching a similar choice to mine: if the baby is going to be turned, the sooner you start trying the better. If I had begun in earnest at week 36, when the first signs of a breech baby were noticed, before the amniotic fluid is reduced and the baby grows some more, I would have had a better chance at getting her to turn. On the other hand, as the doctor at the hospital told me, there might be some good reason why the baby is positioned that way. Uteri are shaped in different ways and sometimes the baby is more comfortable head up.
In our case, my belief is that my baby turned head up in order to be closer to my heart and voice, in a show of support and closeness. This is what some cultures believe. In fact, it was just a few minutes after my husband had walked out the door after the winter holidays to return to his overseas studies at around 7 1/2 months that I felt a HUGE flurry of movement inside of me. I actually worried the baby might be having an epileptic seizure and then it all settled down again. In retrospect I think she turned right then, better to keep Mommy company, and she never once turned back. So you see, it all turned out for the best.