Breech birth - would you be up for it?

[linzkg]

doh - just now read properly and it seems the baby is heading south head first - great! ;-)

[alieh]

Actually, now that you say it, linzkg, I think that the Breech Birth book did talk about whether the baby was expected to be over 4 kgs as a factor in whether to consider a natural breech birth. Of course how they decide in advance whether baby is expected to be over 4 kgs is another story, as your experience shows!

Thanks for sharing your story. What a miracle that your son survived, and I hope that both you and he are managing okay.

[GinaG3]

linzkg, your post brought a tear to my eye, what a miracle, good that you had such great midwives on hand for your birth. 10.7 well done you, i was 10.10 when I was born. When I gave birth to my daughter she was 7.01 and I couldn't imagine the pain of delivery any bigger naturally, although a lot of people say its no different.

Breech births are such tricky subjects, I think the big factor is safety of both mother and baby, if it was safe I would go through with it, but its a massive decision. I wouldn't be able to live with myself if I went through with it and it ended in tragedy, I would blame myself everyday. I hope I never have to make the decision! My mother in law birthed a breech baby naturally, the thought gives my shivers but labouring any way still doesn't scare me, only CS...

[claudia_sofia]

Hi,

Because I have a unicorn uterus both my boys were breech, first one was born and Portugal and the second at King's College, in both situations I was advised for a C-Section. For me there was no option, and I was dying for a birth in water, no luck!!!

Definately C-Section is the safest option, but.....

Talk to your midwive, better than anyone she can advise you on your options!

[littleEDfamily]

Thanks so much everyone for your insights into the world of breech birth. We're so lucky around here with the attitude of (most) of the health professionals around natural, intervention free birth, but sometimes there comes a point where I guess it makes sense to hand yourself over to modern medecine - it's just so hard to know where that line is.

[Saila]

Surely the line is when the baby is at more risk and you trust the health professionals to tell you that that line has been crossed. I really think it's that straight forward

[littleEDfamily]

I'm not sure it is that straightforward.

Medical professionals frequently have contradictory opinions as to the relative risks. My midwife, I suspect would be quite supportive of me attempting a natural breech birth provided the baby were in the optimal breech position (and the other criteria had been met), whereas, for me knowing that the position is anything but head down would be a step too far - I would never forgive myself if something went wrong. And thankfully, it seems the professionals around here are mostly supportive of the mother's decision.

And I am sure there are still many doctors who believe the choice to birth at home is completely irresponsible in terms of the risk to babies, and that anything other than a medicalised hospital birth is 'crossing the line'. Whereas, in the absence of any obvious complications, homebirthing would be my preference (based on my assessment of the risks and benefits).

There seem to be very few aspects of pregnancy, birth and childrearing that are black and white, and I am certainly not in favour of completely abdicating responsibility for my health and that of my children to health professionals who are fallible. I am constantly grateful that I am having babies here in England where the attitude is so progressive, but with that comes greater responsibility on the parents' part to choose the right path, and that can be tricky.

[let-them-eat-cake]

Wow.

What an informative thread.....my friend is 32 weeks and her baby is breech too.......she's done loads of research too.

Maybe I should get her to read all this rather than look at all those pregnancy books!

Everyone seems really supportive.....are people medical or just really well informed????

[nunheadmum]

I don't think many of us are medical...probably just the medical profession's nightmare patients who ask loads of questions and read loads on the internet. I was paranoid about it at the time when it affected me. Talking to those who have been through any medical issue is often really helpful I've found - provided you can differentiate what's important for you and what's not.

[linzkg]

Saila - its easy to say that from the outside - of coz no one ever wants to put their unborn baby at risk, or even themselves quite frankly - and yes I can see how its easy to shake your head at us even thinking of it .. but most women want to produce a child naturally etc and that also means going through labour (for some very strange reason!!) and you know its completely 'natural' and there are people living in bushes giving birth every day so why can't we bla bla bla .. so many things go through your mind and all you do is think about your options and no one, even the professionals can give you a black and white answer - my mom and my in laws (the older generation) were horrified at my dilema (and looking back, knowing now what I know I can't belive I even considered it, I'm almost embarrassed to admit I went through that thought .. but everyone's individual and labour is very personal etc - but in keeping with your thread I completely agree and I'd love to say - DONT DO IT :-))) and I'd love to offer to meet everyone for coffee and show them pictures of our son on drips and tubes etc .. anyway I'm harping on but I think hopefully you get what I'm trying to say here - I appreciate what you're saying and it seems so simple.

let-them-eat-cake - experience is everything! My medical professional (the Doc at Kings) told me to go home and he was happy to take me on to 43 weeks!! 'No indication of a big baby .. 10.7 not big?' - a mother's intuition is important too!! Listen to me, I sound like I have it all sorted and my son is only 11 months!

[Saila]

you're right - i am speaking from the outside as i'm not pregnant with a breech birth baby.

The OP asks 'would you be up for it' so i'll expand on what i mean a little more.

My personal opinion is that i dont' view birth as a personal challenge like a marathon or something. I just wanted the baby out as safely as possible. It was my first so i was really scared that there was something wrong with the baby anyway regardless of how he decided to come out.

as for woman give birth in bushes every day etc. I can't help thinking that's a little niave. The evil stepmother in fairy tales stem from mummys dying in childbirth. It was a significant cause of death before modern medicine spotted complications such as placenta previa (sp) which my sister had and wouldn't be around today had it not been for scientific advances.

i think it's one thing to give birth naturally when you know everything's normal. At least you know to the best of your knowledge. But to know there's a 'complication' and i think breech is classified as that then i think it changes things a bit for me anyway. Not only is there the baby to think of but also the mum. Do you want to spend every day regretting something? Like in Mellors post? Even though things go wrong in labour, to have a warning and something to go wrong is a different kettle of fish cos you'd blame yourself. Also the risk of an emergency c-section must be greater with breech birth? maybe not but it'd seem logical. Emergency c-sections aren't fun. Planned c-scetoins are much calmer and nicer for the mother etc. So that's anotehr risk for the mum IMO

So for that reason I wouldn't be up for it. Now PLEASE don't shout me down. I know this post will cause most mums on this website to spit their coffee out over their lap top. But this is the original posts question 'would you be up for it'. And my response is No, i woulnd't because of the above. I wouldn't judge anyone in doing that in the same way i wouldn't judge anyone's decisions in what they do. I just wouldn't do it myself.

i think it's one thing to argue about giving birth naturally when everything's fine but another thing when clearly there's a complication.

edit to say - i'm not shaking my head at you? really i'm not - it actually just makes me feel a little bit sick with worry, even though i don't know any of you... weird reaction but true

[Fuschia]

I think your reaction to these issues depends very much on your experience and trust in the medical profession. If you know someone who has had things go wrong in a natural birth, you will look more favourably on intervention/CS. If you have reasons to be suspicious of hospitals, or problems that arose from unnecessary intervention your perspective will be different.

Twin birth can be quite risky for twin II. I knew a homebirth wasn't really an option (though I had two independent mws with me at kings as "supporters" and the have delivered quite a few twins at home. But being also on blood thinners... my feelings were being IN hospital but minimal intervention unless clearly indicated was a good compromise for us. I was clear I didn;t want continual monitoring or to have to lie down unless there was a problem, this worked well for me... birth was very fast.

One thing really, really stuck in my mind. My MW said that they had been friends to another twin mum giving birth in hospital. (All went well) There were two other wome having twins that night at the same hospital and the births were being very heavily managed (delivery by a doctor, epidural, continual monitoring etc) She said afterards just as a natter of interest she checked the records to see how those borths had gone. In BOTH cases twin II had died.

Now, she was quite a new midwife who let that slip to me, I can tell you it preyed on my mind. But being in hospital and fgollowing all their instructions is no guarantee problems won't arise. Whatever your birth situaion, whatever you choos,e you have to be INFORMED. It's your body, your baby and your birth and especially if it's likely not to be straightforward, you have to be able to discuss the options and make your decisions based on facts.

[Saila]

That's so sad. God, the poor parents.

I wonder if those woman with twins had been offered/opted for a c-section instead of natural birth it would have been ok?

OP asking about whether people would be brave enough to opt for natural over a c-section i think?

[alethea]

I have just had my second child naturally after a c section for an undiagnosed breech last time, in hindsight there is no way i would have been able to cope with a natural delivery, my son was also 9/8 so it would have been tough.

At the time I was offered to discuss the option of natural birth, but after I had made the decision to opt for the c section they said that I had been right to choose that.

Ax

[Sanne Panne]

Very interesting discussion, don't have any insights to add to all this wisdom, just my preference since you wanted to have an idea of what people would do in case of a breech baby...

After one great (head down, anterior, no issues) home birth I'm keen to have #2 at home as well (due in 3-5 weeks) but if she were breech I'd want a c-section. The thought of forceps (etc) and extended baby distress just freaks me out. In spite of the fact that c-sections are far from ideal for various reasons I'd rather have the birth over with quickly (either at home without intervention or in hospital with a c-section) without worrying about heart rates dropping and mums getting 3rd degree tears).

That said, I'm a convenience home birther rather than a "naturalist" - I just hate the thought of getting in the car while in labour and being in a busy messy hospital if there is any way I can just have my baby in the living room followed by a shower in my own bathroom and then lots of cosy cuddling in my own bed... If anything would look even remotely risky before or during labour I'd be off to King's in a second though.

It's a very personal choice, I can't judge what's safest, this is just what would feel right to me.

[sillywoman]

Saila Wrote:

-------------------------------------------------------

>

> as for woman give birth in bushes every day etc. I

> can't help thinking that's a little niave. The

> evil stepmother in fairy tales stem from mummys

> dying in childbirth. It was a significant cause of

> death before modern medicine spotted complications

> such as placenta previa (sp) which my sister had

> and wouldn't be around today had it not been for

> scientific advances.

>

> Actually I think the main cause of maternal mortality pre 1940's was puerpal or 'childbed' fever. Not a complication of childbirth as such - an untreatable (no penicillin) infection of the womb. Not actually to do with the specifics of getting the baby out, rather to do with what happens after.

There's a lot of fear about childbirth, hence the huge medicalisation of the childbirth system over the last 30-40 years. Most of the fear is completely unfounded and the small minority of truly tragic cases are repeated over and over, the stories told and retold increasing women's fear and anxiety. Comments like saila's one above play in to that fear absolutely.

The system we have is great (though not perfect)at spotting most cases of 'at risk' pregnancies and for those cases often C sections can literally be lifesavers. However where the system fails us is that it shows no confidence at all in women's natural ability to give birth whether cephalic or breech presentation. Your body is - on the whole - designed to do this. And generally does it brilliantly if given the right circumstances. The Obstetric model tells us we need to be monitored, and drip fed, to have this drug to make this happen and that drug to make that happen, it erodes womens confidence and makes them fearful of the process thereby increasing the likelihood of needing to have interventions - a self fulfilling prophecy if you like. By listening to scaremongers and allowing ourselves to be led down the medicalised path without question we could easily end up emulating the Brazilian model and find ourselves with an 80-90% CS rate. We are slowly moving that way. Would you really say that 80% of Brazilian womens bodies are incapable of giving birth safely? Do we really think that 30% of British womens bodies are incapable of giving birth safely? The WHO tells us that any CS rate above 10-15% in a developed country is putting womens lives at risk. This is where scaremongering about any birth processes will lead us.

As to whether I'd be up for it or not - personally, like other have said, it would depend on the position of the baby and the availability of an experienced midwife, but given those as a positive I'd say yes. For me the risk factors under those circumstances would be sufficiently low. I'm not a natural risk taker, but living & the very process of creating life is a gamble and there are no absolutes - the line is different for everyone I know, but for me that's where I think it would be.

[Saila]

Just in response to your post SW... I think that there's a lot of scaremongering around c-sections that pressure woman to go down the natural route, when perhaps it's not the best option because we make out that a woman has 'failed' if they have a c-section.

anyway - we're getting off topic here a little

edit to say: or that you're 'brave' or 'up for it' if you don't opt for a c-section

[buggie]

Fuschia - the breach in confidentiality by your midwife is very concerning to me... especially as she specifically looked up the records rather than knowing as she was involved. Also it is a very black and white view - she didn't add whether there had possibly been further problems/issues with the pregnancies that could have caused this (and could be why they'd needed closer monitoring/medical care).

Think it's very unfair to suggest that twin II died in both cases just because they had a more medical route/didn't have their own midwives with them.

[littleEDfamily]

I have to say, I would feel a bit like I had opted out if I went for a c-section instead of an 'optimal' breech birth.

That's the flipside of the 'natural childbirth' movement (of which I am mostly a big fan), you do feel you need to be courageous, and on balance I think that is a good thing as for much of the 20th century the medical profession in general made women lose confidence in their bodies, irrationally fearful of pain (dare I say it, a bit wimpish) and too reliant on doctors' (often wrong) advice. However, I think we are getting to the point though where we need to be careful that women do not, as Saila suggests, feel they have 'failed' for opting for a C-section if there are complications.

Just to add - I was much more gung ho about labour and birth when I wasn't actually pregnant - 5 weeks out from actually having to go through it all again, it does put a different perspective on things somewhat, and you do have to keep telling yourself to be brave (but not always feeling it).

[Saila]

LEF i think you've summed things up really well

the other elephant in the room is another person's opinion... the Dad's

we never discuss their opinion when in reality 3 people go into that delivery room and 3 go out (baby, mum and dad)

not just mum

[The Nappy Lady]

Really interesting thread.

I think that we, as women, and mothers put a huge amount of pressure on ourselves to 'get it all right'. Now exactly what this means for each one of us will vary, but it seems to me that for many of us there is at least an element of feeling natural birth and breast feeding are optimum, and that if we don't go down that route we are somehow failing, or need to defend our decisions. I suspect we are our own worst enemies as the criticism/need to defend ourselves is mostly stemming from what is going on in our own heads (bar the odd difficult mother-in-law).

I had 2 home births, and exclusively breastfed both my girls (still going with no.2 at 19 months - but she WILL be stopping by 2 like it or not!). However, this does not mean I am 'anti' any other route, it so happened my pregnancies were straight forward, and like Sanne Panne I just didn't want to have to get in a car to transfer to hospital during labour - if no medical reason to do so I simply took the approach 'why not stay at home', and lucky me - it worked out...but I had to accept all along that it might not. It goes with the territory.

My gut feeling is that all women should approach birth feeling as confident as possible - so if for you that means being in hospital, or at home, or taking all the pain relief they can offer, or having a planned C-section that is the right choice for you. That is all that matters. I think that should apply to a breech birth too - with of course plenty of medical advise and research, if you feel confident enough to try it and the baby is in the optimum position, and the medical profession see no reason why not then I'd support the decision (though for me I don't think I'd ever have been brave enough, end of story).

We all (god/fate willing) will end up in the same place, with a beautiful baby (or two Fuschia!) to care for and that is what matters most of all. Same with breast feeding, I have HUGE respect for those that try and try but eventually have to turn to bottles and would never, ever criticise them. I will admit to feeling slightly less comfortable with those who simply don't want to even try, BUT it is their body, their baby and their choice. Until the day I can claim to be the perfect parent myself I wont be throwing any stones in my glass house!

Molly

[The Nappy Lady]

Saila,

Very true about Dad's, and of course their approach varies hugely. My hubby basically said "your body, I will support whatever you want to do" bless him, even though the 'bump' was most certainly 'ours' not mine IYKWIM.

I would hate it if my partner was putting a lot of pressure on me to go down a route I didn't want to though. I had a friend who had to really fight her other half to have a home birth. In the end she got her way, and he is not a complete convert. Interestingly, he is in the medical profession and we think the issue was that during his training he of course heard about all the complications that can occur during birth and so they were foremost in his mind. So, a whole different approach again.

Must be such a hard thing to go through as a couple of you have different views on how/where to give birth, especially if things dont go right and you had to then deal with any blame etc. within your relationship.

M

[Saila]

In our situation the dad was like that too i.e. 'your body, your choice'

however if it was a breech baby i think he'd need a great deal of convincing as to why i'd gone against medical advice at the risk of his son or daughter

it'd be great if some dad's commented about whether they'd be up for it too?

[sillywoman]

Yes, good post Molly.

Guilt about Caesarean is whole other thread as you yourself point out Saila. I myself haven't personally come across any scaremongering around having Caesareans, but it's probably out there . I would like to say though that when you say "we make out that a woman has 'failed' if they have a c-section", you may referring to your own experience, but not to mine or any other health care professional I've met. Again, I come back to Eleanor Roseveldt "No one can make you feel inferior without your consent".

Ulitmately there's no right or wrong way to do this 'birth' business. Each woman has to make decisions based on her own individual circumstances and the best advice and research available at the time. For some the right way is elective CS, for others trial of labour with the possibility of an emergency (terrible misnomer) CS, for others an epidural based labour and still others an unmedicated labour. Each woman needs to examine the evidence she has to chose the option that feels right to her. I would only warn against relying too heavily on the viewpoint of someone committed to an Obstetric model of care as your sole method of decision making. Balance the view by reading widely and well to try and get a sense of the bigger picture. Scary stories are not of any use to a woman about to have a baby at all - steer clear of them if you can.

And whilst Dad, if he's around, does have some say in this it is ultimately the decision of the woman herself. After all not everyone experiences the cosy "3 people go into that delivery room and 3 go out (baby, mum and dad)" scenario, and it would be naive to think so.

[Saila]

i agree it is completely the decision of the mum.. don't get me wrong. I just wanted to give them a mention at least. They derserve a consultation especially when it gets complicated

edit: to be more specific, i've not heard scare stories about c-sections themselves but the recovery time is often stated as 'horrendous' when actually it depends completely e..g my sister has had both vaginal and c-section and found the recovery for her natural birth far worse. So i was getting at that really.

The procedure itself is recognised as being the safer option versus natural birth with a known complication such as breech.

Also c-sections have been around for centuries, even as far back as Egyptian times. But my god i'd fight to have a natural birth over a c-sectoin in those days!

Pain relief too has been around for donkeys years - it's not a new phenomenon. Queen Victoria insisted on chloroform (sp) during childbirth. Since the 1970s pain relief has been diluted down a great deal from being completely knocked out to what we now know as the epidural. So although epidural use has gone up in the past 30-40 years pain relief's been around since it was discovered.

For the record - i had a birth in hospital, without an epidural (not by choice as i wanted one)

during the 'pushing stage' he was facing the wrong way and was stressed out and his heart rate was dropping

The midwife and dr, said this baby has to get out ASAP and i asked what was safer, a c-section or natural birth

The doctor said, "at this stage it's safer to get the baby out vaginally".

So we went down that route and I completely trusted what he said and we got him out but with the use of ventouse and episiotomy! and he's healthy and fine - yay! :)