Saturday, July 17, 2010

When baby is breech

The best laid plans can often go awry when it comes to having a baby
A month has passed since I welcomed my second child into the world, and I thought it time to write about my breech baby, and the fact that the term “birth plan” is an oxymoron.
Before I had even reached the half way mark of 20 weeks in my pregnancy, I was already planning how my peaceful water birth would go.
My first birth experience was a positive one, but not exactly the ideal scenario I wished for even though it was a drug-free natural delivery, so this time I was putting plans in motion for my idea of the perfect birth.
I swotted up on how to achieve the birth I wanted. I borrowed several books from the library on natural birthing, including water birth, trawled the internet, meditated, and tried to stay positive.
And a week before my daughter was born, I even attended an antenatal course to quiz the midwife about achieving my desired outcome.
What I didn’t count on was that my baby decided she was far more comfortable in a breech position.

From about 29 weeks, it was very obvious that her head was up and her bum was down, but everyone assured me that it was likely she would turn into the head down cephalic position.
I tried hard not to worry about it, but inside I panicked - this is not how it’s supposed to be.
So further plans were set in motion to turn my baby which involved further research and reading, and some rather ridiculous exercises.
For the next nine weeks I did all of the following to convince my little girl to turn around:
  • Doing inversions off the living room couch, as suggested by the website To do an inversion you kneel on the couch, then gently lower your weight down onto your arms on the floor, so that you feel upside-down and your bottom is in the air.
  • Kneeling over a birthing ball.
  • Handstands in the pool.
  • Swimming.
  • Rebozo jiggling (another exercise from Spinning Babies which relaxes the muscles around the uterus).
  • Shined a torch on my belly asking baby to follow the light!
  • Frozen peas on my tummy to shock the baby into moving.
  • Swimming in a really cold creek to shock the baby into moving.
  • Acupuncture.
  • Chiropractic work to loosen ligaments.
  • Moxibustion which involves burning a herbal stick close to particular pressure points on your little toes.
  • And finally, an attempted External Cephalic Version performed by an obstetrician at Cairns Base Hospital. This is a procedure where a doctor attempts to turn the baby by physically pushing the baby on your tummy, therefore making it do a somersault. You and the baby are closely monitored to make sure there is no distress to the foetus.

By 37 weeks, my baby hadn’t moved an inch so it was clear I was going to have to change my birth plan.
Further research, further reading, lots of questions and a few days of disappointment followed.
But then I embraced my new plan to have an elective caesarean.
So why didn’t I choose to birth naturally? There are a number of factors which convinced my husband and I to choose a caesarean birth.
The biggest part of the foetus is usually the head, so if the head fits through the pelvis, the rest of the body will slip out fairly easily.
If the baby is born bottom first, it is possible that the body will fit through the pelvis, but the head could get stuck leading to a very dangerous situation.
Another thing to consider is that when a baby comes out head first, the skull has a chance to mold during labour.
The baby’s skull is able to change shape to fit through the pelvis more easily, but if a baby is born bottom first, the skull does not have the chance to change shape and is more likely to get stuck.
Once a baby is born, the umbilical cord usually stops pulsating and this cuts off oxygen supply from the mother to the baby.
If the baby’s head is still inside the uterus, the baby cannot yet breathe on its own, so it is essential to deliver the baby as quickly as possible.
Life saving attempts to deliver the baby’s head can cause injury to the baby’s neck or head resulting in permanent disability. In extreme cases, the baby can die.
Of course, there are many breech babies that have been born safely and certain factors will make a breech vaginal delivery more successful.
If an ultrasound shows the foetus in the frank breech position, the baby’s head is tucked on its chest and the baby is not too big, then there is less possibility of a trapped head during labour.
Due to so many women choosing to undergo a caesarean for a breech presentation, the number of midwives and obstetricians who are skilled in vaginal delivery has declined. 
Many midwives have never delivered a breech baby, and some have only done so because they did not know the baby was breech until it was too late.
In any case, the desired outcome for every birth is a healthy baby. Just because a mother wants to birth a certain way, if there is a risk to the child, then the mother should rethink her plans.
There are risks associated with both vaginal and caesarean births, so no midwife or obstetrician can guarantee a perfect outcome.
While my original birth plan couldn’t have been further apart from my actual birth experience, I’m thankful that my daughter was born healthy and without any complications.


Harumi said...

Hi, my name is Harumi.
I was working in Japan as a midwife for over 15years.
While Iwas working, I had 2-3 breech baby case without C section. Midwives are only handling nomal birth of course no complication.
Anyway, for breech baby, I usually told to the patient whenever they lay down, sleep on baby's back(usualy patient feel hard)because of gravity, naruraly often baby turn to normal position. however we had to make sure between 32and 36weeks the baby's position was right.
fortunately while I was working, this method was 99% success.

Anonymous said...

Shannon this is from Paul - this is really well written and informative. I hope all is going well

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