Natural breech birth?

[Persephone1]

I'm just curious - Bub has been giving me some cervical kicks in the past couple of days, and it got me thinking about whether, if he's breech at the time of his birth, I'll be supported for a breech delivery.

I'm booked into a Birth Centre. Obviously if he is breech there's some things I can do to try and budge him (acupuncture, etc), but does anyone have information or advice about how hospitals manage breech births? Will they let me stay in the BC? Will I be "allowed" to attempt a vaginal birth? The only person I know who had a breech bub had a planned c-section, for the sole reason that her baby was breech.

What are the risks of breech birth - to me and to him? How are they different from a cephalic birth, other than the obvious - legs come first?

Any info would be appreciated. TIA.

[Amity]

There are a number of different "types" of breech birth - depends mostly on the position of the baby.

Footling breech, where the feet/a foot comes first, are the most dangerous from recollection (someone will no doubt correct me if I'm wrong).

Bum first breech can be delivered vaginally, but it's rare to be "allowed" to do so.

One of our Melbourne members, MeredithD, had a vaginal breech birth with her DS1 a few years ago, but I'm not sure if she would be "allowed" to do so now.

Good luck with your research. Check out spinning babies for some tips.

(And thanks you know what I mean!)

[YoYo]

I know my Mum had my sister breech bum first, but that was 27 years ago!!

Your bubs still has time to move, but maybe try googling that spinning babies website, or some pregnancy yoga websites.

I've never been to a birth centre, but my guts says they would probably send you to the hospital if you wanted to attempt a vaginal breech birth....to cover their bottoms!

[~ Zarava Flutterby ~]

I think it def depends on the hospital and the Dr's BUT after i had DD1 i was told that had they of known she was breach there was NO WAY they would have allowed me to deliver naturally.

With DD1 we did not know she was breech, according to the MW's she was head down and basically engaged but she had other ideas, she must have turned and i had myself a footling breech baby at home alone on the bathroom floor.

As i said the Dr told me had i been in hospital (the mercy) i would have had no choice but to have a c/s, they were in SHOCK that DD and I were both safe and sound without assistance as BOTH of her feet came out before anything else.

I would strongly advise at your next MW appt discuss ALL possible options with them, whether or not they will allow you to attempt a vaginal birth shoudl your baby not budge, if not how far they will allow you to go etc etc.

Here is a link to Ava's birth story, not much help as it's not about being in hospital but erst assured it can be done and you can both come out of it fine, you just need to be aware there ARE lots of risks involved and i think it's best to know what your getting yourself in for.
https://www.bellybelly.com.au/forums...ome-birth.html

GL but i hope that bubs turns for you so you don't even have to think about it.

[~ Zarava Flutterby ~]

DS was a frank breech presentation - the safest to deliver vaginally. Our hospital unfortnately has a strict no diagnosed vaginal breech birth policy. I was diagnosed the day of induction (no it didnt go ahead, instead I was booked in for a c/s for the next day ) You can however deliver there if you go in, undiagnosed, in labour. Thats the only way they will let you here. So hospital/BC policy will dictate a lot usually.

My hospital had advised me even if a foot was out when i arrived in hosp they stil would have continued with a c/s no choice.... wouldn't it be great if these things were uniform and we all knew where we stood.. it's such an important thing and yet there is so much variance.

[Traveller]

If you arrive at hospital and there is a bum protruding out of your vagina no doctor on this earth can force you to have a caesarean section, regardless of their policy. They may advise you strongly to have one, but if you decline then they will be faced with the options of either supporting you, or turning you away to deliver in the hospital carpark. Can you bet which one they will choose?

There are 2 options for having a breech baby vaginally. Breech delivery (often involving routine forceps) or breech birth, which is a hands off event. I would advise anyone with an interest in the topic to google Jane Evans and Mary Cronk's "A Day At The Breech" which is a UK wide training programme teaching midwives how to safely catch breech babies, and when it is not safe to do so.

[Persephone1]

Oooh, thanks ladies. I figure the Birth Centre Antenatal Classes will give me an idea of what the BC policy is, and I have a Doula who will no doubt help me decide what to do if he does go breech. So far the only response I was given from an Ob early in my pregnancy was that breech = c-section, so I need to check what the BC will actually do with that.

Thanks again!

[CharlieBrownGirl]

I don't understand why the change in delivery procedures for breech babies. I was bum first almost 28 years ago. Mum had every intern in the room observing the delivery.
I say there is nothing wrong with me, tho some debate that
Seriously, I was in a harness for a few months for my hips (I'm not sure if that is related to my birth or for another reason) and I managed to reach developmental mildstones i.e crawling and walking in the first 10 months of my life.
Given my limited knowledge medically regarding c/s for breech births I would for now be requesting a natural birth - if my Mum can do it, so can I.

[Arimeh]

I don't know much about breech delivery, but my independent midwife said that if DD2 had remained breech, she would have had to get me to go to the hospital for a c-section because they don't deal with breech births even at the independent birth centre.

Luckily for me she turned at around 35/36 weeks. Still heaps of time for your bubba to turn, I spent a lot of time crawling on all fours and basically doing handstands in the shower every night!

[e_p]

Lisa Barrett is an IM in Adelaide who has written some really interesting blogs about breech birth...and has a video or two as well I think...if you google her name, her blog 'Midwife Mutiny' is the first thing that comes up All the best!

[Inanna]

I've never been to a birth centre, but my guts says they would probably send you to the hospital if you wanted to attempt a vaginal breech birth....to cover their bottoms!
__

Sorry I couldn't let this go without having a "to cover their bottoms"!!! Bottom first = Breech... Get it!!!

There is evidence to suggest that those with unstable pelvis's, spinal issues, back problems have a higher incidence of breech and posterior presentation. So if you are a SPD sufferer (the incidence is rising at a frightening rate!) you are more likely to have a breech presentation. I have all the above & had severe SPD - my babies often presented breech and also posteriorly. I was treated regularly by an osteo during my pregnancies and frequent treatment with that and acupuncture seemed to assist me personally.

Osteopathy & chiropractic practitioners believe that re aligning the pelvis will turn a large proportion of babies. So that is always worth a shot if you are open to those philosophies.

The reason that breech is so shunned I believe is because it is so unpracticed. The optimal way for breech birth to be managed is in a squatting position. The way it's managed in hospital is in the lithotomy position. One of the biggest risk with breech birth is a prolapsed cord. The foot can sweep the cord out. This is rare. It is also well managed with a practitioner that is well versed in breech presentation.

Interestingly breech births are often precipitous - maybe it's natures way...

I will be shocked to hear of any birthing centre in Australia who would manage a breech birth. I know of Women who have travelled from Brisbane to Newcastle to seek a breech vaginal birth with a particular obstetrician who specialises in this.

I hope your baby decides head down is the way he/she wants to be born. But if not please seek out lots of independent advice/opinions.

Remember this is your birth. Your choice. There are practitioners who will assist you to deliver your baby vaginally if it's breech - and I actually suggest to women that it's a good question to ask of a care provider. This may be a deal breaker weather you employ that particular care provider or not. As someone else said MeredithD achieved her birth her way vaginally delivered her breech son with an obs in Melbourne.

Big hugs as you navigate this... If I can help in any way give me a hoi!

[allycat06]

I would think for a breech the birth centre would almost certainly send you off to the main hospital as it would make you 'high risk' (their words not mine). From what I know about BC's they only take very low risk cases and will transfer you over to the hospital for the most minor hiccup. Wouldn't hurt to ask them where they stand though and if you were to get transferred there's no reason why you couldn't try to birth naturally. Just do your research and get yourself a doula, perhaps one who has experience with breech births?

[Visitor6]

With our little man breech and a low AFI the Cx section was inevitable.

My inane questioning of the team about progression of breech management led to the explanation was that the "standard" for unmovable breech presentations was now a Cx section in this public hospital.

Might be **se covering, might be risk mitigation; however I got the impression that the OBs weren't prepared to "hope" to get it right and still potentially cause unnecessary foetal distress when they had an alternative and possibly controllable delivery.

[Inanna]

Nowadays most breech vaginal birth occurs by "accident". So, there is little experience with the management.

I think it is fairly uniform that breech births are surgically managed. Usually by a c/section date prior to onset of labour.

However, depending on the setting & the careprovider. I know obs who are familiar with breech & who will oversee a vaginal breech. There are still quite strict boundaries. Personally I have no problem with a bung so that venous access is available if necessary. However, I would not support the decision to birth in stirrups. As this goes contrary to what is needed for an optimal outcome. UNLESS there was a cord prolapse when then of course the legs & buttocks are raised and head is below the pelvis.

[Early Kids]

I just wanted to add a little something...

I think you should do a lot of research into it and make the best decision for YOU and YOUR baby.

Now I've said that I will tell you a short, quick story on a good friend of mine. Her bub was born breech at 24 weeks, he now has a disability due to the serious inhury he received after being born breech. She was given the option of a CS but chose the VB because he wasn't expected to survive anyway. So please be very careful and know that either way there are risks involved, you need to choose the one that has the least risk in your eyes.

All the best.

[Traveller]

Thank you for sharing your story Sally, how sad for your friends but equally how wonderful their child survived against the odds. However it may interest you to know that those care providers who support breech birth usually do not usually support it in preterm infants, as their head is so much bigger than their bum, making the risk of injury or death much much higher. A preterm baby who was expected to survive would usually (even with pro breech obstetrician) be delivered by caesarean.

In this case the VB was probably supported to maximise your friends chance of using her uterus again, which is a common practice when a baby dies in utero or is not expected to survive long term. A caesarean at 24 weeks is more complicated that a full term one, as the uterus is so much smaller, and makes a future pregnancy much riskier.

[Inanna]

I second what Traveller has said. Breech birth is contraindicated in severely premature babies. If your friends baby was not thought to survive I am surmising that a decision was made that weighed the risk. The liklihood of survival of the baby against the liklihood of damage to the uterus. In this case it would seem it was thought much more likely that the baby would not live.

Your friend must have been so incredibly relieved that her baby is alive & very upset at the injuries. I am so sorry Sally...

[Visitor8]

sadly most hospitals wont allow it. Best to check with them at your next visit