Baby Ava arrives bottom-first! (Long!)

Wow. What a different pregnancy I has with little Ava. After being well and chipper throughout with Millie (DD1), apart from reflux and a bit of fluid retention towards the end, the hits just seemed to keep on coming this time. Bam. Leg cramps. Bam. Varicose veins. Bam. Back pain. Bam. Gestational diabetes. Bam. Breech presentation.

The GD was hard, being a chocoholic at the best of times and craving biscuits and honey toast throughout the pregnancy, but my obs kept telling me that you can’t make a baby smaller than it should be, but you can make it bigger – the difference being sugar in the diet. Having had such a great, quick, natural birth with DD1, I decided to toe the dietary line and was very careful about what I ate.

I’m a big believer in things happening for a reason, and figured the reason for me having GD would present itself in time. At the 28 week appointment, when I found out about the GD, my obs noted a breech presentation, but was unconcerned at that point. Being distracted by the prospect of NO MORE SUGAR, nor was I. 31 weeks. Still breech. Okay. 34 weeks. Still breech. Hm.

“Does the baby move around? Change position, I mean.”

“No. I mean he or she moves a lot, but the head is always around here.” Slightly up and to the left of my navel.

“Well, we can try turning the baby around 37 weeks. My concern is that you went early with Millie and had a precipitous labour, so we might need to start looking at options.”

My mouth went dry. What? After my amazing birth of DD1, we’re talking options? My big sister, Mum’s first child, was a natural flex breech birth (both feet first) back in 1975, so I had not even considered that there would need to be any talk of options or intervention. My obs must have seen the look of dismay on my face as I processed this turn of events. I imagine I had a similar look when he told me about the GD, but he was much more sympathetic this time. Rather than laughing and telling me that I really would cope without a packet of Snack Right biscuits a day, he said that he knew and respected my wish for a natural delivery, and that we’d see what we could do. He did dismiss my suggestions of acupuncture, yoga and chiro to turn the baby as old wives’ tales, but he talked me through the checks and balances he’d want to perform for me to have a natural birth.

Despite my obs’ cynicism about CAM, having had acupuncture before, I sought out a therapist. Oh yes, I can turn babies, no problem. A chiro was similarly confident. “Just a few adjustments will loosen up the pelvis enough for this baby to turn!” I also spent time kneeling on the couch with my head near the floor, thinking my eyes would explode, crawling around cleaning up DD1’s toys etc… Pud would occasionally perform the chicken dance in utero, but stubbornly remained in her happy place.

37 weeks rolled around. Still breech. Obs suggested going for an ECV (external cephalic version). We arranged to meet him at the hospital the next day. The nurse monitored little Pud for awhile and administered a muscle relaxant. Obs sailed in, checked that Pud was still breech (natch!) then started the procedure. Yes, it was uncomfortable. Yes, Pud turned. And flipped back. Thrice. The look on my obs’ face was priceless! But as we had discussed, he wrote me a referral for a pelvic CT scan and a growth and wellbeing scan for Pud. As the midwife gave me the all clear to go after a bit more monitoring, she said, “Good on you for wanting to try a breech birth. But don’t come in on my shift.”

“Why not?”

“Breech births are scary!” I started praying, both that Pud would turn, and that she was the only midwife on the planet who felt that way.

The CT report read: “Breech presentation is noted. Pelvic measurements appear generous.” Ha! The growth and wellbeing ultrasound confirmed that Pud was in the most favourable breech position – frank – with butt first, placenta right at the top of the uterus, and all limbs tucked up very comfortably. Measurements also indicated that Pud was simply tiny – 15th centile, measuring more like 34-35 weeks than 37. DD1 was small at birth (3.050kg at 37+6), so I wasn’t overly concerned. I figured that this was the reason for the GD – had I not been watching my sugar intake, Pud may have been a lot larger.

I rocked up to my obs on 15 August, feeling pretty confident of being able to have a vaginal birth. Sure enough, he was happy for me to try, but recommended an induction so he could guarantee that he would be present at the birth. Given the attitude of the midwife at the ECV, I was happy enough to agree. So we booked in for Tuesday, 21 August (38+4), and I walked out with the strangest feeling – I had just chosen my baby’s birthday!

The weekend was a flurry of organization. Thankfully my Mum had been staying with us, so we had been cooking, stocking up the fridge and freezer, and she would be able to stay with DH and DD1, taking DD1 to daycare and bringing her to the hospital on Pud’s birthday.

Monday night was exhausting. Apart from DH and I being excited/nervous, DD1 had a tummy ache and was up for much of the night. Poor little muffin. We were up early and at the hospital by 6.50am.

“Oooh, you’re the breech birth!” exclaimed Marian. I was so chuffed that she would be attending the birth – she attended the birth of my niece in 2009, and saw me a few times during my first pregnancy.

She explained what would happen with the induction – internal, AROM, drip – and that she would try to attach a trace to Pud’s butt so I could labour upright. I was 1cm dilated, but the cervix was still high and posterior, so her attempt at AROM was unsuccessful. She hooked up the drip, and to be honest, I was expecting things to kick off instantly – that is how my spontaneous labour started with DD1. So I spent an hour grumbling about how slowly it was going, and being irritated by punctuation errors on Sunrise’s scrolling marquee.

Marian checked again and I was about 2cm. She tried unsuccessfully to attach the trace again, but the attempt broke my waters. She dialed up the drip and before long (around 8.30) I was having low, niggly cramps. As Pud’s heartbeat was as steady as a drum track, she took the monitors off and helped me up. I headed to the loo, then stood and swayed as the contractions started to lengthen and intensify. DH got out the oil blend I had made up for my previous labour but never got to use, and started massaging my lower back. Bliss!

Time started to warp and I needed music. For some reason I chose Elton John! I have a clear memory of putting my head back up after whatever weird contortion had got me through a contraction, singing “b-b-b-Benny and the Jets!” and hearing DH and Marian crack up behind me.

Dr Bell came in to check on me – I was 3cm and he was able to attach the trace to Pud’s butt. Yes!! I was off the bed for the duration :) I used the gas this time. I found it a bit counter-intuitive, as usually for relaxation I’s breathe in through the nose and out through the mouth, but DH kept reminding me to breathe in through my mouth, which was great. He also gave me sips of water after each contraction as my mouth was dry from the gas, and massaged my lower back throughout. What a man. He also jumped to it when I asked him to skip to the next song – I think it was “I’m still standing” – the tempo was all wrong! “That’s why they call it the blues” was perfect, and I seem to recall using my gas pipe as a microphone to warble the chorus – again, to the amusement of DH and Marian.

Time was very strange – the contractions were coming thick and fast and I couldn’t comprehend that it was the same 3-4 minute pop song, so I asked DH to switch to my relaxation playlist. It had got me through DD1’s birth and was mostly comprised of Bach – my absolute favourite classical composer. Contractions were still insane, but it made more sense to have so many in the space of a sonata rather than a pop song.

I got DH to call Marian – I managed to tell her that I thought I was close but could she please check – if I wasn’t close then I’d have to consider an epidural. She coaxed me onto the bed and I think I must have hit full dilation as she did the internal, because she went from, “Oh yes, you’re nearly there …” to “… actually, stay there, I’m going to call Dr Bell.”

I could hear her on the phone trying to locate him. I moaned, “If he’s off having a coffee I’ll kill him!” I knew I needed to hold off on pushing til he got there, and kept sucking back the gas. Poor DH, I was pulling so hard on his hands by this point he was very sore the next day. He kept reassuring me, and Marian suggested I try and rest before pushing – ha ha … I had the strongest urge to push and groaned, “Dr Bell, get in here!” Marian said, “Your wish has been granted!” He had arrived.

“Hm, do you feel like pushing Lisa?”
“YES!”

“Let’s go then.”

I have no idea how many pushes or how long it took – DH said it was very quick. I had the mirror again as it had helped me focus so well during DD1’s birth. My eyes were shut most of the time as it was very intense, but I kept looking every now and then – what a weird sight! Rather than a little head emerging, a teeny tiny bottom (complete with a little bit of meconium showing that the bowels were in working order) was coming out! I was surprised that we couldn’t tell the gender instantly – Pud’s genitalia were so distended that it could have been either. Enough of that, back to the business of pushing!

Bottom out. One leg. Another leg. A tiny body. One arm, the other arm. A pause now. The strangest sight in the mirror – Pud’s body out, facing down, feet on the bed, arms braced against my thighs like a rugby scrum. Then one tiny push and my baby was born! Straight onto my chest with a gentle cry, rubbed down, cord clamped and confirmed to be: “A girl!” “Hello, Ava Elizabeth!” It was 11.38am - just over 3 hours of active labour.

She looks like me. She weighed 2.824kg at birth, with a head circ of 34cm. A couple of days later, when my stapler baby finally unfolded, she was measured at 46.5cm long. She pretty much threw herself at my right breast and stayed there for almost an hour. She’s still feeding well and chubbing up beautifully. We’re so blessed.

I’m thrilled that breastfeeding is going so well this time. I missed a lot of joy in DD1’s first days as I was so fatigued from the feeding/expressing/comping merry-go-round I was on. As DD2 was so tiny and my milk was slow coming in again, she did lose 10% of her weight and was becoming jaundiced. The paed requested that we comp with formula, and in the interests of not having another night in hospital, I offered her 30ml. She took 20 ml of that and possetted the 10ml I managed to get into her after the next feed, and has had nothing but breastmilk ever since. I am really pleased and proud! And so grateful to everyone who has supported me in my bf journey this time around.

I’m also really grateful to my obs who supported me in having a natural delivery. I have had so many people tell me that their obs told them they had to have a c-section, without offering to check to see if it was at all possible to attempt a natural birth. I have found myself becoming a huge advocate of birth choice and have joined Maternity Coalition to try and boost awareness and informed choice for women. The birth of both of my girls has changed me so much – my life is soooo rich.

Congratulations, what a lovely birth xx

Congratulations on such a great birth and a beautiful birth story!

Congratulations! Sounds like you had a wonderful midwife.

Congratulations on your brilliant breech birth.

Congratulations, great birth story!

Congratulations on your natural breech birth :) Sounds like a. Awesome OB you've got there!

congrats!!! what a fantastic entrance to the world!!

What an awesome birth story! So cool to read and have breech birth stories available for people to read and get encouragement from!

What an amazing job you did :dance:

So beautiful, well done you!!!

Well done!!! Good on you for sticking to your guns. And how exciting about joining the coalition!

Congratulations! Thanks for sharing your excellent natural breech birth story :D

A.ma.zing.

Such a cool story :D

Great birth story, loved reading it

Wow what a great story :) congrats!

What a wonderful story! You did such an awesome job. Thanks for sharing!

Loved reading this story, thanks for sharing!