Natural breech birth?

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.

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!)

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!

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.

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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.

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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.

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.

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!

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.

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!

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!

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

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... :hug: If I can help in any way give me a hoi! :hug:

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?

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.

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.

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.

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.

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... :hug:

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

I was contemplating a breech birth with DD. She was presenting breech at 36 weeks. I was going to try every thing humanly possible to turn her. I had asked my OB if I could deliver vaginally. He said, if any other Ob or attending was on, then there was no way in hell I would be allowed. If he happened to be on at hte time I went into labour, he would have allowed me (seeming as I had already VB'd a reasonable sized baby, so he had the confidence that my body could do it). He said had I been a first time Mum, there would be no way he would have 'allowed' it. ( Iwas a public patient in a public hospital)
I thought about it for quite a while, and in the end decided that if we couldn't turn DD, that we'd probably lean towards a cs but that I would refuse that before I went into labour in case DD turned.
I was lucky that I didn't have to worry about it as DD turned at 37 weeks.

Good luck! All I can say is reasearch research research!
There's still alot of time left for your little one to turn.

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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.

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I realise this, I was just pointing out that things can and do go wrong (especially with breech birth) and it is best to do full research before making a decision. My friend didn't have the option of doing research and relied solely on her care providers opinion, which we all know is somewhat biased!

All the best Persephone - hopefully you can get your bubby to turn.
In WA, as far as I'm aware, it's virtually impossible to have a VB with a breech presentation if you're a first-time mum as your pelvis is 'untried'. I suspect the real reason is that so few OBs (or middies for that matter) have experience in managing the delivery.

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I realise this, I was just pointing out that things can and do go wrong (especially with breech birth) and it is best to do full research before making a decision. My friend didn't have the option of doing research and relied solely on her care providers opinion, which we all know is somewhat biased!

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I appreciate that, however for the sake of balance on this discussion I wanted to point out that preterm breech birth and full term breech births are two completely different things with regards to risk. This was more so that anyone who didn't have your experience with preterm birth would understand the quandry your friend and her care providers were in. Regardless of how her baby was born there were huge risks. Not a nice place to be at all.:shakehead:

Most hospitals unfortunately will not consider a breech birth and I very much doubt if a birth centre would consider one.
I attended a breech homebirth last year. See thread below.
https://www.bellybelly.com.au/forums...homebirth.html

Hi Persephone,

My son was born by emergency c-section, he was an undiagnosed breech presentation - he was head down my whole pregnancy and flipped in his last week. We didn't know until I arrived at the Birth Centre (in a major public hossy) in well established labour (8cms dilated) and my midwife did a vaginal examination. So it was all fairly rushed.

It would be fair to say that most public and private hospitals in Australia will recommend a c-section for breech presentation. Based on the risks associated with breech vaginal birth and the fact that is has been largely unpractised for so many years that not a lot of practitioners are experienced enough to support a breech birth comfortably.

For us, we had a short time to discuss our options & make a decision and it was fairly clear which way the hospital was trying to point me. And based on the info we had at the time we chose c-section (no less devastating for me, but a choice we own). FWIW based on the info & research I've done I believe that planned vaginal breech birth is safe - the key is confidence of the birthing mother & her support and the experience of your care providers. The type of breech presentation also plays a role. I found Henci Goer's book "THe Thinking Womans Guide to Better Birth" really helpful.

The thing that annoys me the most is that care providers will tell you all the risks about breech birth, but seem to conveniently omit the risks associated with a c-section. Like a lot of things in life, its about balancing the risk and really its your choice.

Its highly likely bubs will turn, I think its only a very small percentage that remain breech, so I'm sending your baby lots of "head down" vibes!

Good luck

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I don't understand why the change in delivery procedures for breech babies.

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I believe it was the international 'Term Breech Trial' in 2000 that really sealed the deal. It reported better outcomes (mortality and major morbidity) for neonates in women randomly assigned to CS than those randomly assigned to VB. Some methodology in the TBT has been widely criticised since (including, from memory, the use of practitioners untrained in VB breech deliveries in some countries, and use of induction in many cases!), owever by the time criticisms came out, clinical practice almost accross the board had changed. Meanwhile, practitioner skills in managing the breech VBs has been lost.

But that doesn't mean it can't be done! There are still a few practitioners around with breech birth skills, and older practitioners are likely to have breech birth experience too. "Hands off the breech" is the golden rule. And hold off pushing until your body is doing it involuntarily to ensure you're fully dialated.

Thank you skeetaboat, that makes a lot of sense. How frustrating that practices have been adopted based on the study without peer review and evulation.

DH was a natural footling breech birth - I'm not sure the midwives even realised until his feet started coming out first! But MIL says he was her fastest labour.

He was her 4th baby, maybe that makes a difference?

You Ladies (and Alan) are such legends. Thank you for all your wisdom, frank and interesting discussion and support. I'm not quite 29 weeks, so not really worried about his position at the moment, but it raised my curiosity and I'm glad I asked the question now.

I'm a bit sad that breech tends to = c-section, but if I do end up with a breech bub at least I'll try and be prepared enough to know what decision to make at the time. And I'll be doing what I can to turn him if that's the case.

Thanks again,
Seph

Hi Seph - just wondering if your baby turned or is still in the breech position? I am almost 35 weeks and had an Ob appt today and my little one is still head up - so just thought I would check in and see if your baby had turned and if yes, did you do anything to assist this? Xx

I had Ds3 at a birth centre. I had no previous birth complications. I had brought up this exact query with my midwife around 34wks because I dont feel breech should neccesarily mean csection.

She told me that birth centres cannot legally birth breech babies BUT that they cant force you into a csection so if I wanted to vaginal birth I should and could at the hospital. She made it clear the OBs would try and talk me out of it and get cranky at having to attend the labour (another legality) but that they would let me do it. It was my plan if he was breech but he wasnt. He was born through Townsville Hospital who are teeny bit more progressive than most hospitals so that may be why I had a choice.

Just reading this with interest as I have a friend due in a few weeks & at this stage her bub is breech.

What exactly are the risks for breech birth? I know cord prolapse has been mentioned...what else? Does anyone have any stats? (even a rough idea would be of interest).

Such an interesting thread. I've been wondering the same thing as this is my last bubba (probably) and I'm sillily thinking something might go wrong (unfounded reasoning). I'm booked into the Angliss FBC and I imagine they wont assist a breech birth (but will still ask them next appt).

My question is - if you're going through a public hosp and have no private insurance but have a breech bub can you ring someone from the list Kelly made up (wow, can't believe how lucky Vic is to have so many obs willing to deliver breech, awesome) and see if they'll assist? Pardon my ignorance!! Will they come at short notice? And what on earth would it cost you?

Hi,

Sorry, I lost the thread. Baby is still breech, although they're saying he's actually still transverse. His head bobs up under my ribs sometimes but at other times he's lying across my belly. If he doesn't shift, my GP says it'll likely be a c-section, which is making me need to re-visit this question of whether I'll be supported to deliver vaginally. Certainly I won't stay at the Birth Centre, but I might look into finding an Ob who will support me - only we're going public, so I don't know if that will affect us. Augh, so many questions!

I'll come back and post when I know more. In the meantime, please send me your "turn upside down" vibes!

transverse has to be a a csec. there is no physical way you can het a child out that way :)
breech is different.
please read this Breech Birth | Homebirth: Midwife Mutiny in South Australia
it will give you lots of information about breech
get on to the spinning babies www now get bub moving while it still can easily. see a chiro/physio accupunturist.. its best to get your body in to alignment so baby will simply go into the rigth position.

Hope your bub turns for you soon, Persephone :)

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My question is - if you're going through a public hosp and have no private insurance but have a breech bub can you ring someone from the list Kelly made up (wow, can't believe how lucky Vic is to have so many obs willing to deliver breech, awesome) and see if they'll assist? Pardon my ignorance!! Will they come at short notice? And what on earth would it cost you?

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Congrats on the pregnancy, Cat! :)
In a public hospital (at least in Sydney - I think it is nationally...) you can choose your own private surgeon, however you have to pay their fee. I would think this would vary greatly between practitioners. My guess is you'd be up for at least a grand for attending a VB or performing a c/s.

Depending on the type of breech position there are a couple of private obs in melb who you might get to support you but you'd have to go private

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transverse has to be a a csec. there is no physical way you can het a child out that way :)
breech is different.
please read this Breech Birth | Homebirth: Midwife Mutiny in South Australia
it will give you lots of information about breech
get on to the spinning babies www now get bub moving while it still can easily. see a chiro/physio accupunturist.. its best to get your body in to alignment so baby will simply go into the rigth position.

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:( Thanks Oorki, I didn't realise transverse was actually worse than breech. This makes me a bit sad...vaginal delivery is what I've been aiming for during the entire pregnancy, so to realise that if he doesn't move very soon, my only option is c-section, is very hard. But I will try and move him over the next fortnight and hope for the best. If nothing else, I'll have to accept those things I cannot change!

I'll keep everyone updated.

ETA: Does anyone know where I can buy Moxa Sticks on a long weekend? I'm seeing the acupuncturist but not until next Thursday - I need those sticks now! According to Spinning Babies, doing moxibustion works best between 34 and 35 weeks - I'm on a deadline here!!!

Just googling moxa sticks and they say they should be readily available at your local Asian stores/supermarkets or acupuncture clinic...if you have any nearby? Apparantly they look like cigars so perhaps hide any spares so DH doesn't smoke any after the birth!!

wow cat not long!!!
so is your bubs breech?? have you thought about homebirth then?

if it was ME and it wasn't a footling breech, I would show up at the hospital in labour about to push the baby out :) Breech births were SO common and it's sad that now you have almost no choice :(