Because most philosophies that frown on reproduction don't survive.

Monday, August 18, 2008

A Frank Breech of Trust

So we're at 36 weeks now. Everything is in readiness for the home birth. I've got my kit, I've packed all the supplies I need where the midwives can find them easily, I've cleaned my room and the bathroom. We're all set except for one thing: baby has flipped breech.

The problem with this is that these days, not so many people want to deliver a breech baby vaginally. My midwife, with almost thirty years' experience, has only assisted at three or four breech births. Doctors are reluctant to allow vaginal breech births because of the slight risk of the cord getting pinched and cutting off oxygen to the baby -- and I'll grant that, if it happens to your baby, the statistics on the low incidence of occurrence mean nothing. So we're looking at opposite ends of the medical intervention spectrum -- if baby flips head-down, we can have a home birth; if he stays breech, we have to go to the hospital and have a c-section. Needless to say, I'm rooting for the former.


It turns out there are various methods for encouraging a baby to rotate, one of which is for the mother to lay pretty much upside down. This is about as uncomfortable as it looks (though less uncomfortable than a c-section, I keep telling myself). The awkward part is not in maintaining the position for twenty minutes at a time, but in getting into it in the first place. Baby does respond, especially when I put a bag of ice on his head to encourage him to wriggle away up toward the pelvis. (Image from SpinningBabies.com)

Other low-intervention methods include massage, chiropractic adjustment (though my friends tell me that no chiropractor will see you without an x-ray, which seems counterproductive in this case), acupuncture, and swimming. I have a massage scheduled for this weekend, and I'm going to need it after laying on my neck and shoulders for twenty minutes at a stretch. I also have an appointment with a doctor to discuss external version, should the at-home fixes fail. This involves the doctor rotating the baby from the outside, sounds to be quite painful ("Like ligaments tearing," the midwife suggested), and needs to be done after 37 weeks in a hospital with ultrasound monitoring in case baby gets tangled up in his cord and needs an immediate c-section. I'm praying we don't have to take it that far.

UPDATE 1/27/10: This post seems to get a lot of traffic from people searching for information about breech babies, so I'll let you know how it turned out: Acupunture and massage, though relaxing, did nothing for me. Nor did hanging upside down or floating in water. In the end I went in at 37 weeks for a version. It was successful and amazingly fast -- I'm still talking about it a year and a half later. Since this was my fourth, my muscles were sufficiently relaxed for the OB to get a good grip.

The version wasn't painless, but I didn't find it agonizing. He had to grab pretty deep to get under baby, and I had to consciously breathe and keep my muscles relaxed. But it went by quickly, and at the end I had a head-down baby!

Jack was born at home on 9/11/08.

18 comments:

hallie said...

Yikes! We'll be praying! And , hey, if you need to hang upside down at your baby shower this weekend, that is a-ok. ;)

Melanie B said...

My sister-in-law had a version. She said it wasn't fun; but, yeah, better than a c-section. I, of course, had to have a c-section because they didn't discover Bella was breech until after my water had broken and I'd been in labor for 8 hours. So at least you've got advance warning.

Saying lots of prayers that your little one will decide to turn on his own.

Barb said...

I'm saying a prayer that your little guy decides to turn on his own. I've known several people who have had that happen.

entropy said...

Praying things turn around for you!

Kiwi Nomad 2008 said...

The other reason the medics don't like breech births is that the bones in the head don't come together so gradually in labour. Then sudden big contractions onto the head can cause damage to the brain. I only know this as it happened to a friend's baby.

Here's hoping you do manage to get a natural flip before baby decides to arrive!!

AnotherCoward said...

I'm fairly certain that a good combination of prayer and swimming turned our baby around when my wife was pregnant last. A good long stroke like a breast stroke was what she used based on a recommendation from a nurse, and my wife said it really had the baby wriggling - though we never thought the baby turned until the doctor did an ultrasound just before the narrowly escaped C-Section.

CMinor said...

A friend of mine did handstands in the pool to turn her breech--but I bet she had to put up with a lot of staring!

Lately I seem to be in baby prayer mode, so I'll add my voice.

Shannon said...

I am not sure what area you are in, so I can't speak to whether or not a chiropractor will see you in particular without an x-ray because yeah, it is kind of contraindicated in pregancy. ;) However, I saw a chiropractor in my second pregnancy when my pelvis was so loose that I was walking with a severe limp. No x-rays were done ever. That was in Chicago. I am pretty sure they would go ahead and see you without an x-ray and I would definitely give it a shot! The chiropractic technique that is specifically mentioned in attempts to turn breech babies is the Webster technique, but chiropractic care in general is awesome for moms and babies and can possibly lead to a shorter labor as well. A great website to find a doctor who may be Webster-certified in or near your area is www.icpa4kids.org. Good luck on your strategies and I hope your babe is responsive!!!

One last note, I teach Bradley Method classes and recently had a student whose breech baby turned after she had gone for a good, long swim at the local pool so don't rule out that method either!

Shannon

Christine the Soccer Mom said...

May God's will be done! If it's in the baby's best interest, may he flip on his own, and if not ... well. (My sister's second daughter was breech and I was busy praying that the baby would turn when suddenly I felt very compelled to pray, instead, for the baby to be healthy. Turns out that no one, including the doctors and nurses who did multiple ultrasounds (my sister works in L&D at a women's hospital and got a few free ones) noticed that the cord was around the baby's neck!

So may the good Lord protect you and your son and guide the physicians and midwife to do what is best for your whole family!

[PS: Hope I didn't just distress you. That is most certainly not my intention, because the moral is that God will often take care of us and do what's best in spite of our prayers. ;) ]

mrsdarwin said...

Thanks for your prayers!

I do plan to get in the pool, but I'm wary of our (postage stamp-sized) HOA pool because I'm not sure how often it's clean...

Shannon, thanks for the advice. My midwife also told me today that a chiropractor will certainly see me without an x-ray, so perhaps that's just the policy of the certain guy a friend referred me to. My mom (a massage therapist) suggested I schedule a massage with a pregnancy specialist, who could use the Webster technique and pressure points to trigger some good uterine reactions. The doctor I saw today said that an acupuncture technique called moxibustion often seems to help breech babies turn, so I'm going to see if I can try that this week.

Catholic Bibliophagist said...

We're praying, but tell that little guy to get with the program!

Aimee said...

This happened to me with my fourth. He flip-flopped all over the place until 38 weeks and then he decided to go bottoms up. I tried all the positions, etc, but I finally had to convince my doctor to schedule a version. It was hard because she needed another doctor who would be willing to help her turn the baby and no one wanted that job.

I'll pray that you little one decides to turn around and mosey out the "easy" way :)

The Opinionated Homeschooler said...

Prayers. I've had 3 c-sections, and let me tell you they don't get easier. I'd stand upside-down in a pool for a week if I thought it would have avoided a c-section.

That said, they give you morphine right after, which is wonderful stuff. I would have been a junkie for sure if I'd ever been given the chance.

Amber said...

Oh no!

My second went breech at about 34 weeks and stayed there until almost 37 weeks. I was doing the breech tilt too and I remember thinking that while it wasn't fun, it was definitely better than a c-section. We were going to talk about more invasive measures at my 37 week appointment, but he turned the night or so before.

I'll be praying for you!

Frances said...

bwah- just for some optimism here: I had an (ultimately unsuccessful) version which didn't hurt any worse than a good Swedish masage. I wouldn't choose it for an afternoon's recreation, but I was able to come home and go berry picking that evening.

I've had 4 C-sections since, for various reasons, and while Ihave no vaginal births to compare them to, they were decidedly *not* very painful (certainly far less painful than the contractions themselves) and recovery time was minimal. The post-anesthesia nausea was the worst part.

Many prayers that the little one turns around and all are healthy!

the other Sherry said...

I spoke with a friend of mine who is an experienced doula and has worked with many homebirth midwives.

She said the breech tilt doesn’t seem to work very well for most people, so you may not want to bother with that.

She strongly recommended that you have the chiropractic Webster technique once, or better twice, before any other interventions, as it serves to loosen things up and make it easier for the baby to move. It worked for me with my third.

Moxibustion is more effective after the Webster technique than on its own. (I’ve had moxibustion for other things; I found it relaxing.)

She said many experienced midwives can also help turn babies, so ask around.

Another thing she suggested was a good heart-to-heart talk with your husband. (This will probably require a babysitter.) She used to think this was just a midwives’ tale, but has seen it make a difference enough times to think there is something to it. If there is anything that may be causing tension between you, talking it out may help you relax enough to encourage the youngster to move around. (This is purely hypothetical; I don't mean to make unwarranted assumptions.)

According to the best evidence-based studies (and she knows all of them), she says that you’re still safer doing a home birth with a breech baby than doing it in a hospital; OBs call it “breech extraction” for a reason. OBs often trade in fear in order to get people to submit to (unnecessary) C sections, so proceed with caution there.

I had an external version with my first; it wasn't bad. On the other hand, if you're at 42 weeks with a 12-pound baby, don't try it. If you go that route, try to get the most experienced doc you can.

We will, certainly, continue to pray for the best outcome possible for all of you.

mrsdarwin said...

Alas! My moxibustion is tomorrow afternoon, and I haven't found a chiropractor yet! As to the breech tilt, it certainly hasn't produced anything yet except wiggles from baby and a sore neck.

I would absolutely have a breech labor at home, but the midwife seems very unwilling to try it. I guess if I went into labor early she'd come, since a) baby seems small, and b) I don't have a doctor or a hospital lined up at this point.

Darwin and I did have a great talk about the economics of modern medicine and interventions after my doctor's appointment on Monday (look for the post soon) but baby must not care much for economics because he has remained unbudged. He kicks a lot, though. That's good.

I really appreciate all the advice and prayers, guys!

Elizabeth said...

We're praying for you! My old Chiropractor I think is still there in Round Rock (Steven and Susan I think still use her) I remember her being very pro-natural birth and midwife. She may be able to help. God Bless and keep us posted.