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.
God Bless you and your family.
ReplyDeleteThank you for your kind response over at the post at Vox Nova where we were talking about global warming or climate change.
The moderator took all of your posts down and I was wondering if you would mind if I reposted your beautiful response along with my response on my blog? I will give a link to your great blog as well.
I believe in climate change but not global warming or that humans are responsible for affecting the warming trend on earth, if there is in fact a warming trend.
Thanks for contributing to the body of useful information on this matter.
ReplyDeleteThere's much ado about external version and delivering frank breeches, but back in the day when going for the knife carried a much higher risk both were commonplace and every practitioner knew how to do them.
In 1977 my OB's partner said to me that he had just been to a conference on the west coast, where they were saying that all breech babies should be delivered by C section. He shook his head. "I've delivered hundreds of breech babies," he said, "and there was nothing wrong with any of them. But now the young doctors won't even learn how to do them. What's the point of being an obstetrician, if you don't learn the skills of one? They want to turn us into surgeons."
ReplyDeleteI had a friend whose breech baby was delivered at home by an old GP who was still doing home births the way they did them in 1920. Everything about the way she (the MD) handled the birth and the newborn could be recognized from the Williams Obstetrics of that era. It wouldn't have been my preferred style of birth...but my friend did get a healthy baby born in her preferred environment.
You can find video on the internet of babies born breech at home.
I certainly would not have let them section me ...once I learned about birth and started having home births...for a breech, but I would have had to find someone experienced rather than going the do it yourself route as we did with several of ours. I would have been willing to travel, say, to the Farm, if that's what it took not to be sectioned again. That would not have been easy, though, considering our financial situation and that I had other small children.
It is an outrage to perform major surgery on a woman for what is a normal variation of human birth.
Susan Peterson