A Natural Breech Birth
Liz P.
CA USA
From: NEW BEGINNINGS, Vol. 18, No. 2, March-April 2001 pp. 47-49
It's been about a year now
since I gave birth to my second son. I am still elated each time I think
about what a rewarding experience I had!
My first son was in the breech
position (head up, feet down) at the end of my pregnancy. Believing
we had no other options, we scheduled a cesarean birth at around 39
weeks. Three years later, we were blessed with another pregnancy and
began to plan for a vaginal birth. As the end of my pregnancy approached,
we discovered that this baby was also in a breech position. This time,
however, I was much more knowledgeable as I had done extensive reading
on birthing, mothering, and breastfeeding in the past three years.
I had chosen to use a midwife
during this pregnancy and hoped to deliver in her birthing center. Knowing
my history of having a baby end up in the breech position, my midwife
started monitoring my baby's position at 28 weeks, when he seemed to
be in a transverse, or sideways, position. During the operation for
my first birth, my doctor had commented that my uterus is heart-shaped.
This tends to make the baby more comfortable sideways or, when he gets
bigger, with his head up, because there is more room at the top of the
uterus for his head. At 32 weeks into my second pregnancy, an ultrasound
confirmed that this baby's head was up. I made the commitment to do
whatever was in my power to turn my baby so I could have a vaginal birth
after cesarean (VBAC). I made an appointment with an acupuncturist and
started doing moxibustion, a technique to stimulate the babys movement.
My plan with my midwife was to try everything to get my baby to turn
head down (vertex), but if that didn't work, we could use one of her
backup doctors, who specializes in delivering breech babies.
By 33 weeks, I was practicing
almost a dozen recommended methods to try to turn my baby. At one point,
we thought my midwife had turned our baby head-down so I stopped everything.
Unfortunately, we soon learned that the baby either hadn't turned or
had turned back a few days afterward. My pregnancy was further complicated
when I started bleeding early one morning at about 33 weeks and had
to go the hospital to be checked. Everything turned out fine and the
bleeding stopped after about three hours.
At around 35 weeks, my midwife
told me that because of the bleeding, my previous cesarean, and the
likely breech presentation, she definitely
wanted me to have the baby in the hospital and to start seeing her backup
doctor. This was hard for me because it meant that I wouldn't be delivering
in her birthing center. Since I was entering the hospital scene, with
all my risk factors, I felt the chances were fair that I would end up
having another cesarean birth. Soon afterward, I scheduled an appointment
with the doctor she recommended. We had planned to try an external version
during this appointment, a procedure in which a qualified physician
attempts to manipulate the baby manually to turn him head-down. However,
an ultrasound exam showed that the baby was already head-down! My husband
and I made our plans with this doctor, and he agreed to do a vaginal
delivery either way, vertex or breech.
When I went back alone to
my next visit with this doctor, my baby had moved back into a breech
position. The doctor said he wanted to do an external version in one
week and then immediately induce labor. I felt strongly that I did not
want to be induced. I was concerned that this would be the first step
down the road to multiple interventions and, eventually, a cesarean
birth. I told him my feelings and asked him to do a vaginal breech delivery
at fullterm, as he had agreed to at the previous appointment. He seemed
more hesitant to commit this time, and it concerned me.
At my next appointment, around
38 weeks, ultrasound confirmed that my baby was still breech. However,
when the doctor examined further with ultrasound, he could find only
a few pockets of amniotic fluid around the baby. He immediately told
me it was dangerous for me to continue my pregnancy and that he would
recommend that I go to the hospital immediately and have a cesarean!
I was in shock! When I resisted, he recommended either the cesarean
or an attempt at an external version and a possible vaginal delivery.
I asked for a few days to drink plenty of fluids, eat well, and rest,
and then to come back to have my fluid checked again. He said he didn't
think that would make any difference. I told him I needed to go home,
think about it, and talk to my husband. The doctor wanted to monitor
my baby to be sure he was okay before I left, which I consented to.
After an hour of monitoring, he was convinced that the baby was fine,
and I was able to leave.
I immediately started calling,
looking, and reading to determine my next move, which seemed to be to
investigate the only other doctor in my area who I had heard delivers
breech babies vaginally. I spoke with another midwife and found out
that he was her backup doctor. She highly recommended him, as she knew
of a breech baby he had recently delivered. My first appointment went
well. I showed him my birth plan, and he agreed to everything I asked
for, as long as there were no complications. I was so happy! He was
even going to let me go into labor on my own! I felt so pleased with
this doctor and his approach. When I asked him about trying an external
version, he said it was too late in my pregnancy to attempt it and we
would just go ahead with the breech delivery.
Two days later, just as I
went to bed, I started feeling some strange sensations. The contractions
continued through the night and the following morning. Walking and eating
normally helped me to deal with the intensity of the contractions. Around
noon, my husband, son, and I met the midwife at her clinic. I was over
six centimeters dilated and my cervix was 100 percent effaced! She asked
me where I wanted to go to have the baby - a tricky decision to make
at this time. The first doctor, with whom I had had an awful experience,
was 20 minutes away, while the new doctor I had just seen for the first
time two days ago, with whom I felt very comfortable, was 45 minutes
away. I stuck with my feelings and chose the latter.
We arrived at the hospital
around 1:15 PM and got settled into a small room. The nurse put an external
fetal monitor on the baby for a few minutes, I called a close friend
who wanted to attend my birth, and then the doctor showed up. My cervix
was over seven centimeters dilated, and my water bag was still intact.
I walked around and got into the bathtub which worked out great! The
hot water in the tub intensified my contractions. Luckily, my friend
had arrived while I was in the tub and was there to assist me during
these difficult contractions. The baby was coming! The doctor suggested
I push when I felt like it. A few contractions later, I did feel like
pushing. That's when my water broke and out popped a foot! Under any
other circumstances, this would have been a flag for an emergency cesarean
delivery. Since I was fully dilated, the doctor was ready to deliver
vaginally. I was moved into the delivery room and with the doctor's
guidance and the help of my midwife, husband, and close friend, I pushed
for about three contractions and out came my baby boy! It was a miracle!
Sawyer was born at 3:29 PM
and weighed 7 lb 3 oz. Right after he was born, they checked him quickly
and immediately put him on my chest, under my gown. The doctor sewed
up my episiotomy, and I kept my baby with me for the next couple of
hours, then through the night until we left the hospital the next morning.
It was terrific! We got off to a beautiful start by breastfeeding, and
we were a happy couple, both of us feeling great.
I am so glad that I stuck
with my goal and wouldn't let go. Even my husband was unsure at times.
For me, the obstacle to a breech VBAC was not the delivery, but finding
a doctor who was knowledgeable about and experienced with breech births.
My hope is that other women who are facing a VBAC and/or a breech delivery
will read, investigate, and consider their options, because they do
have options!
Last updated November 13, 2006 by njb.
Page last edited Sun Oct 14 09:29:22 UTC 2007.
