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Alma’s birth – a planned breech hospital birth

Positive Birth Story; first time mum, Frank breech, planned breech birth in hospital.

I’m 33 and this was my first baby who I had originally planned to have at home. The only thing that had cropped up during pregnancy was a single umbilical artery, which was interesting, but had no impact on my daughter and was not specifically related to her being breech. However my mum was breech (footling homebirth, and I was born prematurely by c-section, so who knows could be something that runs in my family).

She was breech at the 28 week growth scan but I was not at all concerned and assumed she would turn. After that, my midwife had done a check on position and felt she was head down, another homebirth midwife also checked and agreed…. (A sneak my daughter!) However at the 36 week growth scan she was definitely bum down. I panicked an did all the things, acupuncture, moxibustion, spinning babies, handstands in the pool 😂 and agreed to an ECV at 37 weeks but was unsure if I wanted it. She didn’t turn by my ECV date and was still Frank breech and so to try and keep homebirth as an option, I had the ECV (and as an aside I would say to other ladies out there, I know easier said than done, but I wish I hadn’t let the turning activities and worry consume my last week’s pregnancy, so do them, but don’t beat yourself up with them).

I found the ECV painful but completely bearable. They tried twice without success and then almost immediately it felt, tried to push a C-section at 39 weeks. My trust (Homerton) will do VBB but they didn’t want to with a first time mum. I asked for info from the senior midwife and consultant, but also said I wouldn’t be making a decision that day (they really wanted to sign me up so be clear and take pressure off 😂). After a chat with my homebirth midwife, she explained that she wouldn’t feel 100% comfortable doing a homebirth but encouraged me to push for VBB in hospital if that’s what I wanted.

I had a few horrible days of stress trying to decide what to do. In the end, I decided to schedule a section for my due date (arbitrary I know but it gave me peace to have an end to the worry) and then if she came in the meantime I’d “see how it went”…

My waters broke at 4am at exactly 39 weeks. No contractions, but I called the hospital and they suggested I came in just to check all well. Upon arrival I had a VE, I was 2cm and the midwife said she thought she was head down, but scan confirmed she was still breech (told you, my daughter was very sneaky). I was offered a section but declined and asked to see how labour progressed. I was told that if everything progressed “smoothly” and baby’s heart rate was normal then it indicated that the breech birth would proceed well. I was also told I had 24 hours to progress due to water being broken. It was very interesting, as I faced a lot of push back on having a VBB as a first time mum, but as soon as I said I wanted a “trial of labour” aka give it a go, I noticed everyone kind of felt a bit excited. I had asked if the team on were confident with a breech birth and was assured they were.

At this stage (around 9am) I was still not experiencing any strong contractions, though maybe slight twinges. I had thought about going home (I’m only 5 minutes away by car) which they didn’t want, but a senior midwife secretly told me I could do what I wanted and if I wanted to go home I could (remember you are not a prisoner!). They also wanted to put in a canula at this stage but I declined as it seemed uneccesary and I knew I wouldn’t want to labour with one in my hand, so remember you can say no. Husband and I went on a long walk for ice cream, and by 12 midday I was feeling them and by 2pm I was moved to private room as I was 7cm and in active labour.

I was introduced to my birth team, which was quite large and included two midwives, a student (I didn’t mind – better to train more in breech), consultants, anaesthetist, baby specialists, talked through risks and how we would proceed. I already knew my Trust would decline me using a birth pool (apparently so as not to slow labour and then during birth so they could see) and would prefer me to labour upright / on all fours, ideally on a bed. Happy.

I was very active, moved around walking a lot and had terrible back pains so used the shower and counter pressure. At this stage I also agreed to a canula in case of emergency (it was hard to get it in with contractions happening I’ll admit!)

Everything progressed relatively quickly and I felt labour switch to pushing so was helped onto the bed around 7.30pm. Without asking lights were dimmed and all was very calm. 1 hour of pushing in an upright kneeling position against the back of the bed (which felt great and very powerful) and my daughter was born. She came out relatively easily, however there was a slight delay (only a couple of minutes but felt like forever) when her body was out and not head, which panicked me, however we waited for a contraction, which did come and then she was here. It felt amazing to feel her come out.

She was floppy and not breathing on arrival (I’ve since learnt that’s normal with breech, but I was very worried at the time), cord was immediately cut and she was taken to the resus table and I didn’t get to see her. She apparently had fluid on the lungs and a blood clot in her mouth. She cried after 5 minutes, and I held her after 20 minutes, uninterrupted for the next hour. The best feeling ever. I recall saying to the doctor’s “there’s your *effing “proven pelvis”” 😂 (in jest, but that’s the term often used to explain why second time, but not first time mums can do something like a VBB).

I felt incredibly proud of my body. Labour was HARD, but for me it felt right. That said, had I needed a c-section I’d also totally made my peace with it. I was sad to loose out of immediate skin to skin and having the cord cut so quickly, the resus was stressful, and I needed stitches for a second degree tear, but these things may also have happened with a head down birth.

After the birth I had a lot of young excited midwives congratulating me and saying they hoped more breech births could happen, which was positive! One more for the books (as an aside I hadn’t realised as I was on all fours, but my husband told me at the point of birth there were about 15 people in the room, some because they needed to be, others just watching 😂)

Anyway, the story of my beautiful breeching; Alma Medeina.

Filed Under: Birth Stories, Featured Tagged With: ECV, hospital, midwife, planned, vaginal

Isobel’s story – a planned midwife-led breech birth

I just wanted to share my positive breech vaginal birth story. I spent many hours in the weeks leading up to the birth searching for such stories, so hopefully mine will bring some comfort to those who are in a similar situation.

We found our little boy (second baby) to be breech from about 28 weeks following regular growth scans. I had an unsuccessful and rather distressing ECV at 38 weeks and was then given the option by our hospital of a planned C-section on our due date, or to attempt a vaginal delivery. I was desperate for a natural birth so I was lucky that our local hospital supports this option and we were told we would be assigned a senior midwife on arrival if I went into spontaneous labour.

Fast forward to 5/7/21 at 39+3 I started having regular contractions so we made our way in to the hospital. I was put on continuous monitoring as per protocol but was allowed to move around.

4 hours later I noticed the telltale signs of transition and began to push. I was allowed to be on all fours which was my preference. I heard some commotion of more people entering the room but we were made aware of the need for a doctor, NICU nurse and additional midwife to be present for the birth due to the potential for myself or baby needing some additional help.

The whole birth was hands off, with the midwife just talking me through what was happening which I found a huge help and a great motivation.

His body delivered in 2 contractions, these then died off and I was instructed to push his head out without the aid of contractions as there is a time limit on how long they will let the head go undelivered. This was actually not as difficult as I had anticipated and I got away with not even a graze.

Our little boy was born unresponsive, and needed immediate cord clamping, CPAP and vigorous stimulation at the beginning but quickly came round with no ill effects. Having the NICU team present was actually a real comfort and at no point did I feel anxious, I knew he was in safe hands and having done plenty of reading in the run up to birth I knew that this was quite normal for breech babies.

Apart from having some spectacular ‘frogs legs’ he is doing really well and my recovery has been far easier than my first vaginal cephalic birth.

I hope that this helps even one person in a similar situation who may be undecided about what sort of birth to go for. I knew I wanted to avoid surgery and felt that on balance trying for a vaginal birth was the right thing to do for me.

At the end of the day, you must go with your gut feeling – you will make the right decision for you!

Filed Under: Birth Stories Tagged With: diagnosed, ECV, hospital, midwife, planned, vaginal

Natalie’s story – a c-section in labour for a footling breech baby

My pregnancy was low risk, straightforward and with the usual pregnancy symptoms. I was active until the end of pregnancy by walking our dog every day.

We found out our baby was breech on a scan at 35 weeks. I tried everything to turn her – spinning babies, inversions, moxibustion, chiropractor, lots of walking and gardening (being on all fours). After a position scan at 37+2 confirming she was a flexed breech we agreed to the ECV to try to turn her at 37+4. The ECV was unsuccessful as baby was well and truly wedged in my ribs. She coped really well with the ECV (whereas I found it quite stressful and uncomfortable). It did, however, make me feel at peace with the fact that my baby was breech and I don’t think I could have done anything else to turn her! I finally started enjoying my very low down kicks instead of stressing about her position.

We initially agreed to an elective caesarean at 39 weeks as the only realistic option presented by the obstetric team that day. However, on leaving the hospital I was devastated. I felt she was not ready and surgery seemed a huge reaction to a healthy baby and mother when the only issue was her position. The next morning I called my community midwives who were incredible supportive and directed me towards AIMS and referred me back to the consultant midwife at my hospital to discuss other options.

After doing 2 days of research into vaginal breech births I was really confident I wanted to try. I cancelled my elective caesarean and came up with birth preferences with the consultant midwife. It was highlighted to me that my birth would likely be influenced by the skills and experience of those on duty.

With my plan in place and me feeling much more confident we enjoyed our last week before she arrived! I did lots of batch cooking, swimming, walking the dog and just really trying to enjoy ourselves.

The day before I went into labour we had spent a stunning day at the seaside; walking, enjoying the sunshine and fish & chips on the beach. I went to bed that evening feeling completely normal.

Contractions started really mildly at 4am. They woke me up and felt very different to Braxton Hicks, I took paracetamol and tried to go back to sleep but couldn’t. I ended up downstairs on my birth ball. The contractions became regular very quickly but then slowed and got more intense. My partner took our dog out for a walk at 9am and my contractions basically stopped and only restarted when he got back. I also felt very nauseous at this point. We attended my community midwife appointment at 11am. Contractions continued throughout the appointment (and the 30 minutes spent stood in the car park because of the fire alarm). I came home, had lunch and bounced on a ball for the afternoon. Contractions continued at variable intervals, intensities and lengths. Nausea and indigestion were pretty unpleasant as well – I was having my bowels open many times for the clear out! I managed to breathe through contractions and could talk and walk through most of them. The worst discomfort was when I stood still outside and felt it in my bum and hips.

By about 5pm I wanted a change of scenery so got in the bath. This shortened my contractions but increased the frequency. According to the Freya app I wasn’t ever in established labour but I called the hospital just in case. I wanted a plan for the evening and I thought there was no point in heading in. However, because baby was breech and we’d be delivering on the labour unit they wanted me straight in for assessment.

This was the least pleasant part of my birth story. We arrived in the hospital at 8:30pm and started the CTG monitoring. Sitting in a chair whilst labouring and not knowing whether we’d come or go was so stressful and uncomfortable. We tried to joke around and keep positive but more than anything I just wanted to go home. When I was allowed to stand I breathed and danced through the surges. Eventually, I had a VE and was happy to hear I was 4cm although the midwife could only feel her feet. Immediately afterwards my waters broke. There was light meconium staining but this is normal for a breech.

We were taken around to the labour unit at around 10pm. Once on the labour unit I wanted to settle in. We’d agreed to wireless monitoring but it was very problematic and intermittent. My partner went back to the car and got my bag, put music on and we had dim lighting.

The specialist registrar came in and discussed our footling presentation. I requested a ultrasound and ‘thorough’ VE in order to confirm the presentation had switched from flexed to footling. It was confirmed I was now 7cm and baby’s feet were definitely below her bum. They explained the biggest risk was cord prolapse and that a footling presentation is a contraindication to vaginal birth under RCOG guidelines. We asked questions about the likelihood of an emergency caesarean under general anaesthetic and risk to baby of cord prolapse. We requested a few minutes to discuss our options and came to the conclusion that with the risks of a vaginal birth combined with the confidence of the medical team in delivering a footling breech vaginally our best option at that time was an immediate caesarean. One downside was that no one read my birth preferences or offered me any pain relief. I wanted to use my TENS and gas & air but didn’t get to try either. On reflection, for the medical team caring for us it was more of an emergency than I was aware of. Also, at no point were my contractions indicative of established labour. They were powerful but only every 5 minutes or so despite my labour progressing very rapidly. I’d gone from 4-7cm in a hour with moving units, never having time to ‘settle in’, constantly having the monitoring adjusted, an ultrasound and vaginal exam.

I felt very confident in myself and my baby to deliver safely but did not have the same confidence in those looking after me. On reflection, with the attitude and staff confidence levels in delivering breech babies I would make the same decision again in the same scenario. However, I might have made a different decision somewhere else with a different attitude to vaginal breech birth.

After agreeing to the caesarean, less than 10 minutes later we were in theatre. Despite my birth preferences not being followed again we just tried to keep calm and get through it. I was shaking terribly due to the fact I was still having contractions and in a very cold operating theatre. The anaesthetist and assistant were the kindest, friendliest people though and really tried everything to make it positive for us. I had to have the spinal on my side as I was still contracting and they did not want labour to progress any further than it had. The anaesthetist was incredible and managed to do an effective spinal despite me not being about to stop shaking uncontrollably. The shaking was also worsened by having the spinal and is a common side effect. Although it wasn’t what I ‘wanted’ the staff were so professional, supportive and explained what they were doing. Her birth was very rapid and she arrived on her due date at 11:55pm. However, she was straight off to the paediatric doctor and it took a couple of minutes for her to cry but she then bawled loudly and for a long time. The anaesthetist was keeping us updated but I couldn’t stop crying and was just desperate to have her in my arms. The staff had placed the ECG monitoring and gown so that I could have skin to skin as soon as possible. Very quickly she was passed to me and they finished off the section with her on my chest and my partner by my side. I was still shaking but so relieved and happy to be talking to and holding my baby.

We were wheeled back to the labour unit for recovery where she latched on with a bit of help from the midwives. After an hour I was allowed to eat and savoured the NHS standard of tea and toast whilst my partner had skin to skin.

At 3am my baby and I were taken to the ward for recovery where we were both monitored and were absolutely fine. We stayed in the hospital for nearly 2 days but I was keen and ready to leave after the first! Although we had an emergency caesarean in my mind it was a speedy caesarean to prevent risks. Recovery has been straightforward and we are settling at home well.

I feel my story was very positive because I was informed and empowered throughout my pregnancy and labour. Although it was not the perfect birth I had initially envisaged I always felt in control. I knew that a caesarean was a likely outcome for a vaginal breech birth as a first time mother so we had prepared ourselves for it. I felt incredibly powerful as I had managed to get so far using breathing and could ask questions and make rational, informed decisions. My baby chose when she wanted to arrive and I feel I made the right decision at the right time for us both.

Filed Under: Birth Stories, Featured Tagged With: ECV, emergency c-section, footling, hospital, planned

Cina’s story – an upright breech birth in a hospital birth centre

My baby had been breech basically since 28 weeks. She was breech at 28 weeks for my midwife appointment, at 30 weeks I was told her head was up where my ribs were. I don’t know why but even though there was plenty of time for her to move I just knew she would remain there! At the 34 week scan she still was there too.

I was referred to the breech clinic at 35 weeks for confirmation of position and advice on how to turn baby. At 37+2 I had a failed ECV and baby was firmly engaged into my pelvis.

My waters broke at 6.30am with some twinges. I headed to hospital just to get checked etc. It was decided it would be best to keep me in due to breech/second baby and contractions had started at this point which I was more than happy to do. I had planned to have my VBB on the birth centre which luckily was honoured and not met with any disagreement. I stayed mobile and upright and contractions picked up quite a bit. Was 3 almost 4 cm by about 10.30am. At about 12 a foot presented itself. Contractions picked up and by 13.49 baby was born- about 5 mins between bum and head.

I am very happy about all the support I’ve received at Chelsea and Westminster Hospital and am very pleased I was able to be on the birth centre which made me feel very comfortable.

Filed Under: Birth Stories, Featured Tagged With: birth centre, chiropractor, ECV, hospital, midwife, planned, upright, vaginal

Freya’s story: Two breech babies, both born naturally

First breech birth – Abigail

Born at the Oxford JR Hospital, 15 June 2017, 8:43pm, 7lbs

We found out at the 36-week scan that our daughter was breech. Having limited knowledge of breech babies at the time, I assumed this would rule out a natural delivery. I was booked in for an ECV (external cephalic version) for the following week. (This is an attempt to manually turn the baby back to a head-down, or cephalic, position through manipulation and pressure on the bump.)

In the days between the scan and the scheduled ECV, I began practising some of the techniques from the Spinning Babies website to encourage the baby to turn – crossing my fingers that something would work and the ECV wouldn’t be necessary. I also went to see an acupuncturist, who specialised in moxibustion, a technique of heating acupressure points, involving holding a burning mugwort stick next to your little toe for ten minutes at a time over several days. While these various techniques have undoubtedly been successful for other people, none of them worked for me, as the scan prior to the ECV confirmed: she was still in an extended, or frank, breech position.

The ECV appointment was my first experience with the Oxford JR breech team, and from this point right through to the end of my birthing experience they were absolutely amazing in their approach, treatment, care and expertise. They told me that they would make a maximum of two attempts during the session: the first with no other assistance, and the second, if it was needed, with an injected muscle relaxant that could help things along. As it was, both attempts were unsuccessful and Anita, the breech team’s lead midwife, said we should stop there; that there must be a reason the baby was stubbornly staying breech. We would not try again the following week. The procedure itself was uncomfortable and not particularly pleasant; however, it was all over relatively quickly, and I didn’t feel any residual pain or discomfort afterwards.

I spoke to the team for some time following the procedure – they took the time to explain things fully and answer all my many questions! My options now would be either to book an elective C section (usually at around 39 weeks) or to aim for a vaginal breech birth. I already knew the latter option was what I wanted to try for. The possibility of needing an unplanned C section during labour was higher than if she was head down – but, as I had been discovering ever since that 36-week scan, the main reason breech births had been considered so “problematic” is that hospital staff in many areas simply didn’t have the experience of dealing with them. Since the early 2000s, when a flawed report (the Term Breech Trial) sparked off the stigmatisation of breech birth, the number of hospitals able, or willing, to deal with natural breech births had fallen dramatically. Most people, when learning my baby was breech, automatically assumed I’d be booked in for a C section.

Following my ECV, and after a couple more days of doing moxibustion and Spinning Babies techniques, I decided to embrace the breech, and spend the rest of my pregnancy focusing on relaxing, breathing and doing hypnobirthing techniques (I listened to Maggie Howell’s Hypnobirthing Relaxation tracks), and generally looking forward and being positive. I’m so glad I took this approach, rather than desperately hoping that she would turn right up until the birth. 

I went into labour on 15 June 2017, when I was at 39+1. I felt the first twinges not long after lunch, which initially felt like period pains. At first I thought it might be Braxton Hicks, not having felt them up until then, but they got stronger and it soon became apparent that something more significant was happening. Things progressed quite rapidly after that. My waters broke on the bathroom floor and contained meconium – which is very normal for a breech birth, given the position the baby is in! Even so, the MAU told my husband on the phone that we should come in straight away. He managed to get the TENS machine on me (the only pain relief – or, really, pain distraction – that I used) and we drove the 20 minutes from our house to the JR. I was now fully contracting, and it wasn’t the most pleasant journey, but the TENS vibrations and me making a lot of noise definitely helped! We arrived at around 6:30pm. Once at the MAU, I was assessed fairly quickly, and then taken through to the breech team in the delivery suite. It was a lovely room with dimmed lighting and floral patterns on the wall, helping create a calm and soothing atmosphere. Once in there, I was given space to let things happen. 

I didn’t have an internal examination at all throughout the entire labour; it wasn’t necessary. The breech team’s approach was the preferable “hands off the breech”, and that’s exactly what they did – simply talking me through the breathing and pushing when appropriate. They needed to attach a heart-rate monitor to my tummy, which was quite difficult as I couldn’t lie back at all, it was far too uncomfortable. But very soon after that, they could see the baby coming. I instinctively started pushing and the birth started happening. The only assistance Michaela, the midwife, needed to give was to ease the baby’s arm down once her bottom, legs and other arm were out. Her head was still to come, but then my contractions stopped, so I had to push without a contraction – this was more difficult, but I managed, and all was fine in the end. And then, at 8:43pm, just over two hours after we arrived, our baby, Abigail, was born weighing just under 7lbs.

I found the labour and birth to be a positive experience – the whole thing was relatively quick, so I wasn’t in painful labour for hours, and only pushed for a few minutes. It was extremely intense but not unmanageable. My recovery post-birth was relatively rapid too. I felt that if we ever were lucky enough to have another baby, I would be OK with him or her being breech too, given my first breech experience. 

Second breech birth – Camille

Born at home (born before arrival), 11 October 2020, c.2:50am, 8lbs 6oz

Having joked about the likelihood of this baby also being breech, I was still a little shocked when I found out this was indeed the case at the 36-week scan. She appeared to be in exactly the same position as our first daughter had been: frank (extended) breech, with her back to the right. I knew already that this was an optimum position for birthing as far as breech went, and due to my previous positive breech experience, didn’t feel the same anxiety as the first time. 

After discussion with Anita from the Oxford JR breech team, I ended up opting for an ECV this time as well, as the absolute ideal position (with the minimum risk) to birth a baby is head down, and I knew I’d be constantly wondering if she could have turned if I hadn’t tried it. I had the ECV towards the end of the following week, at 38 weeks. I knew there was more likelihood of it being successful as it was my second pregnancy. However, this one also failed; the baby, just like her big sister, was completely sure she wanted to stay bottom down! 

We booked ahead an appointment for 40+4 to discuss options if the baby hadn’t come by then (they don’t like to let breech babies go too far over the due date, generally ten days maximum, rather than two weeks plus for head down babies – and breech babies aren’t induced; if labour doesn’t start naturally, it will most likely lead to a C section). As my first baby came at 39+1, I kind of assumed this one would come at a similar time, or maybe even earlier as it was my second baby. However, 39 weeks, and then 40 weeks, came and went, and I became very keen for her to make an appearance, as I really wanted a natural delivery again. The Saturday night following the Thursday due date, I couldn’t sleep (again!) and eventually went downstairs around 1:30am (so, now Sunday, 11 October). I’d been feeling low-down pressure in my abdomen, which was getting more pronounced, and found I was unable to sit comfortably on my birth ball, and after a bit longer, was unable to walk to the kitchen (I really wanted a cup of tea!). It took a little time for my brain to catch up with what was happening: I crawled back to the lounge where my waters broke. It was then that I called to Gareth, my husband, and he came rushing downstairs. I managed to make it to the downstairs bathroom to go to the toilet, then got a very strong, continuous contraction, followed minutes later by an uncontrollable urge to push, so I just went with it. We realised that the baby was coming – right now! She started emerging, and Gareth raced to get his phone to call 999 and grab towels (I was insistent that we needed them!). As he came back, the baby was born into my arms. It only took about three or four pushes; an incredibly quick birth! The 999 operative talked us through the checks to do on the baby; thankfully she was fine and was responding well. A short while later, the ambulance arrived and transferred me and our baby, Camille, to the JR hospital, while Gareth followed in the car (once he’d cleaned up the downstairs bathroom!).

Camille passed all her checks and observations at the hospital with flying colours, and we were back home at lunchtime that day. Her weight was 8lb 6oz (3.8kg). I was really pleased to have had another successful breech delivery; even though this one was much speedier than I’d expected, it was still a positive experience. Our first daughter, Abigail, who is now three, was fascinated to learn that her baby sister was born the same way up that she was – our two special breech babies!

Filed Under: Birth Stories, Featured Tagged With: diagnosed, ECV, home, hospital, midwife, moxibustion, positional exercises, vaginal

Helena’s story: breech birth in a Birth Centre

I gave birth to my daughter in December 2020 and I just want to share what an amazing experience I had at the Royal Oldham Hospital Birth Centre.

When I found out that my baby was breech I was extremely worried. The last thing I wanted was to have a section. I had a straightforward, head down water birth with my first baby and I was obviously hoping for the same experience again. The thought of having a section filled me with dread and worry.

When baby failed to turn, I had an ECV at 37 weeks, which was unsuccessful. The consultant who carried out the procedure then informed me straight away, in no uncertain terms, that the only other safe option would be to have a section. The midwife present quickly stepped in and informed me there were other options that could be considered. She then very kindly put me in touch with a specialist breech midwife, Amy Meadowcroft, who luckily worked at the hospital. She was amazing to say the least. She explained to me that a section was not my only option and that I could give birth naturally to my breech baby. As we were both low risk, the risks to my baby from being born breech were incredibly low, the same as a straight forward head down birth. So I decided that this was what I wanted to do. With the constant support of Amy, we made a plan for me to birth naturally at the hospital birth centre.

Baby decided to arrive 8 days before my due date and the labour and birth could not have gone better. I gave birth to my baby girl naturally, bum first, and everything went perfectly. The support I received from Amy and all the staff at the birth centre was just amazing and I couldn’t have done it without them all. So for that I will be eternally grateful.

I just wanted to share my experience with any ladies out there, that may be in the same position as I was, and are worrying about what to do. If it wasn’t for the midwife stepping in, after my ECV, I would have been none the wiser about my options, to an extent, and I would not have been put in contact with my midwife Amy. I just want to say to any ladies in the same position as I was, please ask if there is an experienced breech birth midwife at the hospital or if they know of any at other local hospitals. If you want to go down the vaginal birth route then it is worth fighting for. I am so glad that I did.

Filed Under: Birth Stories, Featured Tagged With: birth centre, diagnosed, ECV, midwife, vaginal

Zoe’s story : A first baby born breech

I planned a home birth but found out at 40 weeks that my baby was in extended breech.

I felt scared into a caesarean after a failed painful ECV but went away from the hospital and had a think and spoke to midwives and my friend who’s a midwife and decided on a natural breech birth.

The hospital had little to no experience with breech births so I think the doctors discouraged me but always remember it is your choice. The midwives were fantastic and very supportive and excited!

I went into labour 40+5 at 3:30AM and delivered at 11:24AM with no issues.

Now I have had no problems throughout my pregnancy which was my first and he came out 7lbs 1oz. A natural pregnancy can be achieved even with breech 👍

Filed Under: Birth Stories Tagged With: diagnosed, ECV, hospital, midwife, vaginal

Ada’s Birth: A Hospital Breech Vaginal Delivery

By Lizzie Johnson

Even before I became pregnant, I always knew I wanted to give birth at home. Home births seemed safe and familiar because my mother had me in her own bed thirty-four years ago. Moreover, hospitals had bad associations. Their wipe-down surfaces and windowless rooms reminded me of the months I’d spent being treated for breast cancer a decade earlier. A hospital birth was the last thing I wanted. And yet here I was, under the moonlight, my body bent double by contractions, climbing into the back of a car destined for St George’s hospital in Tooting. How had I got here?

The news that my baby was breech was delivered without much fanfare during a routine (but late) ultrasound at University College London Hospital (UCLH) in week 34 of my first pregnancy. At the time the sonographer was more concerned about a suspected and potentially dangerous complication to do with my umbilical cord, making my baby’s breech presentation seem almost incidental. Even after the doctors established that my umbilical cord was fine, I wasn’t concerned about my baby being breech. I had been breech until late in my mother’s pregnancy. She persuaded me to turn using moxibustion; a practice used in traditional Chinese medicine where dried mugwort is burned next to particular acupressure points. Plenty of time to turn, I thought. And there was always moxibustion to fall back on if my baby didn’t make its own way into a head down position.

Up until that ultrasound, my pregnancy had progressed without any real difficulties. It was deemed low risk and I hired a private midwife to help me give birth at home. I also registered with UCLH to have my antenatal scans and ensure that I could easily transfer into hospital if needed. My midwife seemed relaxed about the breech presentation, but suggested moxibustion and swimming to encourage the baby to turn. Each night before bed I ground up fresh ginger and put it into a plaster that I taped to the outside edge of my little toe. I got to grips with the exercises designed to encourage optimal foetal positioning on the Spinning Babies website, and could often be found lying on an ironing board propped against the seat of my sofa with my feet elevated in the air. Friends and acquaintances made suggestion after suggestion about how to turn breech babies. It seemed that everyone had a theory and a tale of a baby turned at the last minute. I was happy to give anything a go, no matter how peculiar, so long as it might prompt my baby to turn and keep my home birth on track.

Three weeks passed and despite my efforts the person growing inside me remained stubbornly bottom down. My midwife advised me against a homebirth if my baby stayed breech, and made an appointment for me to have an external cephalic version (ECV) at UCLH to try to turn the baby around. I knew the procedure came with risks, but on balance I thought they were worth taking if it meant I could potentially avoid a medicalised hospital birth. The talk of caesareans only began after two doctors failed to push the contents of my swollen belly into a more typical position. Responding to what they referred to as my baby’s “malpresentation”, the team at UCLH strongly encouraged me to opt for a planned caesarean section, arguing that a vaginal birth represented an increased risk to my baby. They could support a vaginal breech birth, and did agree to respect my wishes if I made this decision, however it was made clear that it would likely be a highly medicalised affair. I would have to give birth on the labour ward (the midwifery-led unit was not an option) and the delivery would likely involve obstetric interventions including lithotomy, and potentially forceps and episiotomy. An emergency caesarean might still be necessary if my labour wasn’t making sufficient progress, and I would have to agree to a caesarean if I had not gone into spontaneous labour by 40 weeks. Whether they intended it or not, I left UCLH with the feeling that I would be regarded as reckless were I to choose anything other than an ‘elective’ caesarean.

The problem, I later learned, was a scientific report published almost twenty years ago known as the Term Breech Trial (1). It concluded that an elective caesarean section presented a significantly safer mode of delivery for mothers and babies than planned vaginal breech births. Following the publication of the report vaginal breech births became a rarity in developed countries and a whole generation of doctors and midwives went through their professional careers with almost no clinical experience of this type of delivery. As I read more and more online articles, clinical guidelines and blogs about breech presentation, I discovered that they were rare, affecting only 3-4% of pregnancies at term, but not abnormal. I also learned that since its publication in 2000 the Term Breech Trial had been widely criticised and aspects of its findings found to be flawed (2). Vaginal breech births could be as safe as vaginal cephalic births so long as the supporting doctors and midwives were trained and experienced in this mode of delivery (3). This is the catch 22 situation familiar to all pregnant British women who discover their babies are breech. Vaginal breech deliveries are safe with experienced staff, yet the Term Breech Trial had all but eliminated that clinical experience.

The day after the ECV my tender stomach muscles needled my conscience about going through with the previous day’s potentially harmful procedure. Weary with guilt, I tried to make sense of my new situation. A caesarean represented a major surgery; a prospect coloured by my previous treatment for breast cancer. I was terrified of what I perceived as the loss of physical sovereignty that my past surgeries had entailed. Following my mastectomy, the slow dissolution of my surgical stitches had counted out the postoperative days, turned into weeks, in which my body was bruised and swollen. I knew all too well how flimsy the promise, “You’ll be up and about in no time”. Despite their obvious differences, I struggled to separate the idea of a caesarean from my mastectomy. Having a caesarean was the most sensible decision given the lack of vaginal breech experience at UCLH, but it also meant letting go of the idea that my birth could be an opportunity to heal; to regain trust in my body and its physiological processes.

The fragile belief that there was still time for my baby to turn was my only shield from my fear of a hospital birth. Foetal positioning exercises took up hours of my time each day. I listened to hypnobirthing audio tracks designed to encourage breech babies to move into a cephalic position. Instead of resting, I took almost daily trips across London, spending hundreds of pounds seeking help from chiropractors, osteopaths and acupuncturists.

Two weeks before my due date I had the good fortune to meet midwife turned acupuncturist Meredith Churchill. Meredith placed her needles in my skin with care. She suggested that my baby had been given every opportunity to turn and perhaps there was a good reason for it staying with its bottom lodged in my pelvis. If I wasn’t sure about the caesarean, she proposed, perhaps I should research whether there were any other London hospitals with staff experienced in breech vaginal deliveries. That way, if there was nowhere supportive of a vaginal breech birth, I might find it easier to accept the caesarean and focus on making the experience as meaningful as possible to me. Her suggestions recognised how important it is for women to feel that they have agency in the way they give birth. Referring to the psychoanalyst D. W. Winnicott’s theory of the ‘good enough’ mother, Meredith sensitively suggested that my experience of birth did not have to be perfect: it only had to be good enough. Buoyed by these words, I began to let go of the perfect home birth I had envisioned and wonder what my ‘good enough’ birth could look like.

After a few hours of searching online, I sent emails to mothers and midwives interested in physiological breech birth asking if they knew of any London hospitals experienced in this area. One of the people kind enough to respond was Dr Shawn Walker, Midwifery Lecturer at King’s College London, who directed me to the breech clinic run by Emma Spillane, Lead Midwife for the Carmen Birth Centre, at St George’s hospital, Tooting. On contacting Emma, I discovered that over the past few years the team at St George’s had been building confidence and clinical experience in physiological breech birth. In the thirty-ninth week of my pregnancy, my boyfriend and I met Emma, looked around the hospital and booked in with St George’s. St George’s had strict guidelines designed to minimise the risk to mothers and babies. I had to give birth on the labour ward, rather than in their friendly midwifery-led birth centre. If I had not gone into spontaneous labour before week 42, I could not be induced and a caesarean would be necessary. Finally, if my labour did not progress smoothly, I would have to have an emergency caesarean. Although its policies were broadly similar to those at UCLH, for me the difference between the two hospitals was that the team at St George’s made me feel my wish to attempt a physiological breech birth would be supported and respected. What I was being offered was a chance at a vaginal delivery: there were no guarantees. I knew that I might still end up having a caesarean, but if that happened I could be certain it would be the right decision at that point. After weeks of anguish and confusion I finally felt ready to have my baby.

A day after my due date, I returned home from a long, slow walk in the summer evening. My boyfriend had gone to a work event and I slumped on the sofa, glad to take the weight off my feet. Ten minutes into an episode of the Great British Bake Off, I felt a small rush of water flow between my legs. I jumped to my feet confused and thinking that I might have wet myself. More fluid trickled into my knickers and down my leg. It took me a few seconds to realise what was happening. This was it: my waters had broken. I called my boyfriend to tell him he probably ought to come home. I called my midwife to ask her to come to check on me. I called my mother to share my excitement.

I rushed around the flat, shoving my slippers and phone charger into the hospital bag, wiping down the kitchen surfaces and tidying away clutter. My boyfriend arrived back. We sat on the sofa chatting, giddy with excitement. When the midwife appeared she checked my amniotic fluid, told us all was well, to get some rest and to head to the hospital, where she would meet us, once I was experiencing three contractions in every ten-minute period. My first contraction came as she spoke; a tightening in my uterus like period pain. It was about 9pm and I had no idea how quickly things would progress. I got into bed with my boyfriend and tried to rest, but the tightenings were too distracting. With each tightening I felt the urge to jump out of bed, as though I could run away from the feeling now taking over my body. I repeatedly ran to the toilet, responding to an urge as though I wanted to poo. I’d fail to shit and climb back into bed. After about an hour of this back and forth between bed and toilet, I stopped returning to the bed, preferring to lie on the bathroom floor. The surges of energy consumed my body for short periods at a time. I found myself saying to my boyfriend, “This really hurts,” for some reason surprised by the intensity of the feeling. With each surge I’d jump to my feet as though I could outrun it, and then bend onto all fours moaning. Not once did it occur to me to ask for the TENS machine or the glass of wine I had planned to drink as an analgesia, and had so been looking forward to after nine months sober. The sensations consumed me.

By 11.30pm it was clear to me that if I did not head to the hospital there and then I would refuse to go at all. I had no idea how many contractions I was having over what period of time, but I knew I couldn’t face getting into a car if we left it any longer. The plan had always been to take a taxi, but now in the heat of the moment I had no confidence in my power not to puke, shit or leak amniotic fluid in the back seat of a cab. We decided that my boyfriend would drive us. Armed with a bucket and an incontinence pad, I climbed into the footwell of the backseat.

In the car I fumbled with my headphones, eventually managing to start the playlist I had put together. Focusing on the music between the surges and the speedbumps, I belted out familiar songs all the way from Kilburn to Tooting. The sensations and the music enclosed me so completely that I was shocked when the car stopped and my boyfriend told me we had arrived. The short walk from the carpark to the labour ward was punctuated by several contractions, with pitstops leaning over bike racks and railings, but eventually we made it. I hobbled through the ward’s double doors and immediately got onto all fours in the corridor. Everything in my body told me to stay low to the ground with my bum in the air. A midwife directed us towards a waiting room, but the idea that I could sit on a chair was preposterous. After five minutes on all fours in the corridor, I was moved to “somewhere more appropriate”, which turned out to be a triage room. It took some persuading to get me off the floor and onto the bed to be examined. The routine blood pressure test and internal exam seemed unnecessary to me when I was certain that what I needed was to be taken to my own room and left alone. I only agreed on the grounds that after this there would be no more routine exams. The midwife checked my dilation and went to fetch a more senior colleague who also examined me. I watched them realise what I already knew: my labour was well advanced.

The midwife led us to a small room with no bathroom. I requested that the lights be lowered and the resuscitation equipment pushed to one side. The blankets, fairy lights and pictures that I had so carefully selected to make my hospital room feel more homely remained untouched in my hospital bag. All I wanted was to kneel on the floor, leaning over a couple of pillows, and disappear back into the headphones’ cocoon. I hardly noticed when my private midwife arrived and various hospital staff came and went. Surges of pain ebbed through me with no clear beginning or ending. I found myself chanting as their intensity increased, sometimes Buddhist chants my mother had taught me, sometimes instructions like ‘relax, relax, relax, relax, relax, relax, relax,’. When the intensity slowed, I would tune into the music playing on my ipod, occasionally giggling at song lyrics. “Nothing’s gonna change my world,” sang John Lennon, as my world was in the process of changing forever. The surges rose up regularly and relentlessly, crashing over my body. There was only one occasion during the labour when I integrated the contraction into my being, instead of trying to escape it. I rode the feeling, rising to meet it with my breath. It was my only glimpse of how labour could be experienced without feeling pain in its usual sense.

The surges continued and I was starting to get tired. I wriggled around on the floor searching for a position where I could rest a little. But as I lay on my side I had the sense that it was a mistake to try to slow the surges’ intensity. It seemed that any momentary relief would merely slow the juggernaut of labour. There was no way out but through.

My midwife suggested I stood and leaned over the bed, swaying my hips from side to side. I managed this until the next surge propelled me to climb onto the bed, where I would stay, on all fours, for the rest of the labour. My birth plan specified that I should not be offered pain relief and I was so overwhelmed by sensation that the idea didn’t enter my mind. What I did do was tell my boyfriend that I didn’t think I could do it. “You’re doing it,” he replied. I gained strength from knowing he was at my side throughout it all; holding my hand, rubbing my shoulders, encouraging me to relax my clenched jaw and making sure I kept drinking water. Seeing that I was flagging, my private midwife waited until the hospital midwife had left the room and encouraged me to eat. (Eating is generally discouraged in hospital because it increases the risk of complications should a labouring woman go on to need a general anaesthetic.) Instead of eating, I slurped a carton of apple juice and felt replenished by the sugar.

Every so often I would surface from the pure sensation of the surges and become aware of the people around me. I turned to my hospital midwife, who had already cared for me for over an hour, and said “Hello”, as if introducing myself for the first time. This represented a rare occasion during labour where my feelings towards her were not warped by circumstance. I hated her when she did her initial internal exams; when she explained that she needed a small lamp light in the room so she could see to write her notes; when she held the Doppler to my belly to check the heartbeat of my baby at ten-minute intervals. I also developed a passionate dislike for the objectively personable man who was the Consultant on duty. Although I was well aware of the risks associated with a vaginal breech delivery, he insisted that I remove my headphones so he could explain again and warn me about the possibility I might need a caesarean. “Just say what you’ve got to say quickly and I’ll consent,” I murmured; prepared to say anything so he’d go away.

The labour drove on and my hips began to feel as though they were about to burst from the pressure. Then, when the baby’s body started lowering into the birth canal the sensation changed completely. Still on my knees, I gripped the metal bed head and emitted a low, fast “Huh!”, like the sound made by someone doing martial arts. I felt prised apart and as though I couldn’t breathe. As the surge subsided I could feel my baby’s body slowly slide back up into my body. “Huh!”: the sensation of my baby’s body moving down again. I felt it slide back inside me. “Huh!”. “Huh!”. “Huh!”. The surges pulsed the baby’s body in and out, until it began to move down and stay down. “Huh!”. Somehow my headphones had been removed. I was kneeling on the bed facing the wall, unaware of the crowd of people gathered behind me. “Huuuhhh!”: I felt my body opening. At this point, my boyfriend would recount later, a tiny bottom emerged from my backside and did a swirling shit of treacle-black meconium. Another surge came and I went with the feeling, experiencing relief as a leg flopped down out of my vagina, then another. A downwards movement forced my body open and out slipped the arms. The baby was now out up to the chin and the surge subsided. “You need to push now,” said the midwife. “But I don’t feel the push feeling,” I replied. The directions issued by my body had got me this far and I was unwilling to listen to advice that ignored my instincts. But the medical team now gathered in the room explained that getting the baby out quickly was now imperative, so I forced myself to push like I was doing a shit.

I felt a tremendous rush of relief as my baby slipped fully from my flesh. I spun around and there on the end of the bed lay a lanky purple doll on its back. The Consultant rushed towards the silent, still baby to cut the cord. My boyfriend tried to stop him, hoping we could still achieve the delayed cord clamping set out in our birth plan. But our baby still hadn’t drawn a breath, and a medical chorus insisted that cutting the cord now was necessary. We consented quickly, the Consultant cut the cord and our baby yelped and opened its eyes. Everyone in the room cried out and sighed with joy. My baby looked so utterly unfamiliar, like a person I had never seen before. A paediatrician I hadn’t noticed until that moment whisked the baby over to the resuscitation equipment to perform some initial checks. “What kind of baby is it?” I asked my boyfriend. “It’s a girl,” he replied. It was 4.20am. I had been in the hospital for barely four hours. My baby weighed 7lbs and 3oz. Five minutes after her birth her Apgar score was 10. I had a small perineal tear, but apart from the stitches that sewed it up I had managed to avoid any intervention. We had made it. She was safe. She was well. So was I. I felt elated.

My daughter was not born at home surrounded by the sights, smells and people now familiar to her, as I had hoped. She was born in a room filled with wipe-down surfaces, strangers and her parents. Her birth was not what I had imagined. But it was good enough.

1) Hannah, M, et al. (2000) ‘Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial’. The Lancet, vol. 356, issue 9239, pp.1375-1383.

2) Glezerman, M. (2006) ‘Five years to the term breech trial: the rise and fall of a randomized controlled trial.’ American Journal of Obstetrics and Gynecology, vol. 194, 1, pp.20-25.

3) Royal College of Obstetricians & Gynaecologists (2017) Management of Breech Presentation (Greentop Guideline No. 20b).

Filed Under: Birth Stories, Featured Tagged With: diagnosed, doctor, ECV, hospital, midwife, moxibustion, planned

Sarah and Michael’s breech birth story

So after a lot of thinking I have decided to share my pregnancy story in the hope it helps other mummies and daddies to be.

I found out I was pregnant with my sixth child and me and my husband were over the moon. We decided to have our baby in Lewisham Birth Centre and couldn’t wait till the day came when we got to meet our bundle of joy. Everything was going according to plan – we had our 12 week scan and baby had a strong heartbeat and was growing lovely. Me, my husband and our children were so happy to see her.

Then we had our 20 week scan and found out we were having a girl and were so happy – we had our name picked. Baby Niamh was due on the 9/9/19. We were all so excited – we couldn’t wait to meet baby Niamh to see who she looked like, what colour eyes she would have, what colour hair she would have. We then had our 32 week scan and baby Niamh was breech. We weren’t worried as at this stage there was still time for baby Niamh to turn.

So at 36 weeks I went to see my amazing midwife and she then told me that baby Niamh was still breech. I had to have a scan just to make sure baby was breech and talk through my options. So I went for my scan the next day and was told baby Niamh was definitely breech and there were a few choices I had. The choices were talk to a consultant about a cesarean, or try an ECV (external cephalic version) to try and turn baby Niamh, or have a breech vaginal birth, but there was no way I could have my baby in the birth centre. So I went away feeling a bit worried about a breech baby and disappointed that I couldn’t have Niamh in the birth centre, but I was looking forward to talking through my options with a consultant.

At 37 weeks I had an ECV to try and turn baby Niamh – she was monitored constantly to make sure her heart rate didn’t drop but her bum was firmly in place in my pelvis and they couldn’t move her. So I had a scan at 38 weeks just to see if baby Niamh was still breech. She was so I saw a consultant/senior doctor. This was such a bad experience I cried and cried after this appointment feeling worried I was going to be putting my baby at risk if I went ahead with a breech birth and then on the other hand I was putting myself at risk if I had a cesarean. I was booked in for a cesarean for the 7/9/19, 2 days before my due day and really wasn’t looking forward to major surgery as I had 5 other children.

I then spoke to my midwife as I was so unhappy about my consultant appointment. My midwife phoned me and spoke to me for a while trying to calm me down and talk me through things. She then said that she wanted me to speak to her manager (a lovely lady) so she passed my details on to her manager and told her what had happened. Her manager then phoned me and asked me to go in and see her. We spoke about a cesarean and also a breech birth. She made me feel a bit better about it all. I was still nervous but feeling better.

She also phoned the labour ward to see if they could fit me in for another ECV. Which they did so I went along to try and get baby Niamh turned again. Sadly it was unsuccessful again. Niamh’s bum was firmly in place in my pelvis and wanted to be born breech (cheeky baby). I was then trying everything I could to get baby Niamh moving so I could have a breech birth but nothing seemed to work, she was just too comfy.

It then came the day 5/9/19 to have my pre-assessment for my cesarean so I went along to Lewisham Hospital to have my bloods taken and find out what time I had to be in on the day of my cesarean. The midwife I saw was absolutely amazing – she asked me if I was 100% sure I wanted a cesarean. I said no I didn’t want it but baby Niamh didn’t want to move. The midwife then asked me if I wanted to push back the date of my cesarean to give Niamh more time to come naturally so of course I said yes and was so happy so my cesarean was now booked for the 9/9/19 my due day.

I asked if I could have a sweep as it worked with my last daughter. So in came a matron (absolutely lovely) and I had a sweep and she said she could feel baby Niamh’s bum so I was excited things might start moving soon. I then went home and drank more raspberry leaf tea, bounced on my ball, went for walks, but still baby Niamh didn’t want to move. So on the 7/9/19 I went back to the hospital for my pre assessment. When I got there I saw the same midwives again, had my pre assessment done and also had another sweep in the hope it would work.

Then on the 8/9/19 my waters broke. I was so happy I phoned the hospital and off I went to give birth to my breech baby. I was still a bit nervous as I have never given birth breech before but it was just as simple as a normal (head down) birth. The midwife on the labour ward knew about baby Niamh being breech and talked me through who would be in the room when I gave birth.

Then the time was here to push. Her bum was coming, then her legs came, then her arms, then the final push and she was in my arms. All the worry was over. She was here safe and sound and perfect. I gave birth to a breech baby. I was fine and healthy and baby Niamh Fionnuala was finally here happy and healthy.

It was such an amazing experience I would do it all over again. I’m so proud to say I gave birth to a breech baby and to share my amazing story with you. I hope this helps some mummies to be feel at ease with a breech birth.

Stay positive you can do it. Good luck!

Filed Under: Birth Stories, Featured Tagged With: birth centre, diagnosed, ECV, midwife, planned, vaginal

A midwife-supported home breech birth

“I was surrounded by mothers who all labored at one time. With the next contraction, I began thinking of my midwife, the talented Lora Burgess who passed away last year, who worked with Evelyn who always said that there are some births that fathers shouldn’t attend. She was right… With each contraction, my midwives, my mother and my friend would breathe with me, sigh with me, and rest in between. They labored right with me and their support, along with counter pressure from Christina, and her whisperings of support and love made me feel that Lora was right in the room with us, nodding her approval and smiling.”

“I didn’t want a c-section unless my baby was in danger. She never was. Her fluid was perfect, her placenta was posterior, her cord was adequate, and she merely arrived bottom first in 4 of the most intense pushes that I have ever experienced. With vertex babies (my previous 4 were posterior vertex), the “work” is basically over once the head and shoulders emerge. The rest of the baby sort of slithers out quickly. Not so with breech babies. I had to work for every inch of my baby daughter’s arrival. The first pushes of her birth exposed her bottom. (She pooped….not unusual for breech babies when their bottoms are exposed to the cool air). The next brought forth her legs because her hips were flexed and her legs were folded Indian style against her body. I roared with the push that brought her shoulders, and lastly, one enormous push later her head was born and I couldn’t believe that Evelyn was saying, “Carla, take your baby!” in a shocked voice.”

http://enjoybirth.com/blog/2008/08/21/beautiful-breech-homebirth-story/

Filed Under: Birth Stories Tagged With: ECV, home, independent midwife, planned, vaginal

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