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!
He didn’t need any support with breathing, we had delayed cord clamping and some skin to skin then about 20 minutes later my husband cut the cord and had a cuddle whilst I had some stitches done. After that we were left for a good hour or so to have some lovely skin to skin and take it all in. We stayed in hospital for observations to be done on him due to him having slightly low blood sugar at birth but there were no further concerns and we went home the following day!