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Sophia’s story – a positive and empowering attempted HBAC

My beautiful baby Victoria was born on 14 July at 41+5 weighing 7lb 1oz. She is my second baby.

I had an unplanned c section with my first after two days of 2 in 10 contractions and a mini panic attack which prompted me to transfer in to hospital (had planned a home birth). Once in hospital I had a lot of unnecessary interventions that caused my son (and I) distress and I opted for a c section over further interventions.

When I got pregnant this time I knew the birth was going to be different and early on I planned an intervention free home birth after c section (HBAC). I also engaged private midwives at around 20 weeks pregnant to provide continuity of care.

At 31 weeks I had a private 4D scan where I was told baby was lying in the breech position. I wasn’t too phased by this as my son had also been breech at around the same gestation but then turned. As the weeks went on however I started to notice a hard lump at the top of my uterus that I hadn’t remembered feeling with my son. My midwife thought they might be knees at our 36 week antenatal appointment. I wasn’t sure however and booked in for a presentation scan at 37+1 when it was confirmed that baby was breech. The sonographer classed it as a footling breech but since doing a lot of research she was actually a complete breech with dropped feet. The doctor I saw after that scan basically told me my only option was an elective c section at 39 weeks. I said I was certainly not taking that option and would do my own research and even if I felt a c section was safer I would not choose the day, I would wait to go into labour because then I know my baby is ready to be born and you never know she could turn head down at any point.

Over the next week I did A LOT of research and concluded that a planned breech home birth was what I felt would allow the ideal conditions for a physiological safe birth.

Unfortunately I was told by my private midwives that they were not breech competent and thus could no longer support me at home, only as advocates, so if I still wanted a home birth I needed to arrange that with the hospital.

Arranging a breech HBAC with my hospital was no easy feat. I think I was probably the first person to request a breech HBAC. The last breech home birth was 5 years ago and that wasn’t an HBAC. It wasn’t until my due date that I finally received a letter from the hospital agreeing to support my birth plan with the help of an amazing independent midwife who luckily already had a contract with the hospital and was confident to support a breech birth. My private midwives were supposed to also attend the birth as advocates but at 40+5, the company they are employed by withdrew the contract so I lost their support which really upset me but at least I still had the plan in place with the hospital.

All of this fighting for the birth plan I wanted and the emotional rollercoaster it caused I have no doubt delayed me going into labour. I was getting period like pains for weeks and then in the week before I went into labour I would get bouts of contractions at night that would die off by the morning.

At 41+4, after dropping off my son at nursery, my husband and I decided to go for brunch at a nearby cafe. Whilst there, I had about 5 mild contractions and felt that things might be starting. After brunch I spent the rest of the day relaxing on my sofa watching Netflix and had a nap. Mild contractions kept coming and going about every 10-20 minutes. At around 6pm as I was preparing dinner I felt a couple of stronger contractions that I needed to breathe through. I texted my independent midwife (IM) and doula to let them know something might be starting. Sure enough a couple of hours later contractions ramped up and were coming at a more regular frequency and greater intensity. My IM lives only 10 minutes away so she popped round for a quick check in. All was well with me and baby so she went home to rest and I went to bed to try and sleep as best I can and save energy.

Just before midnight I had a very intense contraction which caused my waters to break quite spectacularly. I jumped out of bed and ran to the toilet, losing my mucus plug in one huge blob on the way. It was all quite exciting for me because with my first, my waters were artificially ruptured so to feel my body doing it naturally was exhilarating and it gave me a mental boost that things were progressing well. I texted my IM and doula and suggested they make their way over. I had a quick shower and went downstairs. My husband started sorting out the pool and thankfully my son was fast asleep. Over the next 3 hours I laboured in mostly upright positions and got in the pool (which felt amazing!).

At around 4am, the consultant midwife and a band 7 NHS midwife arrived (this was part of the plan agreed with the hospital). My living room started to feel quite crowded and I was getting more and more tired so I decided to go up to bed and lie down. The contractions felt more painful lying down but at least in between contractions I was able to rest.

At around 6am I agreed to my first VE. I was ecstatic to find out that I was 5cm and my baby’s bum and foot were engaging. My midwife said she could feel my baby’s toes curl around her fingers when she touched her foot! It seemed I was going to have a ‘dropped foot’ complete breech birth as I had expected. I had seen a birth video recently like this and decided to watch it again with my husband for motivation.

I then went back down to the living room and stayed upright which I felt was the position I managed best through the contractions which were now 3 in 10. After a couple of hours I was feeling very tired again so went back to my bedroom for the next few hours alternating between standing through each contraction and perching on the side of the bed whilst the midwives would knock on my door every 15 minutes to listen in to baby. All observations were reassuring but contractions weren’t getting any more intense or closer together. I eventually asked if we could change the listening in frequency to 30 minutes as I felt every 15 minutes was too frequent and was potentially disturbing progress.

At around 10am I was offered another VE but I declined and pushed it back to 12pm. I decided to change location and went to my son’s room who by that point my husband had taken to nursery. I had quite a few intense contractions and kept losing more amniotic fluid. I thought things might be ramping up. At 12pm I accepted my second VE, was feeling so hopeful, but unfortunately it was bad news. I was still 5cm, my baby’s foot was now poking through my cervix and her bum had actually moved back up my pelvis. This meant that there was a greater risk of cord prolapse due to there not being a tight wedge over my cervix. At this point the advice of all the midwives was to transfer to hospital. I was really unsure. In the weeks leading up to the birth I had connected with an expert in breech birth and decided to call her to ask for her opinion as well. She said that baby was probably trying to move themselves into a more optimal position for birth and although she had supported women to birth ‘dropped feet’ breech babies this was done in a hospital setting. Based on this I decided to go into the hospital and continue my labour there with every intention to still have a vaginal birth.

I refused to go in an ambulance as I live less than a 5 minute drive away. Despite this, the consultant midwife arranged for two ambulances to turn up at my house! I just walked passed them and my doula drove me and my IM to the hospital. Such a waste of resources!

At the hospital, I was lucky that the pool room was free. It was nice and spacious although a bit too bright because there were no blinds just frosted windows. I had told my IM I did not want a cannula and she was amazing in not even letting the anesthetist into the room to offer it to me! (I only found this out afterwards). I agreed to 30 minutes on the CTG and baby was doing just fine so I then reverted to intermittent monitoring every 30 minutes. I was determined to birth my baby, I was moving all around the room and used the pool for pain relief but I was losing strength as the day went on so I started to ask about other options for pain relief. I had 2 paracetamols, tried gas and air but didn’t like it. Considered pethidine so I could potentially sleep but then decided against it. An epidural was always a firm no due to wanting full sensation in my body for birth and my risks of complications being higher due to a couple of minor back conditions I have. So in the end I just carried on with my deep breathing and paracetamol.

At around 5pm I agreed to my third VE. Was absolutely gutted to find out I was still 5cm but was excited to hear that my baby had moved her foot back out of my cervix and her bum was now the presenting part (but not yet engaged). The mood music in the room was certainly one of this is not good, a c section is looking necessary but I was feeling positive that she was now in a better position and I just needed to do all I could to help her move down. So I asked for 2 more hours and even if I only made 0.5cm progress that would keep me going. So I got up, did some deep squats, my amazing doula and IM did the ‘labour dance’ (search it on You Tube- it’s great!) with me and I just kept upright moving around to hopefully encourage gravity to do its thing.

At 7:30pm I was checked again but sadly no change at all, still 5cm and there was swelling on my cervix. By this point my temperature had gone up slightly, there was some meconium in my waters, and baby’s baseline heart rate had gone up. As much as I didn’t want to accept it, I had to look at the situation – it was well over 24 hours from the first contractions – and realised at this point the safest way to birth my baby would have to be a c section.

I had a good cry as the anaesthetist inserted a cannula and read through the procedure and risks for a spinal block and c section. I reluctantly signed the paperwork and made my way to the operating theatre. I found my strength to ensure my gentle c section wishes were met so I had the curtain dropped when she was born, delayed cord clamping, my cord tie placed on her, skin to skin in theatre and the midwives took pictures of her birth. She was so calm when she was born, as though she slept through the whole thing!

The surgery felt like it took longer than with my first with a lot more tugging and pulling. I was also told that the incision had to be made slightly further down to my previous one, so now I have a scar for each baby but to be honest I don’t mind, might as well have a mark for each! The doctor said he didn’t see any signs of scar dehiscence so that was good news. The placenta looked really healthy although the cord was shorter than average which could potentially be a reason she was breech?

She was born at 21:16 and despite being 41+5 by that point, only weighed 7lb 1oz! Looking at her tiny bum, I did start to think how difficult it would have been for her to engage and apply enough pressure to my cervix! I really needed her head!

After the section I spent an hour in recovery and then a day on the postnatal ward before going home. The first week postpartum I was in a lot of pain and so upset that I ended up with another c section, another long recovery and another missed opportunity to experience a physiological birth. I can’t help but feel I am broken in some way given both times I planned a home birth and went into spontaneous labour but still ended up with sections. But looking at the facts, I had a long latent phase with my first with no sleep and got tired which factored into me transferring in and then not having the knowledge I have now to decline the unnecessary interventions that were made. And this time sadly it was an awkward breech presentation that just wouldn’t descend.

The things I am grateful for is that both times my babies chose their birthdays, we both experienced labour and my second labour experience in particular was really positive and empowering even though it didn’t end the way I had hoped.

I’m not currently planning on having any more children but if I do I will be attempting a hba2c and hopefully will be third time lucky!

Filed Under: Birth Stories, Featured Tagged With: complete breech, emergency c-section, footling, HBAC, home, hospital transfer, independent midwife, planned, VBAC

Anne’s story: a calm breech midwife-led VBAC

Back story: Ever since my (unnecessary emergency) Caesarean section with my first breech baby, there was nothing more I longed for to experience a natural vaginal birth. Hence, I was quite devastated when my second daughter turned breech at 33 weeks and nothing worked to turn her back (spinning baby positions, moxibustion, ECV, you name it).

Because I found the thought of a planned Caesarean unbearable and my current hospital wasn’t breech experienced enough/ advised against a VBB, I did a fair bit of research online. All I wanted was being able to give it another go whilst being fully aware that it could end up in another caesarean which I was totally ok with. It was pure luck that the wonderful and amazing Emma Spillane worked at a hospital (Kingston) that wasn’t too far from where we lived.

The day after I had contacted her I transferred hospitals at 37+1 and was so relieved and happy. Emma briefed me in detail about pros and cons and I was given a 40% chance of success. Labour started 1.5 weeks later with sporadic contractions every 10-20 minutes during the night (midnight to 6am) which paused during the day and then became more regular from 6:20pm onwards (every 5-7 minutes). 30 minutes later my waters went and we slowly made our way to the hospital.

At 10pm I was examined for the first time and was at 2-3cm. I was then put in a beautiful room in the birth centre as I wasn’t in established labour yet. Contractions remained at 5-7cm throughout the night. I was grateful for a slow labour as I could properly relax in between contractions. For the contractions I found it most comfortable to kneel in front of the birthing ball and have my upper body rest on it. At some point in the early morning I had to vomit which I thought was a sign that things were progressing. The best of it all, I was left alone to labour in peace and I felt like I was treated like any other laboring woman. A lovely midwife only checked in every now and then to see how I was coping.

I was examined again at 7am when I felt things were picking up a bit. It turned out I was 7cm dilated which meant I got transferred to the labour ward for the last stretch. I was able to find a similar position on the bed with the headrest up as I had before on the ball and before I knew it I was told it wouldn’t be much longer. I was offered gas & air which didn’t do anything to alleviate the “pain”/ pressure but it helped me tremendously with my breathing. It is also recommended for VBACs to have baby’s heart monitored which was a bit tricky in the position I and baby were in but we got there and the heartbeat was never a concern.

Elise was born at 8.52pm weighing 2890g. She had great oxygen levels and could be put on my chest straight away. I was close to needing a small cut but the next contraction was strong enough to avoid it after all. I ended up with a small tear but nothing to worry about. Overall, I couldn’t have asked for or imagined a better birth experience and will be forever grateful. I felt so incredibly well taken care of and supported throughout.

Filed Under: Birth Stories, Featured Tagged With: birth centre, hospital, midwife, vaginal, VBAC

A successful undiagnosed breech VBAC

An Australia breech VBAC, this time undiagnosed – a planned home birth with a transfer in labour and a successful breech delivery in hospital.

“While I was ‘considering’ the caesarean things were happening very quickly.”

“She unfolded like a beautiful butterfly, legs unfolding, followed by her arms. Not much happened for quite some time after that. It was the most amazing thing to look down and see her whole body, but no head, just hanging there!”

http://www.breechbirth.net/matildas-birth—vbbac.html

Filed Under: Birth Stories Tagged With: home, hospital, midwife, undiagnosed, vaginal, VBAC

One mother, three breech babies

A fabulous series of birth stories by one mother of three children, and all of them were breech.

“Women should feel empowered in their birth choices/experience & should trust in their inner strength and natural ability. Natural breech birth can be done & can be a wonderfully amazing & beautiful birth experience!!”

First – undiagnosed, resulting in an emergency c-section in labour

“I will never forget the feeling of being strapped down to the operating table & having my baby ripped out of me as the OB on duty chatted with the nurses drinking her coffee.”

http://www.mothersofchange.com/2012/07/my-breech-babies-part-i.html

Second – a planned natural breech VBAC in hospital

“I had nurses ask me the next day why I would try to deliver naturally when I knew the baby was breech.  All I can say is having gone through both a C-section and natural breech delivery – I would take the breech delivery any day!”

http://www.mothersofchange.com/2012/07/my-breech-babies-part-ii.html

And third – a planned natural breech VBAC in the same hospital

“He was delivered by the OB on duty and a resident as our OB watched – it was an amazing experience! The tone in the room was also so different this time as the staff were so positive about the breech birth and it was an atmosphere of “way to go, that was amazing – you did it” as opposed to “why would you try and do that” as with my 2nd.  The OB & resident were great & genuinely interested in my wellbeing & in being involved with a natural breech delivery.”

http://www.mothersofchange.com/2012/07/my-breech-babies-part-iii.html

Filed Under: Birth Stories Tagged With: diagnosed, emergency c-section, hospital, planned, undiagnosed, vaginal, VBAC

A video of a breech VBAC in hospital

A planned breech VBAC in hospital in Australia.

Labour lasted less than 3 hours from waters breaking to a successful breech birth (warning: graphic video content). Note the doctor reminding the midwife to stay “hands off” during the birth…

https://lactasticmamachatterings.wordpress.com/2014/01/16/roos-breech-birth-video-the-original/

Filed Under: Birth Stories Tagged With: diagnosed, hospital, planned, vaginal, VBAC, video

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