Potential Unassisted Birth

[Anjali]

Hi Ladies!

I'm trying to stay momma bear strong through my situation and could use some input.

My little lady is due anytime in the next two weeks and she's breech posterior (her back on my back). I've done everything in the world to turn her around and so far no progress. (Moxibustion, acupuncture, chiropractor, crawling around on hands and knees, ice packs to her head, peppermint oil to her heard, inversions, pelvic tilts, pelvic rocking, etc.) I will continue to do all these things in hopes that she will turn around last minute. There is only one doc here who will deliver a breech vaginally, otherwise you get an automatic csec. I consulted with him yesterday to find out that baby has turned a bit and she's no longer posterior (yay) and her back is on my left, and she's a frank breech. This is great news as far as breeches go. He agreed to take me on as a client even though I'm a first time mom, unfortunately he's out fishing for the two weeks that I'm supposed to go into labor and he won't be able to come back for me. My options are slim as our midwives are legally not allowed to deliver breech at home.

We've had a super healthy and wonderful pregnancy and we have planned a home birth. Because of the breech position, my current options as they stand are to find a travelling midwife, to have a csec, or to have an unassisted birth. Hubby and I have been doing a lot of thinking and our gut feeling is really telling us to have her at home. It's a bit of an unsettling decision logically because of the fear mongering, however I know for a fact that breech, if the pregnancy is healthy (and it is), is not a hard delivery and is safe. There are obviously risks just like with any birth, however at this point I feel like it's safer and a better option for us than to have a major invasive surgery for no reason. I know my body can do this wonderfully, and my midwife would be able to come right after. I've told my MIL about this and she understands as we have no options really, but I can't tell the other grandparents as they would never understand or support it and I can't handle any criticism or judgment right now as I'm doing my best to stay strong and make the best decision for my child.

I don't know ladies, I just can't see myself taking away my homebirth from myself or my child and getting a huge, invasive, nonemergent surgery for the sake of a stupid legality. I want her to have a wonderful birth setting and I want calm and peace. I really feel strongly and positively that this is the best thing to do if she indeed does not turn around before or during labor.

Any thoughts?

 

[Srrme]

It's nice to see another Colorado mama!

If you've done the research, and you're comfortable with your decision, go with it. Have you considered what would happen/what you would do if an emergency arises? I would consider all options though and outweigh the pros and cons before making a definite decision.

I just had a home birth, and it was a beautiful experience. I've wanted one since my first pregnancy, but was unable to with my previous babies due to my first 2 being premature, and not knowing I was even allowed to have one with my 3rd.

 

[LoraLoo]

I would absolutely not consider an at home unassisted breach birth. I would not put my own desire before my baby's life, but the decision is yours alone. All the best in what ever you decide to do- hope Lo turns in time for delivery x

 

[crownest]

I totally understand that you want as natural a birth as possible but if you showed up at hospital and your doctor is unavailable surely no other doctor can force you to have c section. There is a reason midwives aren't comfortable with it and doctor google isn't reliable. But you know your body I wish you a safe and happy birthday whatever you choose.

 

[Anjali]

I totally understand that you want as natural a birth as possible but if you showed up at hospital and your doctor is unavailable surely no other doctor can force you to have c section. There is a reason midwives aren't comfortable with it and doctor google isn't reliable. But you know your body I wish you a safe and happy birthday whatever you choose.

A hospital can actually turn you away if you choose not to agree to a csection. Midwives have no problem doing it and actually have more experience with breeches than doctors for many reasons; it has been made illegal for midwives to attend breech births at home.

I appreciate it!

 

[tankel]

I think if you are prepared then to go for it. I see that there is some slight negativity on this thread about your decision and it makes me a little sad. Choosing a different path does not mean that you are endangering you or you baby. I hope that your baby turns before labor starts; but mostly I hope you have a happy, healthy, and wonderful birthing experience whatever you choose. PS if I were in your situation, I would probably take the same route.

 

[LoraLoo]

It's not being negTive it's being realistic- she asked got thoughts and I'm pretty sure when she asked that she was asking for honest opinions and not sugar coated ones.

 

[Quantea]

I will have to agree with LoraLoo.

Please, do not get offended by this, but I am honestly giving you my earnest opinion with the best intent possible.

I have put the rest under the cut in case someone finds it upsetting...

Spoiler

Personally, I would be 100 times more concerned with the safety of my baby rather than me possibly having a good time, or making good memories. A breech birth has possible complications that cannot be treated at home. In other words, if anything goes wrong, you will be risking your baby's life (I am terribly sorry for the bluntness). This is not an imaginary risk, but an actual reality that you should also prepare yourself for.

I have tried to pool some numbers for you which I hope may aid you with your decision. First of all, doing a breech vaginal birth with strict selection criteria at the hospital carries a triple to quadruple risk of perinatal mortality compared to CS. That is 3 to 4 times higher chances of a baby dying, regardless of all other complications, at a hospital with an OB/GYN and a surgical team waiting on the fly. Even with a specialist, a breech VB requires special handling and turning of the baby in order to avoid damage to the head and spine or to release an entrapped arm or head, which is why only experienced doctors that specialize in breech births will take one on. There needs to be special screening (such as checking for the baby's head size and your pelvic dimensions). This being your first VB does not help either. Most midwives no longer have the experience to do the special turning maneuvers to safely lead the baby out, which is probably why they will not take you on. Those that claim they have experience have usually only seen a couple of surprise breech births without complications. There is no data on home breech birth alone, because no one would seriously consider it.

The closest thing I could find to it is this...

If you feel strongly about VB, I would perhaps still pursue a VB at a hospital with another specialist if I were you. But if other doctors, in a hospital, with baby heart monitors and surgical teams on standby ready to swoop in and intervene are afraid of doing this, why would you consider doing it home by yourself? Simply closing your eyes to the risks does not mean they are not there.

And please, do not be offended by this. I hate being strict or upsetting other people, but I am only writing this with the best intentions in mind. Too many people often try to tell us what we want to hear and it's a temptation to keep quiet and stay out of it, but then it wouldn't feel right.

 

[BunnyN]

In general, not specifically about this situation or any particular comment, a lot of people make the mistake of thinking that a mother who wants a good birth experience is putting her baby's interests in second place. I think it makes more sense to take for granted that most mums want whats best for their babies. For me choosing home births was as much about what was best for my babies as it was about what was best for me. I believe that when possible having as relaxed and natural environment as possible can acctually make for a safer birth with less negative side effects for mother and baby. And as a side point as long as the baby is safe why not have as good an experience as possible . I have met with some heavy predudice against home birth that wasnt based on any evidence. I found it upsetting when people assumed I cared more about 'the experience' than my baby. The emotions on either side of the argument can make it hard to make choices based on evidence and to me that was what was important.

Personally I would have strong reservations about an unassisted breach birth at home. Information I have found on it suggests a higher level of risk than I would be comfortable with. Another reason is that the independent MW we had for both births said she under no circumstances will she attend a breach birth anymore. She is very pro HB and pro choice etc. She isnt one for getting too caught up on following 'the rules' without good reason.

In all honesty I think in your situation, if those are your only two options, I'd go with the CS. However I am not in your situation. Thankfully both mine settled head down early on . I do know what it is like to have narrowing options and not feel 100% happy with any choice. It feels like your only choices are extreme. I am very grateful that in the end we found an independent MW we were very happy with. It's easy to make a choice in theory, when you are the one making the choice IRL it is suddenly so much more real and important to do what is right for you and your baby. No one is going to spend more time thinking about it, researching options etc, and no one cares more about it being the right choice. It is your choice to make. Just make sure you do your reseach and know the facts, dont make it based only on emotion from either side of the issue. If you make an informed decision you deserve support from everyone.

It is still worth considering a VB at hospital with a different doctor as a third option but I can also see why you may decide it isnt a real choice. Having a breach VB with a doctor that has no experience and is stongly against your choice could end up actually making it more dangerous in some ways. They could end up making some situations worse and if things became critical how much would they acctually be able to help? Again its something that is worth researching.

 

[tankel]

I guess I should clarify, I was not trying to be combative. I just think that breach births are totally doable and at home and unassisted. If give the choice between a (potentially) unnecessary cs and doing a free-birth, I would choose home birth; but then again, I live 5 mins away from hospital. I appreciate Bunny's eloquent wording, as she was able to better phase what I was trying to say. When someone has a home birth unassisted or not, it should not be automatically assumed that they care only about their experience and not the health and welfare of their baby.

 

[LoraLoo]

The trouble is, she don't know if a breech unassisted birth is possible, until she Is in labour/delivering, by which time it may be too late. There are a LOT of risks with a breech birth.
nobody has stated that she doesn't care about the welfare of her baby, however, if she was looking for one sided opinions then it was the wrong place to ask.
There are times when you reAlly need to listen and take on board medical advice and I believe this is one of those times.

 

[tankel]

LoraLoo: I agree totally with you that there are times when medical advice is key.

I only hope that baby turns the heck around in time!

 

[Quantea]

I think I need to apologize for my off wording, I sometimes can't express myself well in writing and it comes across the wrong way. I never meant to imply that people that choose HB don't care about their baby's safety. It is almost always decided out of the desire to provide the best possible start to a much loved baby.

However, in this case, an unassisted vaginal breech delivery, we are talking about a type of birth that carries a LOT of risks (like LoraLoo said) which doctors and midwives have already advised against. This reluctance from other people to take on such a case is not because it is a safe and natural type of birth with some legal technicalities on the side. There are actual objective reasons. So, if there is an established objective risk on one side of the scale, what would make it lean on the other side for the OP? I have come to regret it as it was probably inappropriate, but I only meant to say that I only weigh in the risks in this kind of situations and not my emotions. Again, bad delivery, sorry.

In the end, I truly hope that your baby turns Anjali and that everything works out alright. I am not trying to be critical or belittle your choices. I am not against HB or vaginal breech birth, but the unassisted home vaginal breech birth would frankly worry me personally, which is why I went on to speak to you as I would to a family member. Furthermore, you don't have to take our word for it. If you are seriously considering it, may I suggest seeking out more information from people with experience on the matter? Perhaps discuss the possible complications of such a birth with the OB that specializes on vaginal breech delivery(before he goes away for fishing)? He has probably overseen lots of them and will most likely have a better idea, or even advice. Or ask if there might be another breech specialist within a reasonable driving distance that you could be referred to.

In any case, I can only wish the best and hope everything works out alright for you.

 

[tankel]

Well said Quantea.

 

[NDH]

Would *I* have an unassisted breech birth? Yes absolutely (I say this as a woman already planning to freebirth and has already had a vaginal breech birth - though in hospital - and is well researched in breech births)

Would I encourage anyone else to have an unassisted breech birth? Definitely not.

would I support someone who made the informed choice to do so? You betcha.


its a shame breech births - especially hands off ones - are harder and harder to provide support for, As the lack of experienced support is what is making them riskier. And a flawed study that made lawyers -not drs or Midwives with the experience mons you but lawyers - decide its too risky to "allow" women to exercise their autonomy is at the root of it.

its not drs and Midwives for the most part saying breech births ate risky, its hospital policies and insurance companies calling the shots. Certainly breech carries an element of higher risk than vertex, but in the hands of an experienced provider or confident unhindered woman the risk is not nearly as high as made out to be.

my first choice would be a homebirth or very hands off hospital birth with an experienced practitioner, but if that wasn't an option yes I would stay home definitely.

I drove 3 hours to a breech friendly hospital last time as I wasn't confident to go unassisted then and had no closer options.

 

[tankel]

I pretty sure that we should be friends, NDH.

 

[BunnyN]

I actually think this thread has ended up with some really balanced opinions on both sides of the subject.

 

[Quantea]

I agree, even though Anjali hasn't been back to let us know what she decided, so we were kinda left discussing it on our own, heh. Figured she would probably be busy taking care of a newborn by now

 

[BunnyN]

Lol, yeh. I really hope it went okay for her whatever she decided. Its a hard choice.

 

[Anjali]

I think if you are prepared then to go for it. I see that there is some slight negativity on this thread about your decision and it makes me a little sad. Choosing a different path does not mean that you are endangering you or you baby. I hope that your baby turns before labor starts; but mostly I hope you have a happy, healthy, and wonderful birthing experience whatever you choose. PS if I were in your situation, I would probably take the same route.

Thank you so much, I really appreciate that! It was most definitely not an easy decision to make as I only had two, both of which were not ideal. I guess we can thank the legal system for getting into women's vaginas. It's been a tough road but we are ready and looking forward to meeting our baby.

There is of course sometimes an opinion that doesn't line up with mine and that's okay, I have done my research and know what's best for me and baby, and I'm sure it's just as difficult to voice dissent with my opinion as it is for me to open up about choosing this option. I do appreciate the support, however!