Potential Unassisted Birth

[Anjali]

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.

Thanks for your honesty, I'm not offended. I have done my research and my numbers are a bit different than yours. You also have to look behind the numbers as studies are often inaccurate and not presented as so. From my research, in a healthy and complication-free pregnancy, vaginal breech births have very low risks and are just as safe, if not safer for a fully healthy mother and baby. Though the risks of unassisted vaginal breech births are often discussed, I think the risks of c-section births are not discussed enough, and there's info out there about that as well. There are just as many risks and dangers to both mother and baby and even more so in breech births.

I wasn't so much concerned about experiences or memories alone. I have been concerned with every factor, as any mother would be of course. But I do consider other factors outside of mortality, since I have considered that as well and since I have found the risk or that factor to be low in my condition.

Again, thanks for your honesty and for disagreeing amicably.

 

[NDH]

You have ky support too and I wish you the best

 

[Anjali]

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.

You sound well informed, thanks for your input. You're absolutely right about the emotional aspects and the misinformation, as well as others' assumptions. It has been a difficult decision and we love our baby more than anyone, so obviously we want to do the best for her and our family. I do have to add however that if you look at the studies (which aren't always accurate or truthful either), and look behind them (really look into the numbers and statistics beyond the numbers), home births are just as safe if not safer than c-sections with the same number of risks. For breech it has been said to be safer for numerous reasons, some of which you stated. I do agree there is a slightly elevated risk with unassisted births, however breech is often considered a variation or normal and specifically frank breech (our position) is just as easy to birth as vertex babies. Unfortunately vaginally birthing breech is a lost art and midwives are legally prohibited from doing it, though some will anyway. Unfortunately we don't have anyone who will do that, so it's either us or a csec. I appreciate the respectful response

 

[Anjali]

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.

Breech unassisted birth is possible and fully legal here, if that's what you mean. Baby is still head up in a Frank breech position, the safest breech position, which is just as safe to birth as vertex babies, if you look into it. I was not at all looking for a one sided opinion and appreciate the input, I do however disagree that breech births have a 'lot' of risks. I often hear that from people who haven't researched into it, mostly because the 'risks' of breech are often yelled out louder than the risks of csecs because csecs have become more routine. I agree that there are times when you can choose to agree with medical advice, however I do my own research first as it is my baby and as doctors usually perform routine orders vs functioning based on current research, but I won't go into that. Rest assured that I care about my baby and do believe after much painstaking effort to make the best decision that we can that this really is best for us. Thanks for your advice!

 

[Anjali]

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.

Thanks, appreciate your input. I have spoken with an OBGYN and he was going to take me on as a candidate for a vaginal breech birth in a hospital. He's the only one that does them here, and rarely takes on first time moms. He decided to take me on because of how healthy baby and I are, and because we have and have had no complications at any point. Unfortunately, he's out the two weeks that I'm due, leaving me with the two options I had: csec or unassisted.

I have indeed spoken to as many professionals on the matter as I could find, and gotten as much advice and opinions as I could. My husband made a very, very informed decision. Had I had complications in my pregnancy or had high blood pressure etc., I may have gone for the csec. It's certainly not something I'm afraid of or wouldn't do for my baby, I just honestly don't believe it's best for us. That's my intuition as a mother, and it's definitely not an easy choice to make in this society but I guess sometimes we have to be the black sheep to do what we truly believe is best for our children. I also want to clarify that we are in the lowest risk category (and that breech home delivery already has very low risks) and that the hospital is very close. We have of course considered that. I'm saying that mostly to put some of you at ease, not to back my decision or anything like that. But I do thank you ladies for being open minded and understanding. Statistics and research is often inaccurate and misleading and we can look things up to death and I believe that a mother's intuition is often the bulk of such an important decision, so that's for backing mine even if you disagree.

Also, 39.5 weeks now and baby is still breech, and very happy and healthy. I'm a lucky momma to have such a healthy baby and I'm counting my blessings! Breech is not the worst thing in the world and I truly believe it is a variation of normal.

 

[Anjali]

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.

Thanks for the support and for being informed! Yes, unfortunately those are not options as unassisted for my first child isn't our first option either, but I believe our children and our experiences are gifts in disguise sometimes and she's given me strength I didn't know I had because of all this. Our closest drive to any sort of assisted vaginal delivery would be at least 8 hours, not something I can do at this late in my pregnancy or something I'd drive back with a newborn. I guess we make do with what we have, and we are celebrating the soon-to-be arrival of our baby girl. Thanks again!

 

[LoraLoo]

No I mean physically birth the baby. Breech unassisted births MAY be possible in some cases, not all. Same as any 'normal' birth- you don't know how it's going to go until it's happening.
I'm in the uk so a midwife could not refuse to assist you here, so it's different.
What are your options if bAbys head becomes stuck which is a risk with breech births? Will the hospital assist you in that scenario? Will you get to hospital in time? What happens if the cord prolapses? These are the risks I worry about. This is what I mean by you not knowing until the time comes.
Of course there is a risk with any labour, but most people have a back up plan, I'm just not sure what your back up plan would be if things did go horribly wrong? That's ignorance on my part because things are obviously different where you are.
You seem to have reached a decision though, so all I can do is wish you luck for a healthy labour and birth. Also, Whilst I have a different opinion to you, I would always, absolutely agree that it is always Mums choice to make. The day choice is taken away from us is the day we need to worry. Please update us how it goes?

 

[Anjali]

Sorry it took me a while to respond ladies, I honestly didn't think I'd get this much feedback.

I appreciate all your comments, whether you agreed with our decision or not. It's been difficult having two imperfect options, and I've been mad at the government and the system for making laws on how I can and can't birth. However overall we have made our decision to birth unassisted at home and have made peace with it and are now just waiting on her arrival any day now She's our first baby and we are smitten to meet the little head that pokes out of my abdomen rowdily on a daily basis

We get checked out by my midwife regularly though we are not really in her care anymore, and baby and I are in phenomenal health. She has never had a stressed heartbeat even when we attempted turning her and she's been such a trooper about all my techniques to try to turn her. She just doesn't want to turn and I think she's just blissful the way she is. I guess head down isn't for everyone. She's a happy, healthy baby and we are so grateful, our issues could be worse than breech I think! So in the end we will birth her at home as we feel this is the best decision and we have done our very, very best to make this decision and prepare for it. I know that years from now I will look back on this and laugh that I stressed so much about it, and I'll know that this was one of my first trials as a parent. I'm super confident in my body and my husband and myself and that the birth will be a powerful, amazing experience and that our baby will be perfect and healthy. Of course in case of an emergency, we are prepared and have multiple plans. We are so excited to have settled down emotionally and mentally as it has been difficult consoling our family when we should be the ones being consoled in this difficult time, but my husband and I have found the strength to get behind our decision fully and celebrate this.

I want to thank you all for your wonderful ability to be open minded and not judge, and to leave room for decisions that aren't 'routine', because making these decisions is not easy for any of us and all we really want is the best for our little ones. So I thank you all for not being critical and for finding support for me in this time I really mean that.

The little lady is due any day now (due date is 17th) and we are exuberantly waiting on her arrival! I will absolutely come back and give you all the wonderful news when she arrives, and will maybe share a picture or two

All my love!

 

[tankel]

It warms my heart to hear that you have made a decision that you feel is right biased on the imperfect options given to you. I wish you the best.

 

[Anjali]

Hi ladies! Just a quick update.. just hit my due date two days ago (now 40 weeks) and we are waiting for our little girl to show up any day now! It's so exciting!

We did have an unfortunate incident where our birth photographer decided last minute (two days ago) that she will not attend our birth because her lawyers instructed her to 'stay far far away' from us and our birth and also in her own words, her friends have instructed her to not do our newborn or family session either. We did offer to sign any legal documents drafted up by her attorney to release her of any liability prior to that announcement, but I guess that didn't make a difference. The discrimination was beyond hurtful and awful to go through at this point in our birth as we won't even be able to find a replacement photographer this short term, but we are keeping strong and are just focusing on the positive: meeting our precious girl. My husband has ordered a good lens and we will try to snap some shots when we can, so that's the way it will have to be. Now I also have to worry about finding a new photographer for newborn and family pics as well.. though I do not understand how or why that was an issue. Sometimes it's hard to wake up and realize that this is the world we live in, where my baby's birth has been treated like a funeral since the day someone uttered the word 'breech'. Anyhow, we will pull through and after many alligator tears we are just excited for when labor starts, as it will be a new chapter in our lives. I can't wait to share it with all of you!

A

 

[LoraLoo]

I'm sorry your photographer has pulled out, that's very sad and not professional of her at all in my opinion. I'm sure you will get lots of your own photographs though, and hopefully they'll feel more personal because hubby will have taken them.
Really looking forward to your birth story. Best of luck.

 

[NDH]

I'm so sorry you've had your photographer pull out last minute If that's her attitude though it may be for the best though as she probably would have brought a lot if fear into the birth which you don't need, especially with breech.
Do you have any birth-minded friends who might come and take photos? Even not being professional photos would be better than nothing or relying on hubby to remember to do it. I have no photos of my births which I really regret as we had counted on hubby taking some but I wouldn't let go of his hands, and then the second time my doula was going to, but when I went 3 hours away at the last minute I lost my birth team so again no pictures.

I just want to tell you as well how much I admire your strength. It took my two births to get to where you are, and at a time when the world is telling you to be afraid you're rising above it.

 

[vermeil]

Aww how awful of your photographer! Sorry to hear that. Hope she manages to turn somehow, if there is still room to wiggle! Can a friend come take pictures?

I respect and understand your reasons though it would not be my choice. My son was a micropreemie; I would have given birth any which way if it increased his survival odds. My friend who made it to term was very sad because she didnt get the homebirth she wanted. To me I don't " get it", but clearly to her it was very important so i respected that and mourned her lost homebirth with her. I think my preemie experience coloured the topic for me. You seem well informed and prepared for this great moment!

Spoiler

in the preemie section theres a recent story of a hospital breech birth with complications. Don't know if you've seen it it called "so scared". Obviously don't read if you don't want to. Like I said you seem well informed and already prepared for the possible complications.

Wishing you the best! Hope your little girl makes her grand entrance soon!

 

[Anjali]

Thank you all for the support!

We unfortunately don't really have friends here yet because we just moved to a new state a few months ago. I did call around to see if anyone else could take photos for us as a last attempt, but no one wanted to take on the 'liability'. Which is fine, it will be more intimate this way. We will set up a timer on a camera and set it up in the corner on an interval, and we'll try to get shots during the most important moments if we can.

NDH, thank you. Though I was forced into the situation, I do feel like it has given me a new strength and confidence that I would not otherwise have had to reach for. Prior to this I considered doing unassisted one day, but not with my first. It was a terrifying decision to make, but I am confident in myself, my body, and my baby. I think a majority of problems with birth started when women were told how and where to birth by people who thought they knew better than a mother's innate knowing. I really appreciate the kind words.

Vermeil, thank you for sharing your experience. I hope your birth went fantastically well. I probably will not read the story you suggested as I want to stay in a particular mindset at this time, however I do want to say that breech babies seem to be safer born outside of intervention, based on my research. Breech babies do worse with c-sections and are not happy with any sort of 'hands-on' treatment. Perhaps it's part nature and part personality, who knows. Thank you for the vote of confidence!

Will of course keep you all updated. Can't thank you enough for your support and interest in the situation. Definitely helps to have someone to talk to outside of my very worried mother

A

 

[tankel]

Oh man, you should be ready to pop at any moment. I'm looking forward to hearing your birth story.

 

[Anjali]

Oh man, you should be ready to pop at any moment. I'm looking forward to hearing your birth story.

I feel like I am! Want her to come when she's good and ready but can't lie that I'm ready to have her out of me lol.

Thank you so much!

 

[vermeil]

Hello! Itotally understandabout remaining in a certain mindset.. So no appearance yet? Aww was thinking of you and hoping today might be the day. I'm sure you'll get to meet her soon

 

[Anjali]

Hello! Itotally understandabout remaining in a certain mindset.. So no appearance yet? Aww was thinking of you and hoping today might be the day. I'm sure you'll get to meet her soon

No baby yet! Still waiting. But my cramps are getting stronger so I suspect I've been dilating and effacing efficiently. My guess is within a few day's time, but who knows!

 

[tankel]

Yay! good luck!

 

[Anjali]

My water broke this morning!!

3 hours ago, to be exact. I was sleeping and GUSH! This is our first baby so I was in a bit of shock and surprise and got a little nervous, but luckily my husband stayed calm and collected and was just perfect.

We are filling our pool and placing chux pads on the floor and generally preparing. We had breakfast and some tea, and I'm trying to do 'normal' things to stay grounded and calm. I generally feel great, having more intense contractions, but nothing crazy. I'll start timing them once I feel like they are more regular. I have a good feeling about this and I think everything will go super smoothly!

Ladies I have to tell you, we do amazing things by birthing babies. I cannot believe we create and grow them, then we birth a whole baby. I don't care where or how you've had your babies or how you will, but you are all super strong, miraculous, and incredible. I'm so ready for this!

Will update again when I can!