Many thanks to Nicole at Bellies and Babies for first posting these — they are awesome! They also give testimony to the voice of wisdom from those skilled in attending breech birth, namely, “hands off the breech.” One website (I believe a UK midwife’s site) said something about attending a breech birth along the lines of, “after the baby’s feet/legs/bum is born, go stand facing the corner of the room, and sip a beer s-l-o-w-l-y,” to allow the baby’s head to be born naturally. After watching these two videos, I understand a bit more why. In one of the videos, the contractions are five minutes apart, which seems agonizingly slow, to see the baby’s body dangling in the water… with his head and neck still inside the woman… and the umbilical cord is obviously next to his head… which makes me think of cord compression… and I want to reach through the screen and grab the baby and pull him out to safety. The other video is not that different, either in timing or in the length of time I was holding my breath! Whew! And if I have that reaction from watching a video clip, I can only imagine what it must feel like to actually be in the room, and be able to act (even if the action is misinformed, misguided, or downright dangerous).
And if you either have no skills or experience in breech birth, or if you want to brush up on them, be sure to read Rixa’s posts about the Breech Birth Conference in Ottawa recently: Day One, Day Two Part 1, and Day Two Part 2 — quite informative!
Putting the videos and the posts together makes me think that I’d rather go unassisted with a breech birth than to have a nervous care provider attending a vaginal birth. Some time ago, someone made a comment on a post at The Unnecesarean about being mad at herself for having accepted a C-section for breech presentation rather than trying to find a skilled breech-birth attendant, and says,
I guess I am also posting because I want to feel that I did the right thing, that it would be unwise to deliver breech while fighting the hospital and without a trained attendant. I still am mourning the birth I almost had.
Particularly hearing the “success stories” of the skilled attendants who spoke at the Breech Birth Conference, contrasted with some of the births they were aware of in which the baby was injured or actually died, speaks much of the difference it makes to have a skilled attendant. I’ve read enough unassisted breech birth stories to know that most women will automatically assume a hands-and-knees or (more commonly) a standing position to birth their breech baby, which is what the skilled attendants at the Breech Birth Conference said is the best position; whereas most doctors (who may or may not have any skill or experience in attending a vaginal breech birth) will want the woman in a stranded-beetle position, for a better view, more easy access to the vagina, etc. But this is physiologically abnormal for a vertex birth, much less a breech birth; and if it can impede normal birth, how much more might it impede a “variation of normal” breech birth?
So, yeah, I think she did the right thing. One of the examples of a fatal breech birth mentioned at the conference, was one of those in the Hannah “Term Breech Trial” that was responsible for the recommendation that 100% of breech births be by Cesarean — due to fatal flaws in the study, as many people, including the SOGC, the Canadian version of ACOG, now attest. One of the deaths was in a birth not attended by a skilled attendant, and when the head did not descend in a timely manner, the baby was pushed back up into the uterus and a C-section was performed. The skilled attendants mentioned a maneuver in which they slightly press on the baby’s shoulders, to get him to reflexively tuck his chin in, so his head could be born. Unskilled attendants would not know this maneuver. They might either do as the aforementioned doctor did, or perhaps start yanking and pulling on the baby’s body to try to free the head (potentially causing spinal problems, or even death), or cut a huge episiotomy to insert forceps and pull the baby out, or something that might otherwise harm you or the baby more than a C-section would.
It is important that women know that vaginal breech birth can happen, without damaging or killing the baby. I’m thrilled that there was a conference on breech birth recently, and hope that it is the start of returning vaginal breech birth to a “variation of normal” instead of its current position of “you’ve gotta freakin’ be kidding me!” One problem, of course, is that few people are taught how to properly attend breech births, with a whole generation (probably) of med students learning “breech = C-section,” and few midwives attending enough births to learn for themselves or to pass on skills they may have in attending breech birth. The SOGC has taken the huge step, the 180 degree turn, to now promoting vaginal breech birth, but it will undoubtedly be some time before it becomes the norm, simply because of the years of 100% C-section rates for breech birth (and the nearly as high C-section rates prior to that). It will take some time before the current crop of med students gain the skills to attend breech birth; and it’s anybody’s guess if current OB-GYNs will take the necessary steps to “go back to school” as it were, and learn this old new skill. But it’s a step in the right direction.
Filed under: breech Tagged: | baby, birth, breech, breech birth, breech birth conference, breech birth video, breech childbirth, breech childbirth video, C-section, canada, cesearean section, childbirth, midwife, midwifery, pregnancy, pregnant, term breech trial