Breech baby = caesarean birth, right?? WRONG.
There are options in all births and with breech presenting babies, caesarean birth is not the default. If a plethora of tricks like moxibustion, chiro, spinning baby moves, or an ECV (external cephalic version) haven't got baby moved in to a more optimal position, then it means that baby has better ideas!
In the UK 88% of breech babies are born via a caesarean section. Caesarean tends to be the preferred option within our trusts, due to obstetricians diminishing expertise in vaginal breech delivery. Typically, pregnant people, who go in to labour spontaneously in a supportive environment, are very likely to have a successful vaginal breech birth.
One of the most important elements to facilitate this is YOUR team! Everyone in that room with you needs to be experienced, confident and knowledgeable to successfully hold the space for you to, calmly and beautifully, birth your breech baby.
I recently supported a mother, Kirsten, who unfortunately, though not uncommon, had experienced a traumatic birth with her first child. Her baby had been presenting breech but was successfully moved with an ECV. My client informed me her previous labour had been long and tiring resulting in a cascade of interventions, ending in a forceps delivery, leading to an injury on her newborn baby. Absolutely heartbreaking, a situation that should never have happened.
I worked with Kirsten and her husband, Kobus, to unpack some of the trauma and fears they associated with birth due to their first experience and discussed, in depth, what they desired for their second labour and birth. The plan was to prepare for a home-birth. Week 36 comes around for my client, and hey presto, her second baby is in a breech position. In our antenatal session after receiving this news, it was evident they were feeling anxious and a sense of a deja vu was ensuing. I encouraged them to reframe the situation. Kirsten has carried two babies in breech, maybe this mama’s path is to birth breech? Is this what she has been built to do? I left them with this idea, I felt very confident that a planned vaginal breech birth would result in the healing experience they were both seeking.
Fortunately Kirsten also had an absolute gem of a midwife, named Cheryl, who was wholeheartedly supportive and agreed this was a positive plan. She suggested moving Kirsten’s care to Queen Charlotte’s and Chelsea hospital where they have an Opti Breech team, as she felt the current hospital would not confidently support a vaginal breech birth.
“Lucky for me I had an incredible team of women behind me that helped me to start to think about what I had previously thought inconceivable - a breech birth. It started with my doula raising an interesting point, that because both of my babies were breech it was possible my body was ‘designed’ to birth breech? I was hesitant, but open minded to learn more.”
Feeling confident with her plan Kirsten then spent the following weeks, meditating with breathing techniques, affirmations and movement to maintain her incredible mindset leading up to meeting her baby.
Birth day came on a stunning Sunday in June, I will forever remember the scarlet sunset that evening. A call came from Kobus at 8:40pm, and it was clear things were progressing at a great pace. They were on their way to the hospital and I agreed to meet them there shortly. As I entered the birth room I could see Kirsten’s contractions were moving in all the right directions I love to see as a doula!
“At 9:30 we were quickly transferred through triage, where I declined a vaginal examination, I knew things were moving fast, I already wanted gas and air at this stage.
With the support of Bex my doula, Gemma the midwife from the Opti Breech team, and, Cheryl the midwife from my original hospital (who came in a personal capacity), I felt incredibly well supported.
At 11:00 pm, my waters had released half an hour before, and now I could feel a lot of pressure. I agreed to go on to the bed on all fours. I held on to the head of the bed while Cheryl and Bex supported me with words of encouragement, electrolytes, and a cold flannel which felt amazing.”
Kirsten moved through her surges like an absolute queen, moving instinctively and using her breath to manage her contractions. At 12 am there was a small lull in her surges where we encouraged her to regain her breath in preparation for the last stretch to meet her baby. 5 minutes later baby’s bum was visible.
“I pushed with everything I had, and the bum and legs came out. Baby was flexing her body so the team could see she was well. The next push, one arm came out, and one still inside. A small manoeuvre was performed by the midwife to make space for the arm to come out. In one final push, the head came out and my baby was born at 12:08.
She was passed between my legs to me. I was in complete disbelief, it felt amazing to have done it!”
Kirsten’s strength and determination was just astonishing and so inspiring to watch, I was in complete awe, and it will be a birth that will stay with me forever.
When we talk about having an empowering birth, it isn’t all about the water birth with fairy lights and all those lovely things one may dream of, its about taking absolute control of your birth whatever direction it may take, being well informed of your options and surrounding yourself with a team aligned and supportive of your choices, enforcing your rite of passage.
Kirsten: looking back
“The experience was completely empowering, and I am still in awe of how birth can work when there is no intervention. I want to share this story as there is a lot of fear and misunderstanding around breech birth - which is just a variation of normal, but we have lost the skills to be able to manage it. My husband and I are incredibly grateful to the people who guided us to trust in the process, and also gave me the confidence to go for it. By putting myself in the hands of an experienced team, I knew I had done everything I could to give myself the best possible shot at success. I would also say trust your gut and your instincts, and question everything. Your body, your rights, your birth.
I would like to thank everyone that played a part in this experience that we will never forget, Scarlett is named after the red sunset the night she was born.”
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