I've just been given permission to post this lovely breech home birth video.
The t-shirt was worn to make Robin Guy and the women of Coalition for Breech Birth smile --they made these t-shirts for the CBB conference in 2009. It says, "Whose afraid of a little bum?" and on the back, "Not me." I almost didn't wear it because of magical thinking, but choose faith instead of fear, community instead of isolation. Thanks, CBB community!
Thanks especially much to the brilliant Jane Evans, UK Midwife and the full-hearted Drs. Anke Rietter and Frank Louwen of Germany for their Day at the Breech training in Ottawa which improved the way I attend breech births. I'm no expert, but simply responded to this woman's clear determination.
She had a cesarean for breech with her first, and had a homebirth for breech with her second.
If she'd have been able to have a hospital breech birth she wouldn't have gone looking for a homebirth midwife. That being said, I do believe we gave her excellent care. This birth is probably safer than what would have happened in a typical US hospital right now. Being hands-off allowed her baby to do the cardinal movements.
Now, honestly, I'm a bit appalled to see that I started to reach to intervene for the birth of the head. (I was thinking the cord on the shoulder was taunt and restraining the baby). I can't remember touching the mother then at all! --and in speaking to the mother (we spoke just now on the day I posted this nad I'm editing accordingly) she does not remember me touching her either. I had thought about it though before looking again and suddenly she was out.
This little girl gained half-a-pound in her first week of life and two full pounds at exactly one month old. She was never separated from her mother, got skin-to-skin contact much of the week, and nursed(s) on demand and not on schedule. Her mother is still blissed out and agreed to let me use this video for education. Please do not try to download it or copy it.
You may be interested to know that there was also a surprise breech birth in June and that momma did have to leave her home to get a safe cesarean because the baby was not able to conduct the breech cardinal movements to get through the pelvis. There was much time to discover that and plenty of time to discuss it and drive to the hospital. We were welcomed and the family was cared for so kindly and well. There is no place for ideology in birthing. Each birth has its own story and we must respond to what the baby tells us.
The family, other midwives and I hope for safer breech births. There is quite a difference in the safety of spontaneous breech birth and what is really a breech extraction. The breech extraction involves pulling the baby through the pelvis and pelvic floor without the fetal reflexes involved to make the breech cardinal movements. Bruising, nerve strain and brain swelling may result.
The mother's hands and knees position lets the baby make a safe rotation through her pelvic floor. Gravity pulls the baby to the sacrum anterior position by the end of the birth when it is important for safety. Never pull on a baby.