Wednesday, June 30, 2010

Frank breech home birth

I've just been given permission to post this lovely breech home birth video.

video
This is a third baby, her second natural (vaginal) birth and first home birth for this family. The baby was small and full term. Apgar Scores were 10 and 10. You also see the first 30 seconds after the birth.
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.

39 comments:

Arya said...

That was so beautiful and encouraging! Thank you for posting it, and please thank the parents for allowing all of us to learn from their experience. Vaginal breech birth can be safe!

midwifeEmme said...

Gail, I love you and your committment to normal birth.
You're Awesome!!!! and so is that mamabebe.
Big Hugs,
Emme

Sarah said...

This is so amazing, Gail! And I see Nickie in there, too... We are so blessed to have such amazing midwives in the Twin Cities!

Alisa said...

Thanks for sharing this! Brought tears to my eyes. Amazing birth, amazing parents, amazing midwives!

Jehefinner said...

This is a great birth video, my second baby was born at home, with me on my hands and knees like this, but not breech, the midwife simply rolled her under me and passed her to me as I sat up and back (she was even more hands off than you in that respect!), her daddy and I dried her off and discovered we had another little girl ourselves, the cord was clamped & cut after about 10 minutes when it stopped pulsing. It was lovely. ♡

Spinning Babies Lady said...

Dear Jehefinner,
I know! I felt so bad having her that long, but I also wanted to get her thick cap of cervical blood off her head and shoulders so that her mama wouldn't be alarmed, it covered the top of her body, but was just from the cervix. There was no tear and the placenta hadn't begun to detach yet. It was a dilemma and I wasn't quite on the ground yet either!

kimroses said...

I WISH I could say I cried with joy watching this video - it certainly WAS beautiful - but my own frank breech birth 5 years ago ended it a cesarean I desperately DID NOT WANT. :( My son was undiagnosed breech - even w/mid-labor ultrasound and not until after my all natural labor while pushing him out did they realize he was coming butt first. Since that hospital literally does not do breech vaginal births, I'll never know if he would have been safe and out quickly in different hands. I'm pregnant now w/a "T" incision from my first birth and desperately want a home birth. If anyone has any words or wisdom I'd be so grateful!!!!

Susie said...

Thanks so much to the family for sharing this gift with the world! Congrats on your beautiful baby and wonderful birth.

Spinning Babies Lady said...

Kimroses
Please feel free to email me privately. Many first time mothers with breeches may require a cesarean for safety, though most will be able to birth safely if laboring spontaneously - and if the baby is allowed to do the cardinal movements, which is not always possible if the mother lays down.
Meanwhile, excellent nutrition and an active, moving lifestyle is important for all pregnancies and, I think, especially for VBAC women. The food pyramid does not present a healthy way of eating. I'd lean closer to the Weston Price model, but then I'm an O blood type ;)

WiseWoman said...

Congratulations to everyone involved, so nice to see the hands off. Great job. Gloria Lemay in Vancouver BC

milkstained said...

I can't believe that after using the spinningbabies site so often & referring people to it that I never knew you had a blog! It looks like I have a LOT of reading to catch up on!!

What a fantastic video. I just found out recently that I was a surprise Frank breech birth and it pains me to think of what my mother went through as a result.

I love your statement that every birth has its own story and that it is up to us to listen & watch it unfold. Beautiful.

Karen said...

You said this was her first homebirth, 3rd baby, but then you said, "She had a cesarean for breech with her first, and had a homebirth for breech with her second."

Can you clarify this for me?

Thanks for this moving and informative article!

Karen said...

You said this was her first homebirth, 3rd baby, but then you said, "She had a cesarean for breech with her first, and had a homebirth for breech with her second."

Can you clarify this for me?

Thanks for this moving and informative article!

Spinning Babies Lady said...

Karen,
Hi, This mother had about 24 hours between findout out her first baby was breech and the time her baby was born by cesarean. She did not have a stalled labor, she had a cesarean because the baby was breech. Period. She asked for options and was told there was no one in the area who would attend a natural, vaginal, breech birth. She was not told of the obstetricians in the area who do delivery breech babies, nor was she told that she might find a home birth midwife with some breech experience. So, for political reasons, she had major surgery.
With her second baby she had a VBAC (vaginal birth after a previous cesarean) in the hospital.
With her third baby, her friends told her about Spinning Babies Website and she tried the activities to no avail. She called me at 35 weeks to ask for a consult but before our meeting was told her baby was now head down. She called me a second time at 39 weeks after being told her baby was breech (again?) and we set up a series of meetings with exam and dual care, with her hospital care and with me. She told her hospital provider that if her baby was breech at labor onset that she would stay home. She would have had a hospital breech birth with them if she could have had a natural birth. They were not allowed by their practice to attend breech vaginal births. I suggested she talk with one or both of two OBs in the area that attend breech births, too. I wanted her to have all her options and know that she could do this one of three ways, by cesarean, an in-hospital vaginal breech delivery (and perhaps hands-off if she chose the one of the OBs who would be open to her request), or a home birth with myself and a partner, or with another midwife pair. The couple weighed in their choices and called me back asking for care should their baby still be breech. The rest is on this film...

ShazEls said...

it still constantly amazes me, what women are capable of. that was a phenomenal birth. thank you so much for sharing it ♥

Ruethee said...

Beautiful. Reassuring. Thank you.

Steph said...

Beautiful video. I am a student midwife in the UK and it's unlikely I will get to see a vaginal breech delivery during my training. In fact, many midwives I have worked with so far, have never seen one either.

Plum said...

I really appreciate you posting this. Like the others I doubt I'll get to see one of these anytime soon. Wonderful training opportunity!

Wendy said...

Thanks so much for asking the family to share, Gail - and thanks, family. It was cool to see our T-shirt too - very wonderful and inspiring.

Spinning Babies Lady said...

Thanks Wendy!
Friends, compare physiological breech to this birth by breech extraction. I so feel for this baby!
http://www.medicalvideos.eu/watch_video.php?v=a4c019fc81a4811

Melissa said...

That was beautiful. Thank you for sharing this video! I wished I would have been able to deliver my son like this.

persephonesunset said...

this was great to see. thank you. i had an unassisted breech with my third borne. second uc...second homebirth.. i am pleased to see that my instinctual hands and knees approach was the correct one. thank you for sharing this..

The Kassera Family said...

Thank you so much for sharing that with us. It was beautiful!

Justine said...

Awesome! Curiously, when you say, "Never pull on a baby," what's your thoughts on shoulder dystocia?

Spinning Babies Lady said...

Dear Justine,
Here is a link to a short description of what I think about Shoulder Dystocia!!
Don't pull on the baby! Rotate!
ANd a few other maneuvers, but in essence, don't pull.

Kerry said...

Gail and NIcky...You ROCK!! Kerry from Hypnobabies. :-)

omahadoulamom said...

Beautiful! Thanks so much for sharing this! :) Its always so nice to have this kind of thing to share and show moms that they do have options!

omahadoulamom said...

Beautiful! Thanks so much for sharing this! :) Its always so nice to have this kind of thing to share and show moms that they do have options!

pdxskater said...

tears of joy! What a miraculous event. Hands off, listening to momma/baby. Continuous encouragement & support. Lovely. I love my calling as a Doula & hope to be an intuitive, conscious Midwife in the years to come. You have amazing material that is accessible, reliable & honest. blessings to all involved! peace on earth begins with birth

Teal Marie Chimblo Fyrberg said...

Thank you SO much for sharing this beautiful birth and for sharing this information. I was a natural, frank breach birth baby in 1970 (my mother's first of 3 natural births)! I see so many women who will not even consider natural birth these days. I believe they are scared into drugs and eventual c-sections. I hope more women will see videos like this and be inspired to take back the power over their own births.

flyingfisher said...

Thank you so much for posting this video. I always wondered what my daughter's birth might have looked like. Her birth was also a frank breech birth at home in 1980. She came early at 7' 4" and we had no film in the camera. We had a home birth doc in attendance.

I, too, was on my knees, resting my head on my arms on a pillow on a stool. I must have a fairly roomy pelvis as I consider her birth very comfortable and the most comfortable of the three natural births I had with no tearing, the second two at home.

He did have me keep pushing as soon as her bottom was coming, instead of waiting, so as not to press on the cord. She never really cried lustily, just made a few mewing sounds like a kitten! Only disadvantage was having to wait a bit longer to actually see her!

flyingfisher said...

By the way, I had only found out the afternoon of the evening I went into labor that she was in a breech position. Not enough time to to worry about it for too long. And the doctor told me that if we'd been at the hospital he would have been
forced by protocol to do a cesarean section.

FEARtoFREEDOMBirth.com said...

Add me to the tears of joy crew - what an amazing gift that the family shared. Beautiful!

Angela
feartofreedombirth.com

WendyL said...

Fantastic! This made me cry buckets. Thank you for sharing!

Melissa said...

Beautiful birth, thanks for sharing!

I would love your advice on my situation. I am pregnant with twins. My OB will delivery vbac as long as neither twin in breech. He said there might be a doctor at the same hospital that would still delivery vbac if baby A is head down and baby B is breech. He said after baby A delivered he would reach in and pull breech baby B out. In your opinion what is the lesser of two evils, pulling a breech baby out or a c-section? Thank you so much.

Spinning Babies Lady said...

Melissa, Find a skilled Obstetrician and run from one who would pull a breech out! Email me if you are willing to travel or change.
It's so sad you feel stuck with someone who has so little skill with twins/breech.

Ikas said...

I too had a c-section cause my 1st was breech. Doctors find that out at the last moment when I was just about to push. It was the saddest news ever for me, that I HAD TO have a cesarean, that there was no other way. Now I'm 17 weeks pregnant and either this baby is head down or breech, I will have a respected home birth. Thank you for posting videos like this, encouraging women like me and many others to be brave and say "my body can do EVERYTHING"
:)

Karen and Mike said...

Thank you, Thank you! This gives me so much hope for my next baby.

Ho-phelia said...

I had a vaginal breech (frank) birth with my first with my midwife in my home. I wish I had had the presence of mind to make my husband record it, but we only found out she was breech at 10 cm dialated, so we were a bit distracted. It was a beautiful birth with no hip displasia. I would do it again.

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