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Natural Breech Birth at Home

Natural Breech Birth at Home

Jessica Winquist shares the story of her daughter’s breech birth – a beautiful, natural birth at home. 

At my 32-week check, my midwife, Sarah*, found the Cub (our nickname for the baby-to-be) to be breech. We were planning a home birth in New York City, and New York State home birth regulations prohibit breech home births. Also, a C-section for breech presentation is considered the standard of care in NYC. Over the next few weeks, we tried everything to get the Cub to turn, but nothing worked; not even the external cephalic version. We barely slept the night after the ECV. Our options were to schedule the C-section, pay over $15,000 for the one doctor in NYC who does breech vaginal deliveries (in a hospital nonetheless), or drive while in labor to upstate New York to a midwife who is known for doing breech deliveries. All of these options sounded terrible, so I called Sarah and begged her for the umpteenth time to allow me to have a breech home birth. In spite of her own fears and hesitation because of the legality of breech home delivery, Sarah agreed. The Cub was frank breech (butt first), which is the safest type of breech delivery. We understood the risks associated with breech delivery and made an informed decision to move forward with our home birth.

On Saturday, September 13, 2014, I woke up feeling extra achy and uncomfortable, but I didn’t let it slow me down. I made Chris breakfast, and then we headed downtown to run errands. All day I kept asking Chris to rub my lower back, but I really wasn’t sure if the aches and pains meant anything. When we got home from a friend’s birthday dinner that night, I of course had to pee. When I finished peeing, tons more “pee” came out. I sat there for a minute not sure if I was imagining that my water had broken. I yelled for Chris that I thought my water had broken. He came running and asked why I thought that – I said I had never experienced my water breaking before, and he said neither had he (with more than a little panic in his voice); and we just stared at each other for a minute. It was clear that my water really had broken when I got up from the toilet and the “pee” didn’t stop. I called Sarah and she told me I probably had a while until the contractions began so I should get some sleep. It is very hard to sleep with that much excitement!

In the early morning, I texted the friends who I wanted to know, and talked to my mom about her coming down from upstate New York. My mom arrived at our apartment at around 12:30pm, while I was baking the Cub’s very first birthday cake and some lactation cookies.

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I had started feeling little contractions around 9am, but they were really irregular and not very painful. Stephanie, the acupuncturist who tried to get the Cub to turn to a vertex presentation, came over at 2:30pm to help kick start labor. After she left, contractions became more regular (about every 6 minutes) and stronger. Chris and I went for a walk to get food from the diner and to the pharmacy for castor oil. At 4:52pm, while in line at the pharmacy, I felt more of a gush. When we got to the diner, I checked and I had lost the rest of my mucus plug (I had lost some of it about an hour and a half earlier). When we got home, we went up to our rooftop to walk laps and to watch the sunset (and later on we enjoyed the night sky). The contractions did pick up in strength and frequency.

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I also took some castor oil at 6pm, so perhaps that was a factor in making things progress. At 6:45pm, the castor oil “kicked in” and the contractions starting gaining in strength, frequency and duration. Chris says that the contractions lengthened to a minute long and were consistently 3 minutes apart but I really didn’t notice clocks at all. At 7pm, on the roof, I had a contraction that lasted about 3 minutes (or perhaps just 3 contractions back to back). That was when it felt like we were getting down to business!

At 11pm I asked my doula, Emily, to come over because I felt like she could be helpful to me in relaxing. I had mixed up some aromatherapy tinctures a few weeks before and Emily used the one for pain management when rubbing my back. I definitely think it helped (not to mention how much Emily’s massage therapy skills helped). I started feeling shaky and there were some tears shed as the pain level increased. It wasn’t because of the pain that I got teary so much as the anxiety associated with it; but I quickly calmed myself down. Whenever Emily walked away to do something and a contraction would come, I would yell for her because the counter-pressure on my back really saved me. This became even truer after I got into the tub and hit transition. The contractions were now about 2 minutes apart.

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Chris went to get some sleep, and I felt in good hands with Emily. Chris ended up sleeping until just shortly before Sarah arrived at 2am. I was annoyed with him for sleeping for so long, but I also knew he needed his strength. He wasn’t experiencing the same adrenaline rush!

When Sarah came in, she saw me talking, and thought that I had called for her too early. But she was so surprised when she checked me and said I was 6cm but could easily be stretched to 7cm. She was just amazed that during contractions I was all business but when they ended I went back to chatting. I just felt relaxed and happy being in my own home surrounded by people I trusted. Chris filled the tub after Sarah checked me and I got into the water right as transition hit, around 3am.

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Transition mostly consisted of back-to-back contractions that upped the pain level to an 11, but only during the peaks. During the contractions I would hold onto Chris and vocalize while Emily pushed on my back. This is definitely when I needed people to breathe with me to keep me from hyperventilating. The contractions were so intense but it really helped me to know that they would end and I would get a break. Sometimes the breaks were very short, but even getting a small window where things were calm kept me calm. I had the Hypnobabies “Easy First Stage” track on throughout the entire labor. A lot of the time it was just in the background and I ignored it, but it soothed me a lot just to have it on. Everyone agreed that it relaxed me and was great.

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At 5am, I asked Sarah if I could push, because it made the contractions hurt less if I pushed a little. She said I could, but that also she wanted to check me. It was tough for me to be on my back, even in the water, but I endured it for one contraction while she checked. She said I was fully dilated and could push. I pushed in the water for just a little while; because honestly, the water was pretty nasty with bodily fluids by this point, and I just wanted to get out. So first I went to the toilet and pushed there, but that didn’t last very long. Then I moved to the birth stool in my bedroom. I sat on it facing everyone except Chris, who was on the bed behind me, and whom I held onto for dear life between contractions. The contractions followed a pattern – initially they were very painful and it felt like the Cub was literally stretching me open, but then the feeling would change to an intense need to push. Once my body was bearing down, it was hard for me to not push with everything I had in me. I was pouring sweat and the level of intensity in those contractions was astounding. After spending about an hour (I assume?) on the birth stool, I moved to hands and knees on the bed. I liked this position but the birth assistant, Ellen, kept trying to get me to try something different. I just kept saying no to her and that I couldn’t move. I never said I couldn’t push this baby out but I firmly believed she was nuts for thinking I could do things like lunges at that moment.

At one point, the Cub’s heart rate was elevated; so Ellen asked me not to push for two contractions. That was CRAZY. I kept alternating between pushing and panting through those because it felt literally impossible for me to not push at all. It was enough to bring the Cub’s heart rate back down. I kept pushing on my hands and knees but Ellen wanted me to give my pelvis some asymmetry to help the Cub with fitting through (hence the request that I try lunges!). I rolled into a side-lying position, and as soon as I did that, a huge contraction hit and I bore down with all of my might. Chris was behind me and held my leg up while the Cub’s butt was delivered. Out came her butt, after which she immediately pooped and peed. Then her legs came out one at a time. I pushed again and her torso was out. Everyone rolled me back onto hands and knees (I didn’t help them do it at all – I just went with it) so that gravity would help to get the Cub’s head out. Next, her arms came out one at a time and then her shoulders were out. This was the MOST insane feeling. To know that her body was entirely outside of me but to feel the crazy pressure and pain of her head still inside was just astounding. After two or three pushes with every bit of strength I could muster, out came her head. We had a baby after 2 hours and 15 minutes of pushing!

I was on my hands and knees, and really just in shock. I looked at Chris and he was crying so I started to cry and then we kissed before even turning to look at the baby. Sarah was holding her and telling me to turn around but I was so stunned that it took me a bit to realize she was talking to me and that I was supposed to turn over. I maneuvered myself around the umbilical cord and watched as Sarah tried to get the Cub to cry. She was still getting oxygen from the umbilical cord, but she looked so dazed. She wasn’t breathing or crying but she was looking around the room. Sarah kept trying to annoy her into crying, but that didn’t work; so she stuck the tube down her throat to clear it out, and then gave her oxygen to try to get her lungs started. Sarah had to repeat those steps twice, but eventually the Cub started making noise (although not crying) and she pinked up. After a few minutes, Sarah had Chris cut the cord, and the Cub was free. She had a bruise on her right hip, so she was probably at an angle coming through the birth canal, and me lying on my side made my pelvis asymmetrical and helped her to be born. That fulfilled the “lunge” request without me actually having to do lunges! The Cub’s APGAR score was a 6 at 1 minute, and an 8 at 5 minutes – not perfect, but I’ll take it!

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I was bleeding (a normal amount) and cramping while holding the Cub, so I handed her to Chris so I could finish my work. I pushed a little and felt the placenta start to detach, and then Sarah checked and knew it was close to coming out. So she pulled slightly on the cord while I gave a small push and it was an instant relief to have that separate. The placenta was HUGE (we weighed it: 2.5 lbs!) and I got 130 pills from having it encapsulated!

I only had one skid mark, so Sarah said it would heal on its own. I was in some pain, but overall felt really good. It was just so wonderful to have the breech home birth that I envisioned. I felt like a warrior woman. Welcome to the world, Dahlia Miriam! Born on Monday, September 15, 2014 at 7:15am, weighing 7 lbs 8 oz and measuring 20 inches long.

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*Name changed to protect our midwife’s identity because of the legal implications of this birth story.

Our Twin Miracles

Our Twin Miracles

My husband and I got pregnant right after we were married. I was told I would probably have a hard time conceiving because of ovarian problems so we decided to start early. I guess I didn’t have any problems after all.

A couple weeks after we found out I was pregnant my husband left for boot camp for the Army. The pregnancy started out well. I was shocked that I was having twins and had to tell my husband in a letter since he couldn’t talk on the phone.

When I was 6 months pregnant my husband started Advanced Individual Training and I decided to move from Oregon to Georgia to be closer to him and so he could be there when the twins were born.

When I was 28 weeks I went to the hospital for cramps and didn’t know I was in labor. They were able to stop it but I was so far along I needed to stay on bed rest at the hospital. At 30 weeks I went into labor again and this time they couldn’t stop it.

Since both babies were breech I had to have a c-section. Both girls were taken straight to the NICU and I had to wait a day to see them and then another few days to hold them. Both girls were 3 pounds. Besides being small they had no health issues. They stayed in the NICU for 7 weeks.

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The whole thing was very traumatic and stressful but they are now healthy, beautiful two year old’s. They are my little miracles.

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A Cesarean for Breech Baby, Jaundice and PND

A Cesarean for Breech Baby, Jaundice and PND

At our 19 week scan, the sonographer found that our son, J’s, nuchal fold was more prominent than it should be. She also found the left brain ventricle to be larger than the other. These, we discovered, were soft markers for some chromosomal abnormalities, such as Down syndrome, and it may have indicated J having fluid on the brain.

I remember I picked up the scans on a Friday afternoon. My next appointment with my GP/ob was not until Monday and I had to work Saturday morning. The first thing I did when I got home with the scans was read the report (of course!). It had a lot of big words that I didn’t understand, and I did the worst thing possible. I turned to Doctor Google. I was in tears when Tobi came home. He said I was being silly, and there was no point in panicking and dwelling on this until we had heard it in laymen’s terms from the Doctor. I went into work Saturday morning, determined not to think about those horrible long words in the report. I stepped into the office, where the boss was sitting, to grab my keys and name tag, and the boss asked me (completely innocently) how I was. I took a deep breath and burst into tears! He took one look at me and sent me home. He is the biggest softy when he wants to be.

We were booked for another scan at the Women’s and Children’s Hospital in Adelaide at 22wks, just to double check the measurements. It was at this point it was highly recommended to have an amniocentesis to confirm whether J had any chromosomal abnormalities. Tobi was adamant it was not a risk worth taking. I needed a little more convincing, but with a 1 in 200 chance of miscarrying, it was not something I wanted to risk. We also agreed, that whatever the outcome, we would still want J, regardless. The doctor we saw also told us that a termination was still an option, right up until 26-ish wks, when “it would start to become a little difficult.” NO! NOT an option!

I felt devastated. I hated being in limbo, not knowing whether our baby was healthy, whether he would be ‘normal,’ or whether he would even survive. Tobi was my stronghold. He never wavered in front of me. He knew nothing was wrong and that we would have our perfect baby with us. I should have trusted him. I later found out from a family friend that he wasn’t ok, and had gone to him and completely broken down. I had no idea! He is so brave for being strong for me. He doesn’t need to be, but it is nice to have a rock to lean on.

For 10 weeks we continued on. I still worked, the world kept revolving. We headed back to Adelaide at about 32 weeks for another scan to check the measurements again and to see whether I could birth our baby back home, or whether (because of the possibility of fluid on the brain) I had to be in the city. There would still be the possibility of a chromosomal abnormality, but our local hospital would be more than capable of ‘handling’ that. The scan took forever. Two different people did the ultrasound. We then waited for the results.

They came back all clear!

There seemed to be no fluid on the brain. It was just a random thing that happened every now and then. The possibility of having a Downs baby, or some other abnormality flew out of my mind. I was just ecstatic that I was allowed to stay home and try for the birth I was so desperate for. Oh, and it was also at this scan that we found out baby was measuring nearly 5wks ahead of dates at 36+ wks!

A bit of history – my first son was posterior. I had always had in my head that I wanted a natural birth. I envisioned walking around, laying in the bath, nice warm showers, not birthing on my back… but after 3hours labour at home, I was crying to Tobi to take me to hospital. Within an hour of being there, I had screamed for the gas. NO, the pethidine. NO an EPIDURAL! I had just got the epidural in when the midwife leant down on the bed and said, “ah… I’ve just read your birth plan… ummm…” to which I replied “I don’t care, it doesn’t matter!” while still waiting for the epidural to kick in! Anyway, 18 hours later, and about 1 hour of pushing (and third degree tearing), we welcomed L into the world.

I was determined that I was going to have my natural birth one day, or that I’d at the very least, better myself. I research and educated myself on natural birth, and found myself a student midwife to help support me. From about half way through, J decided breech was the best position, and stayed there until birth. So I also researched (extensively) about vaginal breech births and had spoken about this with my midwife and OB. My OB was all for trying a vaginal breech birth, but wasn’t confident, and was recommending I see another OB as well to discuss options. I was to make an appointment with him at about 37 weeks. In the mean time I was spending a lot of time inverted or on my hands and knees to try and get him to turn. It must have been hilarious watching me!

On a Wednesday night, at 36 weeks and 2 days, I finished work with MAJOR cankles! It was hot, I know I hadn’t drank a lot of water and I had been on my feet at work for 9 hours that day. I took myself up to the maternity ward as I had never had an issue with swelling before, and it was starting to feel really uncomfortable all over. I was monitored and had my blood pressure taken, but all seemed normal, so was sent home and told to put my feet up. I was planning on finishing work that Friday, and was really looking forward to a week or two off before baby made his entrance. Later that night I thought I noticed some fluid leaking. But I wasn’t sure. I had no pelvic floor muscles left by that point and baby seemed to be sitting right on my bladder for the last 4 weeks, so I assumed it was just wee.

Friday, as I’ve finished work, I’ve noticed my pad is pretty soaked, so again, I trot myself up to maternity to get myself checked out. With my first son, my waters broke after the epidural was in, half way through the day, so I didn’t know what to expect. Tobi came up with me and we sat around for a while, while I was being monitored again. The midwives check the fluids, and yes, it was amniotic fluid. My pelvic floor muscles were better than I gave them credit for! Coincidentally my OB was on the roster that night and she came in to see me. She explained that yes it was my waters. They hadn’t broken, it was just my hind waters. As I had no contractions in the 2 hours I’d been laying there, the (more senior) OB might do an ECV if asked. This was one of my options, as a breech vaginal delivery was NOT a favorable option to most of the hospital staff.

Unfortunately, the OB who was on call, was not one of the local guys. He was an OB from Adelaide and he was driving down (5hours) and still ½ an hour away. He was not aware of my birth plans and didn’t seem to want to hear them.

I overheard my OB was on the phone to the visiting OB explaining my ‘situation’ and, bless her; she was such an advocate for me to have this baby preferably breech, or at least try an ECV. She came back in to see Tobi and I with a sullen look on her face. She reiterated that the other OB did not want to try and ECV, and it was far too dangerous to try a vaginal breech delivery. He had said to book an operating room immediately and prep me for a cesarean.

For the second time this pregnancy my heart dropped. Having a C/S was so far from my mind. For me it was a very last resort. I was devastated. I wanted SO bad to try a natural birth and this person I had never met had just stripped it away from under me. When he finally waltzed in, he sat on the bed and would not listen to a word my OB and I were saying to him. He would not do an ECV as my waters had broken and there was not enough cushioning for the baby. It was far too dangerous to have a breech delivery, it is safer to have a cesarean, especially at 36+4wks. I just wanted the option. I wanted to try. I wasn’t even in labor for God’s sake! The visiting OB stated his reasons, said “hmff” and put the consent forms on the bed. Through tears, I signed the consent for to be prepped for the operating room. To this day, hubby still doesn’t seem to understand why that was so hard for me. Why a cesarean was such a bad thing. For me, I think, it was more the lack of choice. This doctor who didn’t know me from a bar of soap, strode in, told me what to do and expected it. I did not like that one bit.

At some point I was moved from the delivery room I was in to the maternity ward across the hall. Tobi and I debriefed a little and let it sink in that we were going to meet our ‘troublesome’ baby finally! I then did a little panic because we hadn’t chosen a name! It was literally on the way to operating room when we finally agreed on the baby’s name. We didn’t bother thinking about girl’s names as we were almost positive that this baby would be another boy.

So I was prepped for the most relaxed ‘emergency cesarean’ they’ve had for a long time and I got wheeled away. The anesthetic seemed to take forever to work. I swear I could feel them pricking me with something the whole time they were testing. They ran ice over my belly (apparently) and then they were ready to start. Funnily enough, as they cut into me a massive gush of fluid came out all over the Ob saturating his shoes. That made me feel a little better (no fluid or cushioning left, really?). It felt so weird to be tugged and pulled at. My Ob explained everything as it was happening and Tobi took photos over the curtain. It’s cool looking back at the photos, I must admit! I had to have a longer cut than normal as J was footling breech and had his feet were well engaged. Finally they pulled him out and showed him to us. He was perfect. Jackson Eli was born!

breech c-section photo

breech c-section photo

They whisked him away to be checked and I started shivering. Tobi freaked out a little me shivering, but the anesthetist assured him it was normal. It wasn’t long before I was stitched up and moved across to a bed. Still in the operating room, I was given Jackson and we had some skin on skin time and (tried to) breastfeed in recovery.  I think he was born about 9:30pm (that sound horrible doesn’t it, that I can’t remember, without looking at his book!). We got back to the room and J was weighed at 8lb 15oz, or 4.04kg (I think!). The question was floated as to whether we thought our dates were right, but after a couple of days, the nurses all agreed, because of his mannerisms, that J was definitely early.

We had a rough few days. J ended up becoming jaundiced and was under lights. Thankfully he was able to stay the room with me the whole time. Because of his jaundice, he was tired and he struggled to attach properly. I was pumping and expressing like mad and using a syringe to drop colostrum into the side of his mouth while he sucked on my finger. I was determined for him not to have a nasal-gastric tube and he was not having formula. We continued like this for about 3 weeks before he finally seemed to get his latch right.

On day two, the visiting OB came in to see me. He looked at our chart and saw I had been expressing and syringe feeding J. He told me that it babies don’t in fact need colostrum, it’s pointless really. People in such and such a country don’t give it, that’s why milk can take up to a week to come in. So don’t expect your milk to come in until next weekend. My milk came in that afternoon, before 48 hours were up. Just let me mother my baby! Just to add to that, not long after he left the (horrible) midwife on duty told me that J had lost too much weight and needed a formula top up and nasal-gastric tube. I asked why? My milk hadn’t come in, it was less than 48 hours after birth, give us a break! She begrudgingly left saying well, if things don’t improve, we’ll need to do it by the next morning.

I don’t remember when, but somehow J ended up with a tube thing “just in case.” Tobi wasn’t around when they did it and he wasn’t happy when he came in and saw it. He was just about ready to rip it out himself. I was already doubting myself and would’ve agreed for the midwives to give him top ups if it weren’t for Tobi and my friend. Kylie came in that day, and had the same reaction as Tobi. Kylie was an ABA counselor in training and was just about finished her nursing degree. She checked our chart and my colostrum supply in the fridge and said that J didn’t need that tube in. That settled it for Tobi – he marched J down the hall to the nurses and demanded that the tube be taken out. Tobi isn’t one to be messed with. He’s 6ft+ tall and built solid. You wouldn’t want to say ‘no’ to him! J came back without the tube in.

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A week after J was born, with his jaundice levels going down, we decided to leave the hospital. I was going mad, and the midwives and my OB told us his jaundice wouldn’t necessarily improve any faster in hospital, than at home. But they kept telling us, ‘just one more day, just one more day.’ By the Friday, we’d had enough, we discharged ourselves against medical advice and lo and behold, J was fine!

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I was diagnosed with mild PND just before J’s first birthday. I think a lot of it has to do with his birth and the lack of choice I had. We are now talking about trying to conceive baby #3 and I am arming myself with even more research and knowledge. My OB and I are more confident and although I have still been recommended to see a senior OB, she and I seem to be on the same page more often than not and is more than happy to support a VBAC this time.

Surprise Breech Delivery {Home Birth}

Surprise Breech Delivery {Home Birth}

So, 8 months ago I gave birth to my first baby – a beautiful boy, a healthy 3.6kg (8 pound), delivered breech, vaginally, at home! He wasn’t diagnosed breech by my midwives & Dr’s, his position was not easily detected by feel as his legs were up around his head & everything more or less felt the way is should. -Alanna

I had a wonderful & straightforward pregnancy, so we decided to go for the Home birth option as it was something i was really keen on. At 40 weeks & 1 day I woke up at 3am with mild contractions. I was so excited I woke up my partner to tell him the good news- to which he replied, Midwives orders – go back to sleep you need to save your energy!! I couldn’t sleep, so got up & baked (as you do!). I made lentil & veg pies for dinner, & muffins to snack on during the day.

I did go back to bed, and then to the couch, and then back to bed, and so on for the best part of the day.

At about 6pm the contractions started to increase slightly, although I had it in my head that I would be laboring well into the night as I’d been told first babies can take their time! We sat down for some dinner (although I did more of a pace around, eat between contractions sort of thing) and then hopped into the shower. I told my partner he should call the midwives & as I was feeling a lot of pressure like I was needing to push.

I hopped into the birth pool, my waters broke (with a loud pop! Wasn’t like the lovely warm gush I had seen in so many movies), and soon after the midwives arrived. This was a huge relief & they said I could start pushing if that’s what I needed to do. The midwives saw that there was some meconium in the bottom of the pool & asked me to hop out as they could not see what was happening.

After a vaginal examination they determined that my baby was coming bum first! They had to ask whether (for legal reasons) I wanted to call an ambulance, or carry on at home. I just remember looking at my partner, squeezing his hand really tight & crying. My midwife said,  “It’s OK, it’s the same labour, same amount of work for you, the baby is fine and you can do this.”

So we carried on.

About 45 mins later my little guy was born, bum first, then the legs sprang out & down, then finally his head was born. He was arrived at around 9:45pm. The most vivid image I have is of bending over & seeing his little body hanging from me, his head still inside, and thinking just one more push and I can hold my baby. It was almost surreal.

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It wasn’t until the days after that the immensity of it all dawned on me. I asked my midwives all the ‘what if’ questions I hadn’t thought to ask when I was pregnant. It had never even crossed my mind that I would birth a breech baby.

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breech home birth

In hindsight I’m glad it wasn’t diagnosed. I think my whole pregnancy would have become about the breech factor, trying to turn baby, and probably accepting that my dreams of a natural, vaginal, home birth were not going to be a possibility.

As it were I was blissfully unaware, and in the end all went more or less to plan. I would not change a thing. There are always risks with any birth, & for us it came down to the trust we had in our midwives. I don’t think you can underestimate the role of your care givers, especially in a situation like this where you’re thrown a complete curve-ball right in the middle of your transition phase!

It’s like that saying (one of my favorite labor mantras) – She believed she could, and so she did.

A Cesarean for Breech Birth with Video

A Cesarean for Breech Birth with Video

In the early days of my pregnancy, back when I was an un-crunchy as could be, my husband told me I wasn’t going to get an epidural. Told me. He was on the other side of the world serving the last couple months of his tour in Iraq and I was in sunny Hawaii, where we were stationed at the time, stunned at his words. My friends scoffed at the idea, “Forget him, you’ll get an epidural if you want one! They’re heavenly!” I believed them.

When he came home I was 15 weeks pregnant. Around that time, I watched a show where the woman giving birth was doing so at home using techniques she learned in a Bradley Method class. The idea of natural birth always intrigued me. My mom had done it several times and when I looked up what the Bradley Method had to offer, I started to change my mind. Maybe I wouldn’t get an epidural after all. Maybe I wanted an all-natural birth.

Fast forward a few months and we were taking our Bradley class. By that time I was fully convinced I was going to have a drug-free, low-intervention, hospital birth. I wrote out a beautiful birth plan. We were ready to tackle everything. Except one thing: A breech baby.

My family has a history of breech births. My mom and aunt were both breech. I was breech until the very end; my little sister was the same. But my baby was head down, at least at my 36 week appointment, so when I walked in for my 38 week appointment ready to be checked to see how far I was dilated (I wanted to know if I should start any natural measures to get things going), I wasn’t ready for the midwife to find something wrong. She brought the ultrasound machine over, waved it over my belly, and showed us. She was butt down, her head wedged in my right rib.

From there, began the most frantic and stressful two weeks of my life. They sent me upstairs for a non-stress test, which I passed fine, and a chat with an OB about scheduling a cesarean or doing an external version. No way, we said, we aren’t scheduling anything. We would think about the version, if it came to that. They sent us home with instructions to return in a couple days for another NST.

At home, we decided we weren’t comfortable with doing an external version, but we were try everything else to flip that baby around. Chiropractor, acupuncture, inversion table, music, hot & cold packs, music & recordings of our voices, handstands in the pool… everything. Nothing. She wasn’t moving.

At my 39 week appointment, the kind OB and midwife sat us down to talk about our wishes. We told them we didn’t want to schedule anything, that I wanted to go into labor naturally to give her every chance she had. They accepted it. And then again, at my 40 week appointment, we said the same thing.

That ultrasound, though, showed that she had one foot up and one foot down. The OB warned that if my water broke, there was a high chance the cord could prolapse and cause an emergency situation. He still was fine with me going into labor naturally, but urged me to consider scheduling a cesarean by 41 weeks if she hadn’t showed. He said it was up to me, of course.

The next day, while dealing with some awesome Braxton Hicks, I decided if she had showed up by the next day (a Friday) I would schedule something for the next Wednesday, 41 weeks. However, as the day progressed I noticed my BH coming regularly, about 6-10 minutes apart. By dinner time, I knew something was up, and even though I had wanted to labor at home for as long as possible, I was worried about the risk of cord prolapse. The hospital had us come in that night.

Our daughter was born via cesarean at 1:05am on December 16, 2011. She was 6 lbs 12 oz and 18 inches long. We named her Penelope “Penny” Ann.

The cesarean was an interesting experience, but so unlike what I was expecting. I received a spinal and requested anxiety medication as well, because I was feeling a panic attack coming. I didn’t feel a thing except some rocking, like I was on a boat. After the baby was born, my husband went to recovery to do skin-to-skin and I chatted with the anesthesiologist for 45 min while they stitched me up. In recovery, after nursing our desperately hungry baby, I vomited from the medicine. The next few days in the hospital were painful, and the recovery took several weeks before I could walk normal or feel an ounce like myself. I never wish a cesarean on anyone who doesn’t absolutely need it.

I don’t feel guilty about doing it, though. There were no doctors or midwives on the island who would deliver a breech baby. Giving her position, I wasn’t going to risk doing it by myself. In the head, we weighed our options and felt fairly in control of the whole process. Still, I feel some disappointment in missing out of the experience that I was envisioning, though I hope with our next baby we can have a home birth after cesarean.

You can find the video here through this link:  http://youtu.be/Ouf4BywpbRA

breech c-section

breech c-section

Birth of Twins {Baby B-Birth in OR before CS}

Birth of Twins {Baby B-Birth in OR before CS}

A few days after finding out I was having twins, I began mourning the loss of my birth experience. Dramatic? Probably. But as a Doula and at the time, prospective, Childbirth Educator, and someone who’s frankly quite terrified of needles, I knew that medication, needles, scalpels and augmentation were not for me.

Coming to terms with the possibility that my birth was most likely going to be filled with things I didn’t want was very difficult. I agonized, cried and had panic attacks over it for weeks. After seeking the advice of other doulas and doing some serious soul searching, I finally started to feel peace about the possible ways I would birth these babies. However, I was very prepared to make informed decisions and fight for what I wanted and needed during my birth experience.

I knew that in order to have a birth that somewhat resembled the ideal I had envisioned, I would need to have a doctor who was ok and on board with at least some of my desires. Home birth was not an option for me so I chose a practice I was familiar with through both personal experience, and experience as a doula, who I knew would give me the best chance at a vaginal birth of twins in the area. That being said, out of the four doctors in the practice, only two were ok with the fact that I didn’t want an epidural or even want the catheter placed but only one of those two was ok with doing a breech extraction if needed, should baby B turn breech after baby A was born. While I knew I could make the decision to refuse any procedure, I also knew it was probably going to be an uphill journey and one I wasn’t sure I was strong enough to climb.

34 Weeks with twins

On the day I went into labor (around 34/35 weeks gestation), the doctor who didn’t mind if I refused the epidural but wouldn’t deliver a breech baby B was on call, but I felt at ease. We arrived at the hospital when I was 5 cm and 100% effaced. Within an hour, I had progressed to 6 cm and was hardly uncomfortable, despite the air conditioner in L&D being broken, and it being 82 degrees in my room. The rest of the labor progressed quickly, with minimal discomfort, and without any mention of pain meds, or epidurals from the nurses and the doctor.

At 9cm I was not feeling the typical transition-like contractions I had felt with my previous 2 labors and wasn’t quite sure what was happening with my body. I had prepared for something so much more intense! I had also prepared to defend my choices with the medical staff every step of the way, but none of that was necessary as they were in awe that I was completely in control of my contractions and pain management, and was willing to listen to and think about the choices I was presented with and decisions I had to make.

There were a few things I did agree to and ask for after making conscious and educated decisions, but they were MY decisions. I did ask for a bag of fluids when I arrived at the hospital, so I had an IV and I did ask for pitocin to be turned on during pushing if it was needed. Staying in the labor room to birth my babies was not an option because of hospital policy, but I was ok with that and we did move to the operating room at 9cm. Though it wasn’t a climate controlled, dimmed room, I was able to maintain my focus and feel at peace with being there.

Immediately after being checked and found “complete” I felt the urge to push, and 5 pound 13 ounce Baby A was born after a few pushes, 5 hours after arriving at the hospital.  Not one nurse counted or yelled or told me how to push, which was exactly what I had asked for.

When Baby A was born I remember thinking she was tiny and had a great cry, but I didn’t get to actually see her face. She was passed to my nurse who started checking her over, who then had to passed her to the NICU nurses because the doctor needed her help. Baby B had flipped transverse as soon as her sister was born and she did it fast too.

Everything I had read about twin births said that the worst pain you would ever feel would take place if you had to have a version during labor without an epidural. And there I was, facing a version without an epidural. When I made the decision not to have an epidural I was very much aware of the possibility of the pain but I figured I would rather endure 5-10 minutes of intense pain than all of the risks and side effects associated with an epidural through a labor.

Somewhere between both the doctor and me “talking” to Baby B and begging her to turn and the doctor and nurses beginning the version, I went into a trance like state. I didn’t feel pain, just a lot of pressure. I spent the last minutes of labor fully aware of everything that was happening, but It felt like  it was happening to someone else and I was just watching.

During the version there were about 5 hands on my belly, some holding the space where baby A had been, others turning baby B. They were able to turn her to be head down, but she then turned transverse again and her heart rate became rocky.  The doctor decided it was best to do an internal version to try to get her into position to be born. He was holding the ultrasound transducer with one hand and internally moving the baby while trying to keep her cord from prolapsing with the other. He was able to move baby B into position to be born but then she moved her hands above her head. So we sat, and waited. Waited for her to move, waited for something, anything that would allow me to push for her birth. And we waited while the doctor still was holding her cord and her in place, internally.

After roughly 13 minutes of waiting, her heart rate plummeted and wasn’t showing any signs of recovering. She needed to be born right then, but that wasn’t going to be possible to do vaginally. I will never forget the look in the doctor’s eyes when he looked at me and told me he had to do a c-section. He knew how much I didn’t want one and how hard I had fought for this birth. I knew that he didn’t want to do a cesarean and had tried everything possible to get Baby B to be born vaginally. There just weren’t any other options.

Because I had chosen not to get an epidural I was going to go under general anesthesia, which I had never been under before. The anesthesiologist who was standing by quickly started preparing the anesthesia while the nurses were racing to put sensors on my chest. The pitocin was turned off, and the room was switched from a birthing room to a fully functioning operating room in less than 45 seconds.

Right before I was put under general anesthesia, the doctor saw on the ultrasound screen that Baby B had moved her hands, and yelled for me to push. And in the confusion and haste of the OR, I pushed twice and our feisty 5 pound 8 ounce Baby B while the doctor guided her into the world, just 17 minutes after her sister was born.

I will forever be grateful to my doctor for trying so hard to give me the birth I wanted and what I needed. He respected me and my knowledge and trusted me and my body to do what it needed to do to birth these babies. Never once did he look down on or question my choices, he never made me feel like naive or pressured into anything. He went well outside his comfort zone and fought for me and fought for birth and in those 17 minutes, admittingly learned a lot.

Edited To Add:

Even though it’s been nearly seven years, the story of the birth of my twins will sometimes hit me and cause me to pause. I’ve never shared this picture before- I wasn’t ready to. I was honestly scared to. This picture captured and froze a moment so personal, and intense. The intensity and emotion are still fresh, even after all this time.

My sweet Baby B, being born into the hands of our extremely patient and incredible doctor. Her umbilical cord coming before her, after a nearly 15 minute internal version (without pain meds), seconds before I was going to be put under for a crash c-section. This moment, with our baby girl halfway between my womb, and the beginning of her life outside, before she’d even taken her first breath, was captured by my husband as he stood next to me, praying desperately for his wife and baby. He will tell you this moment defined and shaped him more than any single moment before, or since. And I don’t doubt that because it did for me too. But I can only imagine what he felt watching our baby’s birth unfold from his vantage point: the unknowns, the joy, the confusion in the chaos. Truly needing to trust, have faith, and let go.

Seven years later my perspective is changing. Instead of the uncertainty and a moment hanging in the balance, I am starting to see a joyous beginning, a triumphant entrance into the world and the perfect start to the life of our feisty Baby B.

twin vaginal birth

The birth of my twins serves as a reminder of strength and courage that I hold within. If I can get through a nearly 15 minute internal version without pain medication, I can handle almost anything. I look back on that day with peace and a sound mind, knowing it went exactly the way it was supposed to go, with nothing to regret.

GGTwins Mom

gg twins 2

GG Twins sleeping

gg twins

Twins Born Naturally in a Hospital {One Breech} and Breastfeeding Twins!

Twins Born Naturally in a Hospital {One Breech} and Breastfeeding Twins!

I am a mom of 3. I got pregnant with my twins while on the 5 year IUD. When I found out I was pregnant, I already had a baby girl that just turned 1. Finding out I was pregnant was a shock and at 11 weeks finding out I was having twins was a bigger surprise. I had to change midwives because I had my first child with a midwife at home and she wasn’t able to attend high-risk pregnancies. I went to midwives 45 minutes from where I lived to get the care I wanted. Every month after I had an ultra sound. At 20 weeks, I found out they were both boys.

I was always tired and ran out of energy quickly. I had morning sickness the entire time. The smell of toothpaste, eggs, body odor and BBQ sauce always made me sick. I woke up late took a nap and went to bed early! My ribs were popped out of place about 8 times during 30 weeks to 37 weeks. I had to keep my chest wrapped. At 34 weeks Baby B was still not turned. I started having troubles moving, lost my balance often, and couldn’t sleep more than 45 minutes with out waking up and having to stand up and move. At 37 weeks 2 days, I had my last check up I was dilated to 3 1/2 centimeters and both babies turned vertex!

I went home and took a nap, enjoyed my daughter and cleaned up a little. At 8:12PM, I started with painful back labor. When I got to the hospital at 9:35, I was dilated to 9 ½ centimeters. I continued to stand (counting the seconds in my contractions being 20 seconds apart) while they checked me and hooked me up to the monitors. I had to deliver in the operating room in case of any problems! I had my best friend with me, my midwife and 7 other people in the room. I gave birth to my son Landon Jackson at 10:13PM naturally. After Baby A was out baby B turned sideways, My midwife tried to turn him manually and instead of him turning down he became breech. About, 13 minutes later at 10:26PM, I gave birth to my second son, breech. I was able to breastfeed both of my twins for about 45 minutes after birth. My first night in the hospital was spent trying to get my bleeding under control. Around 4:00AM, I received 6 shots and a nurse pushing on my belly until the bleeding finally slowed down.

My babies born at 37 weeks on November 11, 2009 weighed 5lbs 9oz and 5lbs 12oz were healthy. Our second night in the hospital was spent trying to get the blood sugar level under control. Since I didn’t want to formula feed, I wouldn’t allow the nurses to take them into the nursery and bottle feed them. I had no sleep that night for every 45 minutes, I had a nurse coming in and switching babies and testing their levels. On the third day when everything was under control I was able to leave the hospital. I didn’t go back to work until my boys were 9 months old and I was able to EBF until 9 months. I had to start giving one boy a bottle while I breast fed the other. I switched kids each time for every feeding! My twins are now almost 3 and have been fully potty trained since 26 months. I couldn’t be any more proud of my amazing 3 kids! Everyday I learn something from them as I teach them! I have numerous blessings from God and wouldn’t have it any other way.

Jessica's Natural hospital twin birth 1 Jessica's Natural hospital twin birth 2

Jessica's natural hospital twin birth 3

Home Breech Birth 2003

Home Breech Birth 2003

Well, this photo is of my planned breech home birth in 2003. My little girl is still very cautious and likes to “test the waters” before jumping into anything.

image

I was 38 weeks when my midwife discovered a little head under my ribs. I did all the visualizations, yoga inversion poses, wore bells low down, etc. to get her to turn, but she was determined to stay where she was. I did not want to do an ECV (External Cephalic Version, a procedure to turn the baby) as I felt there was a reason she wanted to be that way, so I didn’t.

My midwife discussed all of my options with me and I did agreed to an ultrasound (my first ever in 3 pregnancies) and negotiated by my midwife so she felt comfortable about the position. I knew the whole time that we would be absolutely fine and kept reassuring my poor nervous midwife. I felt most comfortable at home and knew the hospital environment was not an optimal birthing space for me. I chose not to tell anyone about what I was doing as I knew the reactions I would have received would not be positive.

My midwife was an incredible educator and lent me many books to read so I had a full understanding of the physiology of breech birth and of the maneuvers she may need to use if necessary. We discussed and negotiated many other things along the way and worked together with some compromises so we were both happy with the situation.

This labor was a bit slower than the others and very gentle (the bottom is a lot softer than the head so there was not the same pressure on the cervix), I spent most of it walking, climbing cliffs to waterfalls and being outside by the fire. After ten hours, I went into the birthing pool (cow trough) and began second stage. I found the pushing more challenging than my other births, however in the end I birthed my baby who was born doing the splits with the longest umbilical cord ever ( I still feel if I had done the ECV she could have knotted her cord)

I am so grateful to the wonderful midwife who allowed me to birth at home. The experience was empowering and inspiring and I hope more people come to realize that breech is a variation of normal.

A Vaginal Breech Birth with Yoga, Meditation and Visualizations {Take Note, America}

A Vaginal Breech Birth with Yoga, Meditation and Visualizations {Take Note, America}

My water broke when I was 35 weeks. It was an “oh no!” moment. I really wished I’d peed myself, but knew I hadn’t. She’d been breech all along. Despite my inversions, remedies, and visualizations, I knew she hadn’t turned. Maybe I should have been concerned about her being preterm. In reality, my first concern was that I was on my way to the operating room. So much for that waterbirth I’d wanted.

There was an eerie calm in the car as we drove to the hospital. Our son came with us. We’re a military family living overseas. My parents were coming to help with birth logistics but they weren’t scheduled to arrive for another month. This emergency C-section was going to be a family affair.

Months earlier I’d opted out of care at the base hospital. My son was born at a military facility. His birth was phenomenal, empowering, and un-medicated. We have a picture of him wearing the t-shirt they put on all the newborns: “property of the US government”. Really they mean it; don’t take the t-shirt home. I’m a big fan of military medicine. But for some reason when it was time to enroll in prenatal care for our daughter, I had a visceral feeling that we belonged with the British caregivers at the NHS.

They put me on a monitor and brought us some tea. The OB came in to explain our options. Options?!? I had options! We could choose to have a Cesarean right then. We could try an external version and an induction. Or we could let labor progress and deliver her vaginally.

My husband, in a shining moment of feminism, told me it was my body and he trusted me to decide. My answer to him was, “I am confident I can birth her.” That shocked me a bit because it felt 100% true, yet I wasn’t sure if it should be true.

Twelve hours later, we were walking the halls before visiting hours ended, 1960s-style visiting hours being one of the few detractions of our NHS birth experience. I told my husband that I needed to give myself permission to really labor. I’d been holding it off all day. He went home. I decided to take a nap and then have my baby. And I did.

When I woke up from my nap, I started doing yoga, child’s pose in a curtained off corner of a bay of metal beds that look like they came off the set of a WWII movie. That military hospital’s looking pretty glamorous right about now. I meditate on the word “courage” and press my forehead into the thin mattress, telling my baby that I will open my cervix for her, I will press my head against this bed and we’ll just pretend it’s your head pressing against my cervix. Things are moving along now.

There are no monitors. No nurses. No doula. No dad. It’s just me and this upside down baby and God, and the mom three beds down who thankfully took a sleeping pill. Our next meditation is “faith”. Somehow this is going to be ok. We do a lot of cat-cow.

We make 35 trips to the bathroom down the hall. This is so not the spa version of American childbirth. Pacing, swaying, lunges; “patience”.

Now it’s getting real. My hips ache in a way they never did birthing my son. It’s like I need them to move out of the way so her hips can work their way past mine. “Work”. This is going to be work. Horse pose. Warrior. Lizard. Monkey. When my prenatal yoga teacher said we were going to do monkey pose I was all into it until it became clear that she meant for us to do the splits. Now I do every hip opener I can contort myself into. I’m getting louder too. The midwives pop in to check on me once in a while, then they leave us to our work.

24 hours after my water broke, we enter our last gate: “Love”. No more yoga poses, just lots of “oooooo-pen” vocalizations as the midwives rush me to a delivery suite. I was a bit like an animal, bothered by the bright lights and loud noises. The next hour was a little less zen than the four hours that preceded it, but no less miraculous: Matilda Jane, 5lbs 12 oz and who knows how long because they don’t measure them in England.

The secondar miracle is that an OB caught my breech baby. In a hospital. On purpose. As an American, I still can hardly believe it. He cried when I explained how it is in the States and how blessed I felt to have the team of providers that we had with us in that room.

This was the mainstream medicine approach. We didn’t do anything sneaky or even unconventional. I walked into the emergency room with preterm labor and walked out of the hospital a few days later without so much as a single stitch, carrying a perfectly healthy baby girl. Take note, America.

international vaginal breech birth

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