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.

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.

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.

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.

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.

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!

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.

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