Wednesday, February 26, 2014

Breech Babies

My friend Jennifer, who is pregnant with her second child, emailed me a question today and I thought of you, my two blog readers! Do you have breech baby questions?

Here is Jennifer's question from yesterday.

How successful is it to attempt turning a breech baby? I ask because I had a friend whose baby was breech and so they just automatically scheduled a c section. I thought that was crazy to just let it go so easily. Is that common to not even attempt to turn the baby?!? But then another friend said hers was breech and they were able to turn her even in labor. She said she had an epidural and even with the epidural it was painful, but they did it successfully.

So can most babies be turned successfully? I wouldn't be ok with it if the doctor told me three weeks before due date to just schedule my c section. But, maybe that's why about 1/3 of babies are now c sections. And I'm sure there are cases where it's medically necessary, but surely not 1/3 of the time!

Here is my answer.

Hi Jennifer,  You ask good questions. I wonder if your friend who had a cesarean for breech baby wishes she would've asked questions? First read this, I think it may answer most of your questions.

What is the Evidence for using an External Cephalic Version to turn a Breech Baby?

There is a lot of discussion happening about how 'breech' is not abnormal but just another version of normal. There are a lot of midwifery work shops teaching how to deliver breech babies vaginally. It's a dying art that many are trying to keep alive. I have a couple of friends who attended the Heads Up Breech Conference last year. One of the most famous and famously loved OBGYN's who attends VBB (Vaginal Breech Birth) is Dr Stuart J. Fischbein!  Read about him at Birthing Instincts with Dr. Stu

God bless you! ~Rosie
Rosie Peterson Curtis, Doula
760-443-6471 cell 24/7


Another family's baby is due around our meeting time. If I am called to join a woman in labor I may need to reschedule my meeting with you. Thank you for being flexible.

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Note:This blog is straight from my email box and completely unedited. If I thought I was going to post this email to my blog I may have been more politically correct in a couple of words. But this is the raw deal. -Rosie
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Although Jennifer's baby is not breech, with this pregnancy she is much more interested in all things pregnancy related. She emailed me after she spoke to her doctor about vaginal breech birth today. Here is my response:

Hi Jennifer,

Your doctor sounds interesting. I think I would like him. :)  He's right in saying that breech does not necessitate a c-section, but the doctors will ALWAYS offer it just due to past lawsuits. Honestly Jennifer, many doctors do much more than 'offer it', they even tell the woman that they cannot be her doctor anymore! That she has to find another doctor because he/she will not do a Vaginal Breech Birth. Then the only doctor that she finds that may support Vaginal Breech Birth is not in her insurance group. Care providers tell these women terrifying, exaggerated, stories and pressure her to have a Cesarean. Still women can always refuse a Cesarean. Some women have been known to labor at home as long as possible with her breech baby and then go to hospital too late for a Cesarean. I think that it is too bad that our society puts women in that stressful situation. In California I believe if a woman really wants to have a Vaginal Breech Birth she can find a care provider, doctor or midwife that can assist her. Sometimes the care provider with that specialty is not in her insurance plan and the family will pay out of pocket.

The positions your doctor was referring to is referenced on one of my favorite websites. The position is called a forward leaning inversion.  Any one and everyone who finds out their baby is breech will want to check out the Spinning Babies website and even attend a Spinning Babies workshop. There is a workshop in Anaheim on March 15th. Although this upcoming class is more geared toward birth workers and not parents and pregnant women, anyone who is not a birth worker could email Gail and see if she will make an exception. Gail Tully is the founder and she is also available for teleconference. You can read about Gail here. She usually encourages pregnant couples to attend so if you are interested call or email Gail, she's very approachable!

Spinning Babies is a great resource for all birth workers and anyone who is pregnant. I've taken Gail's workshop twice and it helps me a whole lot in my Doula work.  The premise isn't that babies need to be corrected or manipulated (really babies are brilliant!), only that our postures today are sometimes not what they used to be when we were a more active people. And by active I do not mean getting in a car and driving to the gym and doing a prescribed amount of weights and cardio and then DRIVING home! There are postures that pregnant women can practice at HOME that are more 'helpful' in aligning the baby and encouraging baby to be in an optimal fetal position. So although babies almost always find the path of least resistance and come out just fine, it's nice to read Head down is not enough and maybe prevent back labor (occiput posterior) or learn to move in ways that help baby rotate into a position where baby is head down and facing moms back (occiput anterior). There are many head down babies that are being born by Cesarean Section just because they are head down but in a occiput posterior (OP=baby facing forward) position. OP babies cause back labor and many of these moms get epidurals. Then it is very difficult for a mom to push out her OP baby when she is numb and has no sensation (OP babies can be harder to push out) and many of these moms end up having Cesarean Sections although their baby was head down (Vertex position).  Some exercises in Spinning Babies help to balance moms ligaments and release tension, giving baby room to rotate into an OA (Occiput Anterior=facing moms tail bone) position. There is a lot of information in Spinning Babies and it is all stuff lay people, non-medical people, can understand and can do! The exercises described on Gail's website are not harmful to mom or baby.

I want to mention also that years before I ever heard of spinning babies and optimal fetal positioning I attended home births where midwifes knew these things and had great success positioning moms and helping a slow labor or a painful back labor resolve itself.  These same home birth midwives also know how to support vaginal breech birth. Home Birth Midwives Rock!

If you have any questions feel free to call me.

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