Breech, Please!

If, in the past month, you’ve asked me how I am feeling about the upcoming birth/labor of my baby I’ve probably responded that I’m pretty calm. That I know it will be difficult, perhaps painful at times, and could possibly end up going in a totally different direction, but that I’m preparing myself to *hopefully* have a successful vaginal birth at home in a birthing pool. So, it’s a surprise, even to myself, that I am non stop crying today as I read about spinning babies and consider the possibility of a planned cesarean-section.

Photo credit: PhotoAlto/Anne-Sophie Bost/PhotoAlto Agency RF Collections/Getty Images

Yesterday, I had an ultrasound at the hospital and discovered that my baby is breech. This means head up, feet and butt down. Apparently, I’ve since learned, there are different forms of breech (see image) but the technician didn’t explain what position mine is in. The idea of spinning, or turning your baby is to encourage them to move into a more, let’s say, comfortable position for birth. Ideally baby should be head down, chin tucked, back facing your front. That’s an ideal position for the baby to squeeze through your pelvis. All information about pregnancy, from healthcare professionals and pregnancy tracking apps, will say that babies tend to turn between 32 and 36 weeks. I’m 35 weeks today, so I still have a week left. And even after that, there’s the option to have a doctor attempt to manually turn your baby. 

This morning, I had an appointment with a community midwife. This is essentially a midwife in my local area who isn’t necessarily going to be at my birth. They work out of health centres, not the hospital. You don’t always see the same midwife during pregnancy. This was the second midwife I’ve met. I think this is in part due to the shortage of midwives in the National Health Service. Side note: I'm in England now, which I will post about soon!

The midwife, Nicky, had a feel of my baby’s positioning and listened to the heart beat. Had I not just had the scan yesterday, Nicky would have said my baby was head down. It felt that way to her, and the heartbeat was heard in a position that would suggest head down. It could very well be that the baby flipped in 24 hours, but I doubt it. At my first appointment, two weeks ago, the midwife, Petra, had been unable to say for certain. She said my abs were so firm it was hard to tell, asked me if I had been working out prior to getting pregnant! That made me feel good. 

Nicky told me to continue doing exercises for flipping the baby, it wouldn’t cause him to go back again had he already flipped. She mentioned that at my appointment with the obstetrician on Monday I would be assessed again and would likely have another scan in a week or two for a final view.

I contacted my doula team (more about them in a future post!). Immediately they recommended the website SpinningBabies.com. After my midwife appointment today I started to read through the pages and pages of information about breech babies and various techniques to try to help turn them. Essentially, the theory is that the body’s ligaments are a little out of whack– some are tight, some are loose– creating a space that is keeping the baby head up. By using balance and gravity, pregnant women can adjust their ligaments and muscles to create more space for their baby to shift in the uterus and position themselves head down. According to the website, this can even be done during labor. 

I’m learning so much about how a baby’s position can have such a huge impact on birth. Also how many different variations of the “wrong” position there are. “Head Down is Not Enough” is the title of a page full of things for a pregnant woman to think about regarding their baby’s position. For example, if a baby’s chin isn’t tucked you won’t get the usual crown of the head emerging through the cervix and vagina. Instead you’ll get the chin up and neck extended. It makes it harder for the baby to fit through your pelvis and would increase the diameter of the baby’s head because of the awkward positioning - meaning more stretch to your cervix and vagina! Ouch. Not to mention greater risk of the baby experiencing distress during birth. Of course, I’m sure there are many women who have had successful vaginal births of babies that were in less than ideal positions during labor. They are more likely to be longer labors, much less comfortable, and lead to more medical interventions.

With a breech baby, you have two options (excluding the try to flip it option): have a vaginal breech birth or a planned cesarean section (c-section). This morning, Nicky told me that having a vaginal breech birth is possible, though it is considered high risk and would need to happen in a hospital, not at home. She did add that of course it’s my birth so I could do what I want, but the doctors would strongly encourage a hospital birth. I read one online leaflet that said a vaginal breech birth carries a small risk of your baby dying during delivery. It also informed me that 40% of women who start with the intention of birthing a breech baby end up requiring a c-section. I started to panic.

Cesarean sections have a bit of a bad rep in my opinion. From reading a lot about pregnancy and birth, and especially learning about the experiences of other women there’s this narrative that a vaginal birth is “normal” and “natural” and that a cesarean is “less than”. I have been reflecting on this for a while during my pregnancy and decided that if it came down to it and I had to have a c-section, so be it. I would not feel any shame or defeat. I’ve told myself it’s entirely possible that something doesn’t go well and I would need to transfer to hospital and perhaps have an emergency c-section. 

I’ve started to think about what preferences I could express to my healthcare providers to ensure I still get to appreciate and feel part of the experience. I say that because some accounts from women who have had c-sections describe feeling like the experience was passive. They weren’t actively involved. Birthing the baby wasn’t something they did, it was done to them. In most cases, c-sections are performed with a spinal injection that numbs you from the chest down, you’re awake during the procedure. However, you’re surrounded by a huge team of medical professionals– at least 7 in the room– who are busy doing their thing to get your baby out alive. It’s not as chill as a private labor room with a midwife, your husband and that dope playlist you created. Machines are beeping, people are moving about, it might be cold, and there’s a curtain blocking the mother’s view of the lower half of her body. Some have described it as feeling as though someone is doing the washing up in their belly. Then all of a sudden a baby is placed on your chest, or in more intense situations whisked away for tests or special care.

The idea of maternal assisted cesareans is that the birthing mother can be more actively involved in the delivery of their child than a standard procedure would allow for. It could mean that once the doctors have the baby’s head out, the mother can reach down and carefully pull the baby the rest of the way out and onto her chest. Other ideas include requesting specific music to be playing, displaying your own photos on the wall, or keeping the operating curtain lower than usual so you can see a bit more and understand what’s happening to your body. Though apparently, not all doctors/providers will agree to go along with it. You have to hope for an understanding, agreeable team.

Despite knowing all this, and having told myself and others that I would be happy even if I had to have a c-section, I still found myself crying and fretting over a breech baby today. I had purchased an exercise ball second hand recently and wanted to jump on it to do some pelvic rotations - which should encourage the baby to turn. But I discovered the ball is way too big for me, it’s 85cm and for my height I should be on a 65cm ball. This made me cry. Yet all I have to do is drive 5 minutes down the road to pick up the right size ball for £7.99. Watching the videos and reading the advice on spinningbabies.com was causing little outbursts too. I was overwhelmed. How can I do all this stuff? What if it doesn’t work? Where do I start? For some of the techniques you need a helper, and I felt so alone. I must give credit to Steve, who was trying to cheer me up and reassure me that I'm doing great, will be OK, can solve the exercise ball issue, etc. But sometimes, even when help is nearby, in those moments I can feel isolated and alone. Also, a lot of the suggested maneuvers were basic yoga positions I’ve been doing throughout my pregnancy, which made me feel more stressed out that there must be no hope for my ligaments and muscles. Haven’t I already been doing all the right things?

I got into a tizz. Honestly, writing this blog post has really shifted my mood. I haven’t cried since I started an hour ago. It has reminded me that yes, any form my birth comes in is fine by me. I know that I’m strong enough and informed enough to influence and get the most out of my birth no matter what form it comes in. And that for me personally, the birth of my baby isn't all that important. For some women it really is and that's fine. For me it's not, I really do just want to be on the other side with a healthy baby and hopefully not in too much physical pain or injury! It’s also reminding me that, dude you have a whole week yet before being concerned, and probably even time after that for the baby to flip. Plus, only 4% of babies are born breech. The chance is really low. So, Chill Winston. Chill.