Brazon's birth story - on loan from Jodi

Brazon the Brazen Breech
Mother: Jodi Rockwell, www.jodirockwell.com
Doula: Sharon Muza, www.newmoonbirth.com
Acupuncturist: Patrice Hapke, www.acupuncturebliss.com
Delivering Midwife: Jennifer Gallardo, www.waterbirth.net

At 25 weeks, the ultrasound technician casually mentioned the words “in the breech position.” A sense of panic rushed through me; I caught it before it surfaced. It is early. This is common. Most babies turn at 35 weeks.

After my first natural vaginal birth, I was buzzing and wanted another. So I tried everything recommended: flips in the pool, the flashlight, the classical music, tilted board positions, moxabustion, acupuncture and 2 manual versions. Still, my baby did not turn. In fact, the baby pushed back on the doctor’s hands during both versions. This baby boy, fittingly named Brazon, was not going to move. Another plan had to begin taking shape.

Because the majority of our nation’s hospitals have a protocol for breech delivery via Cesarean Section, I typed my best possible birth plan for a C-section using Penny Simpkin’s model. As I considered the procedure in detail, tears of disappointment snuck up on me. I was upset that the health system in our country would not let me try a vaginal breech birth in the hospital. In fact, it does not even offer much support for a vaginal breech birth outside of the hospital. By making C-section a prescribed solution to breech, the system asks me to forfeit the ability to hold and nurse my baby after the moment he is born and to sacrifice my physical ability to rock my toddler and reassure him that I still love him. It asks me to surrender the rare experience of giving birth, depriving my body and spirit of the sensations of labor shared by many women throughout human history. How could I hand this empowering experience over so passively?

Initially, I was strongly encouraged to birth naturally by my doula, Sharon Muza, who supported me through my first “rock star” birth as she would call it. Sharon believed I would be a strong candidate for a homebirth with a midwife experienced in breech delivery. Previously, I had given birth to my first son, Cash, without drugs in 12 hours with no complications, not even a stitch, with certified nurse midwives (CNMs) at a hospital facility in Seattle where they have privileges. This branded me with a “proven pelvis,” which could serve me well for a breech homebirth. In addition, I was carrying an average size, full-term baby in the frank position. Without any literacy on the subject, I was vulnerable to fear, deducing it was too risky without considering my own optimal circumstance. My partner, Shawn, said “absolutely no” to a homebirth with a breech baby.

My CNMs at Puget Sound Neighborhood Health Clinic (PSNHC) would not support a homebirth, believing the midwives who are willing to do such a covert action are not to be trusted. They were unaware of anyone with the experience necessary to catch a breech; it is truly a dying practice for OBs and even midwives trained today. In the state of Washington, although it is not illegal, a midwife who attempts a vaginal breech delivery could lose her license. Therefore, those who do offer vaginal breech deliveries at home are cautious about advertising their service, preferring anonymity. They regretfully do not offer assistance if a hospital transfer is necessary; I was told that I would be dropped off at the Emergency Room to proceed alone. Instead of a homebirth, my CNMs gave me 2 unsatisfying choices: 1) hope the baby turns or 2) have as “wonderful” of a C-section birth as possible. Ideally, I thought I wanted an in-hospital vaginal breech birth, which they would support, if I could find such an option. I set out to find one.

At OHSU in Portland, Oregon, I found only one Obstetrician, Dr. Mark Nichols, with experience delivering breech, as it was once part of the training for an obstetrician and now a lost practice. Unfortunately, he would be on vacation during my due date. He referred me to a colleague at the University of Washington, Dr. Easterling, who was willing to perform breech deliveries, but had not done many in the past 10 years.

During the consultation with Dr. Easterling, the potential complications were graphically gestured, in my opinion, in an attempt to dissuade me from a vaginal birth option, further describing the event as a “circus.” Several teams of people would file into the room once the pushing started. They were ready if something was to go wrong requiring a C-section, which was likely 50% of the time. The OB, Shawn and I all knew this was far from the intimate, empowering experience I was seeking in a natural delivery. Finding the ideal in-hospital vaginal breech delivery with an experienced provider was most likely not going to happen in this country at this time for me. It was no surprise that I continued my search.

Despite Shawn’s conviction against a breech homebirth, I supposed it would not hurt to talk to an experienced midwife about delivering breech. There were 2 possibilities in Seattle, both were referred to me by Sharon and I was asked not to mention their names to anyone due to the state practices. (You can go to www.icanseattle.wordpress.com for more information on practicing midwives.) Oddly, it felt illicit to be discussing my desired birth. One midwife was booked and we could not even catch each other on the phone; the other one had no experience to support her good intentions. Meanwhile, as I read what I could on the internet about the Term Breech Trial and its flaws, responses from Maggie Banks (www.radmid.demon.co.uk/breechbanks.htm), philosophies of Ina May Gaskins (www.breechbirth.ca/Welcome.html ), the Canadian policies regarding breech (www.ican-online.org )and the statistical evidence on the risks of a vaginal breech birth, I grew even more pregnant.

The acupuncturist trying to help turn my baby, Patrice Hapke, mentioned for a second time during our sessions the possibility of going to Portland like another client, Ada da Silva, planned for her breech birth. After exhausting my options in Seattle, I began to open up to the idea. After all, the support of Shawn’s family would be there for us, which is more than we have in Seattle. Meeting Ada to hear her birth story was in order.

Her story was nothing short of remarkable. Ada delivered Bruno in her bathroom in Seattle with her partner while her midwife was on the phone from Portland; the 5 hour labor did not afford them the luxury of driving to Portland, but this footling breech thankfully had no problems passing through without any assistance. That was the trick: “hands off the breech.” I was not about to fly solo at home, so I got the name of her midwife. After one phone call to the Andaluz Water Birth Center in Portland, I knew I had found my support team. Shawn joined my support team with ease, trusting my research and my belief in my body.

At 39 weeks pregnant, my family drove south praying we did not hit traffic on a late Friday afternoon and go into labor. Although the drive was indeed slow, we made it to the birth center for our initial consultation and only prenatal visit with our new provider, Jennifer Gallardo. She welcomed us like the cool relative you actually want to see during family occasions. Using coloring sticks, she drew the baby on my belly and let Cash find the heartbeat with the Doppler. After she offered us food and water, my little family went to our temporary Portland home feeling good…

…until a couple of days later. After all the concerned advice from CNMs and OBs, it took my 2 year-old son to make me question my own instincts and research. One evening, Cash, who was just learning how to put two words together from his limited vocabulary and had never shared a series of thoughts, expressed himself in a surprisingly psychic, disturbing manner.

“Baby come soon. Doctor do it. Cut it out. Scissors.”

Unsure if I wanted an answer, I asked anyway, “Can Mommy push it out?”

“No.”

Silence. Goosebumps.

I lost my confidence and secretly felt a little scared of the messenger. This persisted for 3 nights, substituting scissors with knife, without any prompts from me. I insisted my partner and I go see our therapist with shamanic ability. His advice was to be prepared for anything and make a plan together to strengthen our intimate relationship, while asking Brazon what he needs to come into this world.

After getting reassurance from Jennifer about all of our concerns regarding a possible hospital transfer, we were able to relax that week and spend needed time together as a family, especially with Brazon. We also moved from a shared house with Shawn’s brother into a vacation rental of our own. With the stresses of our busy lives set aside and a sense of home in Portland, I went into labor that night, one day before my due date.

The contractions started at 3:00 am after watching YouTube birth videos, most of them disappointing or disturbing. Through all this searching, I was visualizing my own ideal birth, which did not involve a hospital, only a tub of water and a respectful, loving, confident and small support team. Between each contraction, I fell asleep every 10 minutes. At 6:00 am Cash wandered into my room and asked me to come to the other bed with Daddy and him. I followed, wondering if the contractions had been a dream. As I began to climb into bed, a swift kick broke my water. The excitement that birth was really going to happen made me smile.

I told Shawn to prepare the birth tub and call the midwife. He asked if I was ready and with absolute certainty I said, “Yes.”

Jennifer was stuck in traffic and arrived at 8:00 am. Until the tub was full, I was on all fours telling Cash the baby was coming. Soon after, he went close by to play with his cousin. When Jennifer arrived, Shawn and I were in the tub doing extremely well. She checked the heartbeat and reported 130; the baby was handling the situation beautifully. By 10:00 am, I was fully dilated and I climbed out of the tub to push on a birthing stool. It took 15 minutes to see the buttocks of Brazon, gray-blue and covered in vernix. I did not see anything after that moment; I suppose the legs dropped down. I was unaware of how they dangled, blue and lifeless.

“Keep pushing that baby all the way out,” Jennifer encouraged with an underlying current of urgency. I did as I was told for it was her only advice. She stood by with her hands poised for catching the baby. One minute and 15 seconds later, he slipped out passed Shawn’s eyes and into her hands; she seamlessly brought him up into my arms. The gurgling noises coming from Brazon’s mouth quickly turned to clear breathing and crying. It was moments later that he began to nurse and we all relaxed into a family. We did it. And it was all ok; in fact, it was perfect.