Breech Birth in Seattle and Washington State

Bruno the footling breech baby, two years on

2011-08-29T13:46:00.000-07:00

Bruno has just turned two. He still likes to keep one leg free for kicking. He is a voraciously social little man, speaks both English and Portuguese, and loves penguins and firetrucks best of all.

A beautiful frank breech homebirth (NSFW)

2011-04-12T12:58:00.000-07:00

The Breech Homebirth of Annaka Faith

"This is a video of a successful, beautiful breech home birth. It is not intended for younger viewers or anyone not wishing to see an actual live up close and personal birth."

Thanks to Sarah Jelmeland for the link!

Researchers in Tel Aviv advocate for a return to vaginal breech birth

2011-01-09T01:44:00.000-08:00

Breaching the Breech Protocol: Researcher Advocates Returning to Old-School Methods for Delivering Breech Babies
"Published in major obstetric journals world-wide and presented recently at the Canadian Congress on Breech Delivery, Prof. Glezerman's research indicates that breech babies are no more at risk during vaginal delivery than C-section, and there is reduced morbidity and mortality for the mothers. Based on his findings, Prof. Glezerman is campaigning worldwide for a return to skilled vaginal delivery of breech babies."

The Power of Birth Language

2010-05-04T14:56:00.000-07:00

bringbirthhome.com/guest-writers/the-power-of-birth-language

"If you are wondering if your midwife/doctor will let you do something, consider examining why you, as an intelligent, empowered adult, need permission to do something your body already knows how to do. If you think of the birth process as a delivery, consider questioning why you frame it within the context of that language."

Portland Tribune article on midwifery care compared to OBs

2010-03-25T15:59:00.000-07:00

http://www.portlandtribune.com/opinion/story.php?story_id=126946379588406800

"Choosing your type of birth provider is a critical choice in your care. Oftentimes, parents spend more time researching and picking out nursery décor than they do choosing a provider who meets all their needs. For some women, an OBGYN is the right type of provider and for others it is a midwife."

Ina May Gaskin on Footling Breech Birth

2010-03-22T21:08:00.000-07:00

Midwifery Today has some great clips on youtube of Ina May talking about breech:

and

Enjoy!

why labor is good for babies

2010-01-24T18:30:00.000-08:00

pregnancy.about.com/cs/laborbirth/a/aa042300a.htm?r=et

facts supporting trial of labor before a c-section.

c-section birth story: a healthy baby isn't all that matters

2010-01-24T17:57:00.000-08:00

http://www.cafemom.com/journals/read/870028/A_Healthy_Baby_Isn_t_ALL_That_Matters

a very touching take about one woman's journey to informing herself about birth. thanks to sharon muza.

unassisted childbirth

2009-12-28T20:17:00.000-08:00

ever worry that a homebirth is risky? this is one of the resources that i remembered when i was in labor, halfway dilated, and realizing that i couldn't have a midwife present. positive stories like these are what pregnant women should be hearing about, instead of all the crazy worst-case scenarios that we're routinely fed. www.unassistedchildbirth.com

Interview Questions for Breech Delivery

2009-12-15T15:21:00.000-08:00

An excellent questionnaire to help you choose a provider from Jodi Rockwell, breech mama

Interview Questions for Breech Delivery:

Midwife/ Doctor________________________________________Date:_________

1. How long have you been in the practice total? What was your training like for breech births? Do women seek you out for this choice?

2. How many vaginal breech births have you attended and/or delivered?
What was your most recent?

3. What is your tactic/ philosophy for successful breech deliveries?

4. Have you ever experienced complications or even a tragedy with a vaginal breech delivery? What did you do in that moment?

5. What do you do in the event of a stuck head? How much time do you have to respond?

6. How do you reduce the risk of a prolapsed cord? Are there laboring positions that will help?

7. If there is an emergency, what facilities does the hospital have (that a homebirth with a midwife does not) which are vital for a safe outcome?

8. RE: true risk factor (stats of things going wrong). Do you feel that the risks are too great for a vaginal delivery given my birthing history, current pregnancy and health? Can you recommend this for me?

9. What would be your reservations?

10. How available are you? Do you know your schedule during my due date and would you be willing to add me as a patient?

Brazon's birth story - on loan from Jodi

2009-12-10T19:01:00.000-08:00

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.

come hear two breech mamas talk about their natural births

2009-11-30T16:03:00.000-08:00

Jodi Rockwell, who had a frank breech baby this summer, and I will be speaking at the upcoming ICAN meeting (the International Cesarean Awareness Network’s Seattle Chapter). 7-9 pm on Monday, the 14th of December at Dragonfly Holistic Healing in Fremont, 760 N. 34th St., Seattle, WA 98103.

icanseattle.wordpress.com/ican-seattle-monthly-meetings/

Resources for Breech Birth

2009-11-23T01:21:00.000-08:00

here are the primary websites that helped out when i was looking into my options with a breech baby. i'm dividing the list into four sections:
1.where to go
2.birth stories
3.discussions of breech delivery
4.extended resources (other sites that combine the three categories above)

Resources for Breech Birth

1.Where to go

www.waterbirth.net Andaluz waterbirth center in Portland – midwives experienced in breech, twins and VBAC, who accept WA state clients (and were very open to working with my insurance).

www.thefarm.org Some of the most experienced midwives in the US, experienced in breech and regularly accepting out-of-town clients. Based in Summertown, TN.

I also believe that Gloria LeMay, as well as many Vancouver, BC midwives, do breech routinely - but i don't have any contact info.

2.Birth Stories

www.mothering.com/discussions/showthread.php?t=424742 a breech birth story and various ensuing discussions. There is also a link to the mom’s pictures as one of the last comments: http://s112.photobucket.com/albums/n192/inochizo/

geoffrie.files.wordpress.com/2008/08/breechtwinsmt86.pdf
geoffrie.wordpress.com/sarahs-birth-story/ the birth stories (told by both mother and father) of breech twins born with the midwives at Andaluz in Portland.

www.breechbirth.ca breech info and birth stories

www.homebirth.org.uk/hbstories.htm Many birth stories, and a good assortment of breech stories.

londonbirthpractice.co.uk/joomla/educational/breech/home-breech-birth-photo-series_2.html wonderful photos of a footling breech

3.Managment of Breech

www.homebirth.net.au/2008/03/breech-variation-of-normal.html a discussion of how to attend breech birth, and the Term Breech Trials

www.radmid.demon.co.uk/breech.htm discussions of breech birth by UK midwives, with great links to birth stories and other resources at the bottom.

www.radmid.demon.co.uk/Skills.htm discussion of managing breech birth by Mary Cronk, renowned UK midwife.

www.glorialemay.com/blog/?p=131 Gloria LeMay on management of breech birth

www.moondragon.org/obgyn/pregnancy/breechhome.html a midwife’s tutorial on breech homebirth

www.homebirth.net.au/2008/03/breech-variation-of-normal.html an Australian midwife’s discussion of breech

4. Extended Resources, with many more links to birth stores etc.

spinningbabies.blogspot.com/search?q=breech various posts on breech from the Spinning Babies blog

empoweredbirth.typepad.com/empowering_birth_blog/breech_birth/ various posts on breech from the Empowered Birth blog

breechmama.blogspot.com Breech Mama’s blog – check out the great links!

www.aims.org.uk UK midwives association – you can buy their booklet on breech birth through this website.

a footling breech story in Midwifery Today

2009-11-18T17:20:00.000-08:00

www.midwiferytoday.com/articles/footlingbreech.asp

a touching story by a midwife who was born breech, discussing her own birth and some of her clients' experiences.

bruno's breech homebirth

2009-11-05T00:16:00.000-08:00

Here is my own breech story: my son was born on the 18th of August, 2009 at our apartment in Seattle, weighing in at 7.12 pounds, and 21 inches long. He was footling breech (coming out leg-first) and since we couldn't find a midwife in Washington State to care for us, we planned on driving to Portland to give birth. My labor was very efficient, so we never even made it out the door and had a beautiful surprise home birth. My husband and my mother helped me to catch the baby, and Jesica Dolin, our Portland midwife, was on the phone to give us support. Click here to read Bruno's birth story.

Spinning Babies' post on the breech conference in Ottawa

2009-11-05T00:14:00.000-08:00

Spinning Babies Blog: Coalition for Breech Birth Conference

with lots of lovely links!

defending a woman's right to natural childbirth

2009-10-08T14:33:00.000-07:00

the intent of this blog is to provide information and options to women who are pregnant with breech or other "high-risk" babies. when i was pregnant and found out that my child was breech, the only option that i was initially given was a scheduled c-section. after two weeks of lamentation, i finally found a supportive community and discovered my options for natural birth. i learned that carrying a breech baby was not "high risk" as i had been led to believe, and that i did not need to surrender to what i considered my worst-case birth scenario (a cesarean) without first giving my body the chance to prove itself. i spent the last weeks of my pregnancy intensively educating myself on the risks and benefits of natural breech birth, and my baby was born footling breech at 41 weeks, in a 5-hour natural, vaginal labor with no complications to mother or child (you can read the birth story here). i would be happy to talk or meet with you to discuss my experiences and your options. you can contact me by the email found in my profile page.