Recently a friend shared her awesome birth story with me, and graciously allowed me to post it to the blog. Her baby was breech, and she was facing an unwanted cesarean. In the end, she had an experienced provider and a fast labor that allowed her to birth vaginally.
The thing is, the story is so exceptional. These days it's difficult to find a provider experienced and willing to deliver a breech vaginally. Why? In looking for research, I couldn't count the number of resources that kept saying it's too dangerous. But why is it dangerous? I found even fewer resources who were willing to spell out the risks.
If you cannot find all the facts to educate yourself on a major decision for your birth, are you really getting to make that decision at all? Is it really informed consent? Or has your provider made the decision for you? Have the insurance companies hamstrung our care?
In my last pregnancy, my daughter was breech at 37 weeks, and my OB was skeptical of her turning. (You can read her birth story and how she was turned by scrolling below.) When I asked why breech delivery was such a big deal, my doctor replied, "We used to do this all the time. What's changed is how insurance covers us as practitioners, hospital policies, and how we view these types of births."
So where do you go to find the full scope of information on breech birth? I've compiled a list of resources for you!
1) American Congress of Obstetricians and Gynecologists (ACOG.org) When in doubt, go to the source of the entity that creates guidelines for OBGYN providers. While we are seeing a large gap in what is recommended and what is practiced, this will help you discuss directly with your provider. It gives guidelines for when a vaginal breech can be attempted, or indicators for when a cesarean may be necessary. (acog.org)
2) Coalition for Breech Birth (breechbirth.ca) Both the website and Facebook group are a wealth of resources, including a depth of published research studies and resource links for everything from breech birth videos, turning a breech baby, and chiropractic care.
3) Spinning Babies (spinningbabies.com) Founder Gail Tully discusses physiological components that can attribute to a breech birth and the means of correction. She also fully explains the risks with breech birth, and when cesarean may be more appropriate. The issue of providers being able to keep hands off the breech baby as its born, or not being skilled enough in the case of a trapped head or nuchal arms, is what seems to be the biggest risk. It's not so much the presentation of baby, but the loss of education in handling emergencies.
4) Ina May Gaskin I love Ina May Gaskin. Her books are a wealth of knowledge for midwifery, birth and the art of birth stories. She wrote an article for Peggy O'Mara's website, focused on natural living, mothering, and social justice. Ina May expands on the history of the policies regarding breech birth, as well as the changes in provider skills and care. It's a great read, and you can find it here: (www.peggyomara.com/2014/01/23/vaginal-breach-birth)
These are my top four resources when researching breech birth. These four will keep you reading and falling down the rabbit hole like I have for the last month. When there is so much information to consider, take your time and have open conversation with your care provider. Finding all the facts is just one aspect of informed consent, but may the most important.
Do you have another resource to share? Was your baby breech?