Breech birth - naturally
Informed Consent and Informed Refusal
Breech birth can be smooth and sweet or it can be challenging, even tragic, in any setting and by any method. Not only physically, but politically or emotionally. Parents and Providers in America who choose vaginal breech birth are outside the norm. What's common is not always right, what's unusual is not always wrong.
But that is a piece of philosophizing. Basically, the issue is that breech babies have a higher rate of death due to complications of their position than head down babies. With the right help, that difference can be smaller, but not absent. No manner of birth and no amount of experience can deny that difference. Parents and providers can't rest on the superiority of their favored method and imagine they are safe from complications.
Cesarean surgery involves risks that are well known in medical circles but often understated to consumers. Cesarean surgical birth may be safer than breech birth, such as when providers are not trained and trained providers can not be found or traveled to. To make surgery slightly less invasive to the baby, labor can be allowed to start spontaneously and then a cesarean can be done. Or a cesarean might be scheduled for after the due date to reduce unintentional late prematurity (35-36 weeks gestation) which has a higher infant mortality rate than waiting for full term (37-42 weeks gestation). A family-centered cesarean can be arranged ahead of time with the head nurse, anesthesiology staff and the obstetricians involved in the care of a breech baby and mother.
Hospital vaginal breech birth is not the same in every setting or with every doctor. In the US and Canada, midwives cannot catch breech babies in the hospital. Few doctors know physiologic breech birth. YouTube is peppered with medical breech deliveries and the style can be seen for yourself. Often a partial breech extraction, or occasionally, a total breech extraction, is practiced in the hospital. "Total breech extraction for the singleton breech is associated with a birth injury rate of 25% and a mortality rate of approximately 10%," states Dr. Richard Fischer in Breech Presentation. You can read a mother's story of her hospital breech birth when she refused a cesarean here. It wasn't the easiest birth (and wasn't hands and knees or hands-off) but she would do it again.
Midwives and doctors do vary in what they consider to be physiological breech birth. While Dr. Louwen's team has had tremendous success with knee-elbow (closely resembling hands and knees) breech births. I wish I had a link to a "hands off" birth with Dr. Louwen to show you.
Dr. Andrew Bisits, of Australia, uses a birthing stool and doesn't refrain from gentle touch. Notice how empowered and proud this mother is in her birth with Dr Bisits. The gentle "support of the bum" is followed by the doctor going for the arm or arms. He is exploring completely hands-off, upright (knee-elbow) breech now (late 2013).
Experienced and gentle doctors like Dr. Andrew Bisits are world treasures, to be sure! The difference in approach doesn't deny that, please! I am simply seeking the most physiological approach (while having immediate help available should it be needed).
Parents have to be well informed to choose a safe breech care provider.
When parents are informed about the risks and benefits of breech birth in both hospital and home settings, they may refuse to give birth in the hospital. A mother might refuse a cesarean.
Parents have the constitutional right to pick the care they find best for their baby. We hope to be right with our choices. If a baby dies, a homebirth will be seen as irresponsible, even though the breech death rate at a hospital with poor training may well be higher than with an experienced home birth midwife who knows breech, resolving shoulder dystocia and physiological infant resuscitation.
A co-venture video experience with Spinning Babies and Blooma Yoga! Coming Soon!
Spinning Babies; Daily Essentials For Pregnancy Video.
Together Sarah Longacre, international prenatal yoga instructor and birth doula, and Gail Tully, yours truly, created a unique instructional video for flexibility and comfort in pregnancy and to support better fetal positioning in time for birth.
Here are daily activities for stretching and balancing a pregnant body. Start early in pregnancy to prepare to make the most space for baby's best birth position and the most ease for mother's opening during the birth process.
We begin the program for women of average flexibility (or just plain stiff to start with) and beginner tips. But soon, you'll be ready to move freely! That's when Sarah brings the stretches all together into her easy to follow, playful, sensual, and flowing "Blooma Style" daily routine.
Sarah's "dance of opening," moves joints and ligaments to come alive under the delightful melody and percussions of Carin Vagle. This isn't about core strength; its about freedom of movement and creating space in the body.
Sarah plays along with Gail's little game of "Flashlight" to show pregnant women how to evaluate their own posture and positions. Smart Maternal Positioning helps baby snuggle their backs into the front of the womb for Optimal Fetal Positioning.
The Daily Essentials For Pregnancy includes tips for using Maternal Positioning around the house. Actual scenes in the bedroom, living room -and even the bathroom- gives practical instruction like no other video. You will be sleeping more comfortably immediately when using these tips. Within a week or two many pregnancy discomforts of the pelvis and lower back may be reduced when all these nurturing techniques are integrated into your daily lifestyle. Spinning Babies and Blooma Yoga-- a natural collaborative!
Spinning Babies Childbirth Preparation Class.
Soon pregnant parents around the world can take a Spinning Babies class from their own monitor! Join six couples as they learn the reason why Spinning Babies works and how it can enhance your labor and birth.
See techniques to do daily or weekly. Actual, real consultations with two couples right at our class location, one with a breech baby (head up) and one with a baby in a transverse lie (lying sideways).
Couples do the techniques together and show you how to do these at home.
Used alone or with the Daily Essentials, Spinning Babies Childbirth Preparation Class goes beyond the basics. Simple props show complex concepts sweetly. Little-known anatomy is linked to childbirth and the role of fetal positioning.
The section on labor discusses two labor patterns- the one "promised" in other books and the unexpected one associated with the posterior labor. Learn the common causes of long labor and techniques to help baby through the pelvis.
Be empowered; be prepared. After using this video throughout your pregnancy, while we can't promise, of course, you may not need the tips for labor progress. You can use that knowledge to help your neighbor. This video is all Spinning Babies.
Blooma Yoga Prenatal Yoga for AM and PM.
Warm up in the morning and cool down in the evening in two 30-minute sequences. Sarah Longacre shares her own blossoming pregnancy, Blooma style, to the exquisite music of Carin Vagle. Sarah's affirmations will carry you through labor with emotional strength and encouragement. Play this video when the others become too basic and you just want to dance and have fun. Wait, dance? Isn't this yoga? With Blooma and Carin Vagle, your spirit won't know the difference. Soar to greater freedom of movement. Bring your hormones into harmony with the day. Begin your day with serious play. Cool down at night with a sleep enhancing stretch before bed. This video is all Blooma!
Sarah's video is ready for you now! Get Blooma's AM/PM Yoga here
All three videos are professionally produced by Melissa Koch of Grey Duck Productions, with stills by Tanya Villano Photography, each of these three videos are dynamic on their own. Together they will enhance your pregnancy and labor experience with fun and empowerment in the most practical manner. Feel hope for your birth abilities, this is support for your journey. Gain the confidence and flexibility to fully bloom. I believe these videos carry the potential to bring your best birth dreams into the gentle reality.
Compassionately priced. Estimated Due Date for Daily Essentials March 2014; for Spinning Babies Parent Class, Fall 2014.