Wait, It’s The Wrong Way?

Your pregnancy has been wonderful. Your baby is healthy, strong, and growing like a weed. Week 35 comes along, and your caregiver sees which way the baby lies. She can’t feel a head, so they take you for an ultrasound to see where the head is. They search around since the baby is big now and it can’t stay in one spot to see the entire baby. They finally find the head, and it isn’t where it ‘should’ be. Your baby is butt down, or breech.

Your caregiver tells you your options. Since most don’t deliver breech babies vaginally, they give you a handout that tells you ways you can turn your baby at home, plus they might inform you on doing an external cephalic version, or they might just schedule your cesarean for 39 weeks.

You leave the office in a daze. How could this happen? Everything was perfect. You were prepared for your perfect birth, and now you find out that you probably will have to have a cesarean section, just because your baby is the ‘wrong’ way.

So you go home and research this ‘complication’ in your pregnancy. You are surprised to find that 3-5% of all babies are breech at term. Most turn on their own before delivery, but the few that don’t will stay breech and can be delivered that way.

You try the exercises she gave you. Every night before you go to bed you talk to your baby, praying that will get them to turn. Every morning you feel your belly, and that head is still up in your rib cage.

Your next appointment, a week later, your caregiver once again goes over your options. They do another ultrasound, and the baby is still in that ‘difficult’ breech position. They schedule an ultrasound to check the weight and fluid of the baby the next day, plus they schedule a consultation to talk about the version (if you are with a midwife. With a doctor, they do the consultation themselves).

You get the ultrasound and everything looks good, so you schedule the version for week 37. Your baby will be term, so even if something goes wrong, and they need to give a cesarean that day, your baby will be fine.

You keep trying to turn your baby at home, but it is good and comfortable how it is. You get to the hospital at 5 am for your 7 am version. The nurses take your blood, do a non stress test, the anesthesiologist is called to give you your epidural (to relax you and just in case of an emergency cesarean), you are given an IV of fluids because of the epidural, you are given medication through your IV to relax your uterus (which they say has 0 effect on the baby), the doctor comes in and does an ultrasound to confirm your baby is still being stubborn, and then they “gently” turn the baby. After the procedure, they do an ultrasound to check to see if it is head down and you are monitored to make sure the baby took it okay. If it is fine after an hour, you are allowed to go home, but you still make your weekly appointments until labor begins.

But, yours didn’t go smoothly. The medication made you have panic attacks, and the baby’s heartrate kept dropping after the version. They put you into labor, but your contractions aren’t working as well as they should because of the epidural.

You are finally able to feel your legs, but not enough to be able to walk by yourself. The nurses help you to the bathroom, since they didn’t catherize you. You come back to your bed to find them cleaning it up since while you were numb you either wet the bed or your water broke.

They do a test to see if it was your water, and it comes back negative. The baby’s heartrate keeps dropping, and your contractions are getting stronger, so they do a vaginal exam. You are completely effaced, but only 1 cm dilated.

The doctor comes back in and says that the baby isn’t taking it well, so they are prepping the OR for a cesarean. You don’t get a say because you signed a form for the version that says a cesarean is probably necessary. The anestesiologist comes back in and procedes to numb you up again. Since the epidural is still in, but you moved around trying to get the heart rate up for the last 4 hours, it is likely to have moved. The epidural isn’t working. They start wheeling you to the OR, and they keep pumping you full of more medication to numb you up.

When you get there, they strap you to the table, place a board under you to lift up your uterus, strap your arms out to the side of you (like a crucificion), and then cut you open and take your baby out.

You lie there, strapped and helpless, as your healthy baby is taken out of your body because of an unnecessary, risky procedure that doctors do everyday to breech babies.

The procedure turns about 65% of the babies, but about 50% of the ones that turn are sectioned that same day because of problems that occur.

You wonder what you could have done differently. Is it truly necessary to have a cesarean with a breech baby? Or could you have delivered your baby just fine?

There are three types of breech presentations.
Compelete breech, where the feet and butt are at the same level, incomplete breech, where one foot is up and one is down (sometimes called footling breech), and frank breech, where the feet are up by the baby’s head. My daughter was frank breech, but her ankles were crossed at her head.

Most people think that breech babies are abnormal, and that something is wrong that made it so they didn’t turn. They don’t pause to think that this is a perfectly normal baby. Some just don’t like to go head first into the world (it is a scary place after all haha…)

Doctors don’t learn how to deliver breech babies in medical school anymore. You might be able to find an older doctor that knows how, but their idea is now that it is safer to the baby to be delivered by cesarean.

When you have a baby by cesarean, the risk is to the mother AND the baby. Vaginally it is just to the baby. I know that sounds terrible, since you never want risk to your baby, but that’s how it is. Would you rather risk yourself and your baby, and may not be able to have further children, just because it is a riskier thing to have a vaginal breech delivery than a vertex delivery?

I had a version with my daughter without weighing the facts and risks. The Farm does breech deliveries without any trouble. And, they do try to turn the baby, but the mother has to be willing. They don’t numb her up. They don’t give her an IV of medication. While they are doing a fundal check, they talk to the mother to relax her, then they try to turn the baby. Most women don’t even know they’re turning the baby until it is vertex!

Mine was not ‘gentle’ turning. I felt like they were trying to push all my insides out of my belly button. If I wasn’t numbed, that would have been some of the worst pain of my life. I don’t even like thinking about what it did to Glade. When she was born, the whole left side of her body was a giant bruise. Gentle pushing, my a$$.

Below is a picture of how they turn the baby. Most doctors like to have two people doing it. One pushes the baby from one side, the other pushes from the other side. You need a certain amount of strength to do it too, especially if the baby isn’t moving.

My daughter was engaged in the pelvis, so they had to lift and push. My midwife broke out in a sweat just in the 15 minutes before they got her turned around. I would have bruises on my left side too!!

The risks of a version include, but not limited to:
-premature labor
-PROM (premature rupture of membranes)
-blood loss from mother and/or baby
-fetal distress
-might turn back after performed

You cannot have a version if:
-bleeding
-placenta previa
-nonreactive stress test
-smll baby
-low fluid
-abnormal heart rate
-PROM
-multiples

If you are lucky enough to find someone that will deliver your breech baby vaginally, they will advise you to start practicing your birthing positions for your breech baby. You will need to be more open than with a normal delivery, since the butt is bigger, and you have to be able to deliver faster than with a vertex baby.

The best position is leaning forward, almost on all fours. You only push if you feel the urge, and you breathe your baby down and out. And, unlike in a vertex delivery, your baby won’t slide out after the butt is born. You have to get the arms, and the head out. The baby will assist you in getting its head, so don’t worry about it getting stuck and the baby trying to breathe. If you do not do more than support the baby as it leaves the body, it won’t try to breathe until it is fully birthed. Sometimes they may need a bit of a rub down and a sniff of oxygen, but then they pink right up.

Doctors will try to pressure you into a cesarean by telling you you will end up with a baby with birth defects and dislocated legs and hips if you try a vaginal delivery. This is a risk whether you deliver a breech baby or a vertex baby. No system is fool proof. But, doctors like the hands on approach, they will take the baby by the feet and pull it out. Since he is touching the baby, it will definitely try to breathe. This will not end well.

If you are having a breech baby, please research your options. You do not have to schedule an unnecessary cesarean. The butt will actually stretch you out more so the babies head should come right out with a push. Surgery is never an option if you do not need it.

Please, please, please (!!!!!) research your options. This isn’t something to be taken lightly.

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3 Responses

  1. Great post! Thanks for all the great information! I have never had a breech baby but would definitely plan a vaginal birth for one.

  2. I wish I had. Too bad only one hospital in my entire state does them… I still should have gone up there instead haha.

  3. Interesting topic. I am glad you explained the different types of breech positions.

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