"We don't do breech!"

Following on from my last post about breech presentation...

One of the last appointments that I attended with one of my lovely follow throughs had me reeling again. The day before she had gone in for a scan to assess the position of the placenta which was found to be low lying at her morphology scan. They found the placenta had moved clear of the internal os which was great but also found the baby to be transverse... she was at that stage approaching 35 weeks.

Her last bub has only just turned one and was a big boy so my initial thought was that there was still plenty of room about for this one try different strokes and on palpation previous to this, it was definitely cephalic. She was pretty sure that bubs had turned the night before the scan, so I was of the mind 'plenty of time for change!' and gave her some ideas for getting bubs to at least take on a longitudinal lie thinking that I would get in first before the midwife returned to do the same (haha...)

Midwife comes in and continues to palpate and discovers that yes, the baby is transverse as I had found and obviously the scan had too. She turns to the desk and starts fussing... At that stage we weren't too sure what she was doing so we both break the silence in conversation about the ideas I had given at which point the midwife interrupts and suggests that the only option for her is to get that baby 'head down' or face a c-section.

Me being me now, pipes up and asks the question 'If the baby was to turn breech, will A be able to attempt a vaginal breech birth?' (I knew it was a long shot but took the chance!) Well!!! Lets just say I was shot down in flames - 'No, the hospital does not support vaginal breech'... full stop (all with her back to me, I must add!).

Although expecting this answer, I wasn't quite prepared for how abrupt her answer and for her lack of acknowledgement of the woman sitting before her. I was further aggravated by the fact that there seemed to be no discussion of what A could do to help her baby turn or what her options were other than to say that if the baby was still transverse or breech at the next appointment, A would be visiting the doctor to organise a section.

Sometime around that time she left the room and A turned to me and said, 'I don't want a section, is there anyone that will attempt a vaginal breech?' I took this as my cue to let her know that homebirth was definitely an option which she took on with seriousness.

I have spoken to her in recent days and she seems to think that bubs may have moved, which way she is not entirely sure but time will tell I guess.

Another example of midwives claiming to be woman-centred and being blantantly the opposite. It infuriates me that convenience has become so much easier. But as much as it makes me angry, it also drives me to always, ALWAYS put the woman first, empowering her and informing her with choice and option.

Vaginal Breech Birth

I have just completed placement at SCBU (Special Care Baby Unit) as part of my course and whilst I was working the other night, there was a Code called over the PA at the hospital in delivery suite.

As all news, the word travelled fast... the reason, an unsuspected footling breech.

It was quite fascinating to observe the conversation and attitudes to this as I went about what I was doing. Like Mitch always says, 'opinions are like arseholes'... everyone has one (excuse the language!) Some were of the mind 'so what', others seem to spiral into a discussion and debate about what was going to happen and what should happen.

A midwife that I was working closely with and who trained in the UK, looked at me and I looked at her and we had to giggle. We had only shortly before that engaged in a conversation about breech presentation initiated by the fact that Jyrus was breech for most of my pregnancy.

It is an example of the fear that I have seen nearly everyday I have worked within the hospital system. Somehow and somewhere along the line, this variation of normal has become abnormal and in this case, an emergency. You would think that people would work the logic and realise that there is a possibility that a baby may opt to enter this world bum first if it chooses and in that see it as normal... who created the fear that has resulted in the obviously normal occurrence becoming an emergency? And more, why do midwives and obstetricians continue to treat it as such?

Is it just because the law percentages, statistics and averages suggests that breech only occurs in 4% of all pregnancies that we freak out and deviate from the natural birth process? I have to question the studies that have been done and their suggestion that planned caesarean for breech presentation reduces infant mortality. If vaginal breech are no longer treated as normal, it figures that the amount of care providers experienced in vaginal breech on the verge of being non-existent and to add to this, how do we define experience particularly in relation to the hands-on/hands-off debate? Who defines experience?

It also says a lot about the 'birth industry' (excuse my choice of words but to me it sometimes feels like this) that we can base policy and protocol on one study alone, depriving women from having a choice... because that is truly what it comes down to. Regardless of whether statistically or by opinion breech birth results in greater complications or risk, why has it become someone elses decision to surgically abuse women?