Valerie Gommon Midwife’s Blog

Breech birth

Posted on: June 17, 2010

I know I’ve been quiet of late, not many blog postings.  This is mostly because I’ve been busy clinically, and I thought that today I’d share a recent experience of a breech birth with you.

I had previously cared for my client with her second baby – she had a quick and straightforward birth with that baby and so I was prepared that this labour could be quick again.

The pregnancy progressed without any concerns and at term she called me to ask me to attend … she didn’t feel she was actually in labour, but in view of the fact that she lived some distance from me, she felt she may need me to be there to go into labour.

On arrival with my client I performed the usual checks, blood pressure, urinalysis and abdominal palpation.  Hmmmm … felt strange … I asked if I could perform a vaginal examination (something that I rarely need to do) and sure enough there was no head presenting.  Indeed to start with I wasn’t sure what was presenting – perhaps a leg, perhaps an arm … but her cervix was very dilated, so she had been quietly labouring overnight!

We discussed her options, and I consulted with other colleagues for suggestions and asked another midwife to attend.  Obviously this was not going to be a usual scenario and we discussed transfer to hospital.  My client felt that neither she nor baby were in immediate danger so she preferred to stay at home and try a “knee-chest” position to attempt to move the baby.  This was actually quite successful, and a further vaginal examination showed that the leg/arm had moved.  I still wasn’t sure what I was feeling, and mother and baby were well so we continued.

On a further examination I determined that it was definitely a little leg and foot presenting, so at least we now knew what we were dealing with!  My client felt very trusting that all would be well, or at least accepting of whatever happened.  Her labour was slow and not at all usual, but, it was similar to her two previous labours and we were reassured by this.

Slowly, slowly things progressed and eventually we saw a little foot presenting!  I have some experience of breech birth (as did my second midwife) and I felt quite confident in both my ability and the mother’s.  The foot became a leg, one leg became two legs, little boys “bits” showed, the torso emerged, then one arm and another, before finally a head was born with the membranes stuck tight!  The baby was in good condition and needed no help (something we were all expecting, as breech babies are much more likely to need some resuscitation).

Wow, what a great day – mother was so very pleased with herself, and Dad too – he was great!  Midwives hugged and baby was cuddled!

So, breech babies can be born normally.  Of course it is always going to be slightly more risky and some breech babies will need to be born by caesarean, but this woman would almost certainly have had a caesarean if she had gone to hospital and here she was tucked up in bed with her family at home.

Oh, and by the way, he weighed 9lb!

2 Responses to "Breech birth"

[…] This post was mentioned on Twitter by Pam Wild, Valerie Gommon . Valerie Gommon said: New blog post: Breech birth – […]

I love to read about breech birth .))

My twins were both breech. They were tiny as 32 weekers and I reckon they got a much better start by entering the world the way they did than by me being cut open and them yanked out.
(shame their cords were cut before we got even a moment of skin to skin. grr)

I love the way you WAITED for this baby to see what would happen rather than being reactive. There is obviously a time and a place for adrenaline rushes, but often all a baby and birth needs is hands off (as much as possible) and PATIENCE!!!! (my first presenting twin was oblique breech at arrival to hosp but contracts turned him nicely into position when they were given the time to do so!!)

This is also music to my ears
“My client felt very trusting that all would be well, or at least accepting of whatever happened. ”

We can’t guarantee outcome whichever way a baby enters the world but this is never discussed with section births. They are always described as life saving.

Thank you!!

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