Florence’s Birth Story
A positive breech birth
At 34 weeks I was told my baby was breech. “There is still time for my baby to turn” I told the doctor to which he responded it is highly unlikely and he’d like to schedule me for a cesarean at 39 weeks. What!? My heart sank but my determination grew. I asked the doctor what other options I had if the baby stayed bum down. “Could I have a vaginal breech birth?” “If a cesarean is my only option, could I at least go into labour naturally (knowing the importance of the homormes of labor)?” He’s answers were short, dismissive and not what I wanted to hear. Vaginal breech is rarely offered, and even more rare to be offered to first time mums. Allowing for labor to start naturally means you might be coming in at 2am he said… (so what I thought). I left the hospital and cried. This was not part of my plan. I was preparing to give birth to my baby at home, in a birth pool, with soft music playing and candles lit with just my husband, midwife, and doula present. I had been dreaming of this type of birth for years and now all of a sudden I was being faced with my vision of an empowering natural birth being turned on its head. Or so I thought.
I spent the next several weeks trying everything to encourage the baby to turn. Moxibustion, homeopathy, spinning babies techniques (inversions, sitting on a birth ball, hip tilts…), visualization, swimming, handstanding and somersaults in the pool, crawling around my house on hands and knees, talking to my baby and having my husband try to coax the baby down with his voice. From 36 weeks on I went to the hospital each week only to be told each time that she was still head up.
As the weeks went by I realised I needed to surrender. To let go. To listen to my baby and to my body. I did some internal work to become comfortable with the idea of birthing in the hospital. I also spent a lot of time researching vaginal breech birth and became confident in my ability to birth my baby in this variation of normal.
At 37 weeks I went in for an ECV. For those who don’t know this is when a skilled physician tries to turn the baby manually with their hands from the outside; the success rate is about 50% but I felt it was worth a try. I was still dreaming of that homebirth. The same doctor I saw at 34 weeks attempted the ECV without success. After the procedure we got talking about vaginal breech delivery. I made it clear to him I had been researching it, understood the risks, and believed I could do it as long as there was a supportive and skilled team willing to support me. I am not sure what made him open up but he informed me he was the most skilled obstetrician in the hospital at delivering breech babies and would be happy to support me in birthing my baby this way.
I was just shy of 39 weeks. It was a Sunday and my husband and I were having a slow morning. As I got out of bed my waters opened. All we could do was laugh. This was it, our baby was coming. I called the hospital to let them know and they told me I needed to come in immediately. I told them I wasn’t having contractions yet and I would like to labour at home as long as possible. They insisted I come in. Despite their instance, we were not in a rush. My husband and I took our time packing up bags of random things, clothes for me and the baby, comforts from home, and snacks, lots of snacks. A couple hours later we got in the car and made the hour long drive to the hospital. At this point I began to experience a dull ache in my lower back every 5-10 minutes. Slowly they grew stronger as we continued to drive. It was a sensation that while new to me, it felt so natural. I would take deep breaths through each and just notice the sensations rising and falling in my body.
When we arrived at the hospital I had to go in (without my husband due to the Covid restrictions) to have the baby’s heart monitored for 30 mins. During this time I met the doctor on duty that day. He was not the doctor I had been seeing who agreed to the vaginal breech birth but he was confident in going ahead with the plan. We chatted about his concerns and desires, and I expressed some of my own as well. In between the tightenings he did a quick check to see how dilated I was. “Your cervix is closed and hard” those words echoed in my head. You aren’t in labour yet he told me. I would have to go wait in the antenatal ward until labour began. They told me they’d come and check on me every 6 hours. I told the midwife I wanted to leave for a few hours to spend time with my husband while we waited, who wasn’t allowed in the hospital until I was in active labour. She said that wasn’t a good idea since we didn’t know how quickly labour would progress. I told her I needed 15 minutes to be with my husband and explain to him what was going on. Throughout this time the tightenings were continuing to get stronger. I was no longer able to talk through them and would slip deep into my body and focus on my breath as they rose and fell.
After the brief but much needed reconnection with my husband out in the parking lot, I went back in. They were taking a while to ready the room for me in the antenatal ward. I probably waited for another 30 mins or more, I am not exactly sure since I completely lost track of time. Eventually one of the midwives came to me and said they had decided to move me straight to the labour ward. I am not sure why they made this decision but I was so relieved. I excitedly went to get my husband and our bags.
We made our way slowly up to the birth room. Stopping regularly on the way as the rush came over me like a wave. A midwife greeted us there and said she’d be looking after us until her shift ended at 9pm. She encouraged us to make the room comfortable, she pulled the shades closed to dim the light, brought in a diffuser, and fake candles. We plugged in the salt lap and put on some soft music. I took a seat on the birth ball and that is where I stayed for the next few hours. I slipped deep into my body, a trance-like state. I was fully present with each contraction as it rose up through my body growing with intensity and warmth and then retreated, groaning, humming, and swaying. I wanted nothing more than to curl up and sleep in between each but that was not possible. Instead I sipped water and rested during the moments in between.
This dance continued for a couple of hours. The doctor would occasionally come in and tell me I was handling the pain incredibly well yet he was there to offer me some sort of intervention; I questioned him and declined. I knew I would not be able to bring my baby into this world if I agreed to such interventions. I also knew I could do it without. The doctor was right, I was handling the labour incredibly well and never lost sight of my vision of the birth or control of my body.
At some point, probably around 9pm when the next midwife’s shift began I could no longer sit on the ball, I could feel the baby was moving down. The midwife suggested that with each contraction I squat into it as a way to help bring the baby down. After moving down with each contraction for a short while I got the urge to start pushing. The doctor wanted to check to see if I was fully dilated before I started pushing. I crawled into the bed and he told me I was 9cm on one side and fully open on the other. The midwife suggested I try bearing down with several contractions on all fours. This is the position I was reading was most effective for breech delivery, using gravity to help the baby come down and out. I gave it a try for a few contractions but I didn’t feel strong enough in that position. I felt I couldn’t go deep enough within my power to bring the baby out so I rolled on to my back. The doctor checked again and I was fully open, ready to bring my baby out.
The doctor told me when we first met earlier in the day that he would prefer I give birth on my back because should he need to intervene he feels most comfortable using the tools and techniques he knows with me on my back because that’s the way he was trained. I was a bit annoyed by that desire of his but as it happened I was much more effective at pushing on my back! So there I was in that classic lithotomy position (which in my mind before this moment was the worst possible way to give birth) surrounded by two doctors, two midwives, and my husband – a very different picture of birth than the one I had imagined. Yet by surrendering my control of the “ideal” situation, I regained control and was feeling incredibly empowered.
With each urge to push I could feel her descending. She was folded up in half and her bum emerged first. The midwife said she could see the baby coming and encouraged my husband to look. She then brought my hand down so I could feel her. What a motivator that was. That was it. She was coming.
And she was coming in the way I knew was possible for the two of us to navigate together. With the team around me guiding me and encouraging me to direct my strength down and out I felt like I was approaching the finish line and could hear the crowd cheering me on. With each push I could see a bit more of her emerging. Her bottom and then her lower back, her mid back and upper back, then the doctor slipped her legs out, now dangling down toward the floor.
After another push bringing her shoulders out the doctor then reached in to guide her arms out. With the next push her head began to emerge. It didn’t make it all the way out on that push and I heard the doctor tell the midwife to get the forceps ready. I thought no way they were going to pull my baby out with the forceps and when the next urge to push came I pushed with all my might and out she came. I had done what I knew was possible despite the overbearing narrative that we are not designed for this, that it is dangerous and not worth attempting. She was here and I felt incredible.
Written by: Avery