Here at Ask the Midwife we’ve been sent two different birth stories detailing their vaginal breech births. Unfortunately Midwives and Obstetricians are becoming deskilled in the art of breech birth due to most being born by caesarean section. Vaginal breech birth can be a safe alternative if handled correctly and baby is in a good position, especially when it’s not your first baby. I hope these stories inspire, inform and make you think about alternatives if your baby is breech.
Kelly Simpson’s Breech Birth Story
I had my first daughter when I was 22. I had a very long 36 hour painful labour with her and had only gas and air but delivered with my legs in stirrups and tore very badly, she was 7lb 8oz. My second daughter was 17 hours, I had gas and air and a water birth…I felt every single pain and put that down to being in the water, you’re just so much more aware of your body and what is happening. Then last year on 8th March my waters broke at 6am but contractions didn’t start wich was completely out of the norm for me, as with my other two my waters didnt break ’til the very end. In fact my second was nearly born in her waters – they broke as her head popped out! I went to the oasis birthing centre at my local hospital and they had me bouncing on a ball with a pad on to check my waters had gone. Once that was confirmed I was sent home to see if I could get contractions to start but if they hadnt I was to go in at 6am the following morning to be induced. I went home got some sleep, had a bath, went for a walk and was getting twinges but nothing that was establishing. I went through the night timing them but there was no pattern and nothing I couldn’t easily breathe through so I knew I wasnt progressing. I went in at 6am and the twinges were still coming, I was put on a ward and examined and was only 2 cm… I was put on monitors and had a cannula put in just incase I did need to be induced but also because I’d need antibiotics as it had been 12 hours since my waters broke. I was given co-codomal and told I could go for a walk to get things going. The pains were getting more regular and more painful. I went back to ward and was examined again but I hadnt got any further. The pains were coming thick and fast so they offered pethidine, which I accepted as I thought I was in it for the long run. I slept through the pethidine and the contractions until they started getting strong again and the pethidine just wasn’t cutting it. I was examined and given a sweep again and was now 5 to 6 cm but cervix was still thick but they said they could feel baby’s head and that they thought I had membranes that hadnt gone so I was going to be put through to labour ward to be induced to get things going more and be given an epidural. The pains were so strong at this point and I just wanted some gas and air. The walk through to labour ward was causing lots of bearing down pressure and I began grunting as soon as I got on the gas and air. I knew she was coming but was so desperate for my epidural as I was just exhausted and thought it was going to be ages. The anaesthetist took 1hr to prepare the epidural and had me swaying on my bum side to side to get into position, I had the gown on and was just about to get the epidural and I just knew her head was there, I shouted this and swung myself round to my back the midwife swiftly examined me and said yep ok you’re 10cm push…. I pushed once and her bum was presented to which the midwife said ‘OK that’s not a head, we have a bum she’s breech!’ With that I pushed long and hard and out she slid, the midwife was mid step to push the emergency button and just about caught her! She was still in her membrane skin so literally looked like a sausage and she was completely folded in half. She didn’t cry but she was pink and fine and opening her eyes she was so calm! The midwife cried and told me she had worked at the hospital for 15 years and she had never heard of a vaginal breech birth, everyone had been sent to emergency c-section if not found before labour. Erin was 6lb6oz and perfect, she didnt seem at all affected by her unusual entrance into the world in fact she was blissfully calm! I did have a midwife appointment 2 weeks before hand where a trainee midwife when checking me in supervision of the midwife said she thought the baby was breech! The midwife quickly checked and said no no theres the head, and all those examinations and no one realised! I had no stitches and was up walking around in a matter of minutes. With my other daughters I was weeks in recovery! This third baby was a different labour completely for me as she was with my new partner so i was expecting an unpredictable labour but i wasnt expecting that! My established labour was 5 minutes! Also the main difference was she didnt have a mark on her. My eldest was purple and her head was egg shaped and her face was so swollen. My middle one again was purple and her face was very swollen although not as much as she was born into water, but my breech baby was pink with no swelling or anything.
How can midwives have missed a breech? A breech can be missed on palpation if the bottom is engaged it feels like an engaged (low down) head. If the ‘bottom’ feels hard and is moveable, we should be sending the woman for a scan. On vaginal examination if the membranes (water bag) is intact, it can feel the same as a head, especially if there are no feet dangling. Even when the membranes have broken, a bottom can feel the same as a head with the membranes intact. Above all we’re HUMAN and make mistakes (occasionally) – I’ve discovered a couple of breeches in my time, once on vaginal examination of someone in labour, it just didn’t feel right and was confirmed on scan. She went for a c-section. I diagnose a lot on palpation (feeling the abdomen) in the community and send them for scans. I haven’t had a surprise breech birth myself, but I did have one as a student, plus I’ve seen second twin breech births.
Lisa Hodge’s Breech Birth Story
I went to bed that night to be woken up at 2am with an almighty explosion. My waters had broken! So when our baby sitter arrived to look after our son we left for the hospital. By this point the contractions weren’t so bad, they were bearable as much as they can be! By the time I got to the hospital after requesting a water birth we got into the room with the pool. After examining me they found I was 7cm already! So I got straight Into the pool; after getting to 10cm by around 5:30 I started pushing – alas 2 hours later nothing. Two midwives examined me and couldn’t work out that it was her bum that was presenting until the senior Midwife on shift came up and examined. She said, ‘This baby is breech!’ They whipped me out of the pool onto the bed and down stairs to the high risk ward. When the Doctor examined and they scanned me they said she was quite far down the birth canal so the only way out was vaginally! So with very little help from the Doctor and Midwife and only an episiotomy, she gently glided out with a whole room of people spectating! Apparently it’s such a rare moment all junior Doctors and trainee midwives had to see! Anyway she came out at 7:51 am and was a little shocked so needed some oxygen to assist her breathing. All in all I did this with only gas and air and some parts nothing at all 😁 it was an amazing experience and I managed it all by myself. I believe it must be a harder delivery with them being bent in half and not exactly contract able parts coming first however I did not need the traumatic experience of being rushed to theatre for emergency forceps which nearly ended in a c-section. The mental scars I still have from my first delivery will always remain with me however the second was fantastic and I look back now filled with pride and wonder with myself. A woman’s body can do amazing things if we just trust and believe.