February 14, 2025 • 21 mins
Breech births present unique challenges and require both education and empowerment for expectant parents. We dive into real-life stories, shedding light on the skills needed for breech deliveries and the importance of having informed practitioners.
• Exploring the definition and implications of breech births
• Case study of a hospital breech delivery experience
• The significance of experienced practitioners in breech scenarios
• The art of breech delivery by skilled midwives
• The role of home birth in expanding breech delivery options
• Addressing common concerns and questions about breech births
• Importance of informed choices and preparation for unexpected scenarios
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Show Credits
Host: Angie Rosier
Music: Michael Hicks
Photographer: Toni Walker
Episode Artwork: Nick Greenwood
Producer: Gillian Rosier Frampton
Voiceover: Ryan Parker
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:10):
Welcome to the Ordinary Doula Podcast with
Angie Rozier, hosted by BirthLearning, where we help prepare
folks for labor and birth withexpertise coming from 20 years
of experience in a busy doulapractice Helping thousands of
people prepare for labor,providing essential knowledge
(00:41):
and tools for positive andempowering birth experiences.
Speaker 2 (00:48):
Hello, my name is Angie Rozier and I want to
welcome you to the OrdinaryDoula podcast.
We do this podcast to helpfolks prepare for all things
labor, birth, delivery,breastfeeding, that newborn
phase, that end of pregnancyphase.
I think, yeah, information ispowerful and knowledge is king.
(01:09):
So, hopefully, the betterprepared you are, I want you to
have access, access to knowledge, information and be able to ask
the questions to get a goodexperience for yourself,
whatever your situation isBecause, yeah, you should be
empowered to do that.
Your situation is Because, yeah, you should be empowered to do
that.
So this is a follow up to lastepisode about breach kind of
some breach facts, a little bitof history, where we are with
(01:32):
breach deliveries in the UnitedStates.
I've had a couple interestingbreach deliveries in the last
couple months, so I just wantedto.
This has been on my mind andjust wanted to share a little
bit about those.
I'm going to go back to cause.
This illustrates a lot of whatI talked about in our previous
episode about breach history.
I want to go back about fouryears.
I had a um, a client whose babywas breached.
(01:53):
We didn't know it till the liketowards the end of pregnancy,
Um, kind of a you know,interesting situation.
And she I found myself withthis client.
We were in a hospital and forother risk factors, she ended up
having the MFMs, which ismaternal fetal medicine doctors,
so your high risk doctors werebecame her providers.
This baby was breech and thisclient I mean she was planning
(02:18):
on a home birth.
Things were, you know, changedvery quickly for her, which is
hard, it's really difficult.
So she was really insistentupon's really difficult, Um, so
she was really insistent upondelivering her baby.
After we discovered it wasbreech, she wanted to deliver
breech.
It was not her first baby, Um,so she delivered babies before,
had what we call a proven pelvis.
Um, this baby wasn't termed tobe very big, Um, she was healthy
(02:42):
, she was of low risk factorsfor that.
So the team little team of MFMsmet and they talked to her and
they were awesome as wediscussed it and talked about it
and they said, well, and thisis not a great facility, right,
Like, it was an awesome facilitythat I worked at in North
Carolina and this team ofamazing doctors so I really
enjoyed working with.
They said, you know what?
We don't, we don't know how todo that.
(03:03):
Like, we're happy to you know,given the situation, we're happy
to support you in that, butnone of us have those skills.
Like, we just don't know how todo that.
Um, and they said what we dohave, we have a chance of
finding someone who does.
So.
There's a certain doctor in thearea this was a weekend and if
he is available, if he's homethis weekend this was a weekend
(03:25):
and if he is available, if he'shome this weekend, then we're
happy to try it.
So her chances were on the factthat this doctor would be
available.
And this doctor is older.
He came from a time where hewas taught to do breach
deliveries and he had donehundreds of them in his career.
He was in his 70s.
He got a call from the hospital, they he got a call from from
(03:47):
the hospital and, yes, he wasavailable that weekend.
He was willing to come in,willing to do it.
Um, he came in, he sat with usthrough the night.
So great it was.
Just it was amazing to have himthere.
He made another interestingcomment this is going down a
tiny rabbit hole here, Um,because his career had spanned
several decades, you know.
And he said you know, as wekind of sat there and this, this
(04:07):
baby was born in the morningtime, kind of as the sun was
coming up, and he sat there withus throughout labor and he said
you know what?
This is how it used to alwaysbe Like babies so often were
born as the sun was coming up,like in the morning.
That's when we did so manydeliveries.
It was a very busy time beforewe started taking control of
labor and inducing.
This is kind of a natural timethat babies would be born.
(04:31):
So I thought that was kind ofinteresting too.
So he'd seen shifts in hiscareer and how, how practices
change right, how we managelabor and do inductions and
things.
So I thought it was interesting.
They called this doctor in whohad the skills and he's 74 years
old and he was good at it andhe did have the skills and he he
had a maternal fetal medicinedoctor assist him and they did
some maneuvers, things thatthese younger, newer, very
(04:51):
talented, smart doctors hadnever been taught.
So that was kind of interesting.
Um, all right, so my more recentbreach stories.
What was that?
A couple months ago, and thisperson had chosen an out of
hospital birth.
They were birthing at home witha midwife.
It was her second baby, Um, andshe had given birth unmedicated
(05:13):
before, right she, like in ahospital setting, and um.
So she, she knew what she wasgetting into and she made the
decision to have a home birth.
Great, I love it, Um.
And towards the end ofpregnancy, found that well, I
think we were like a 33, 34weeks the midwife found that
this baby was breech right, Headis up.
So she gave the mom some thingsto do and I'm like all right,
(05:36):
let's try these few things.
And the mom, the pregnant mom,did them and the baby turned,
the baby went head down,cooperated pretty nicely, I you
know I was like, oh good, thatsimplifies things.
And then in time the baby wenthead up again.
So I'm like, oh, here we areagain, where you know babies
breach.
This home birth midwife, um, hadbeen trained in delivering
(05:58):
breach babies, that you know.
That may seem preposterous tosome, but this is a skill that
has been used for think back onit right Centuries, millennia
midwives way before obstetricswas even invented midwives were
delivering breech babies atwhatever rate breech babies were
(06:18):
coming right.
They delivered 100% of breechbabies vaginally over the
millenn, the millennium Um.
So this is an art that's,that's out there, right, it's,
it's.
We have lost it in our medicalcommunity, but it's out there.
So this home birth midwife said, all right, we'll just, we'll
deliver, we'll, do you know,deliver a breech baby.
And, um, I was like, okay,should we try the things again
(06:40):
to turn the baby?
And we did, they didn't work.
So we got, you know, to the duedate and kind of creeping past
the due date and in my mind I'mlike, all right, I wonder if we
need a transfer plan.
Like, where are we going to go,if you know?
And this mom's previous baby,by the way, was born very early
for some medical reasons, Ithink at 34, 35 weeks.
(07:03):
So very little baby, right?
So, yes, she'd had a babybefore, unmedicated, but a small
baby.
And now we are past due date.
Right, we're past 40 weeks witha bigger, theoretically a
bigger baby, like almost surelygoing to be a bigger baby.
So I, like in my mind, wasgetting a little bit nervous.
I'm like, all right, what canthis pelvis accommodate?
We know this pelvis canaccommodate a five pound baby.
(07:25):
Can this pelvis accommodate alarger baby and a baby who is in
a breach position?
And the midwife was just calmand confident about it.
We were getting to 41 weeks.
I think we went a couple dayspast 41 weeks and in my mind I'm
like, all right, what's ourplan?
Like you know, we can't likejust induce labor because
(07:45):
they're at home, not in the sameways anyway, right, the midwife
, home birth midwives have somegentler ways of inducing.
They're not nearly as strong orpowerful as the hospital ways
and that's why they're homebirth midwife ways.
But in my mind I wanted a planlike all right, where are we
(08:09):
going to transfer?
Is this baby going to be bornby C section?
And I wanted my client, on anemotional side, to be prepared
for that.
So I gently explored with herwhat those plans were and, um,
she was fine not to have any.
The midwife hadn't presentedany.
So this was a learning thing forme, right, like years and years
into my um practice, like Iagain, once again, like all
right, cool, like I learned totrust because I mostly work.
I'm about 90% 93% in hospitaland about 7% out of hospital,
(08:35):
and so that's my mainexperiences hospital deliveries,
which in this case would be aC-section, right, A C-section,
probably two weeks ago at thispoint, um, so I was a little had
a little bit of trepidation,but I got to this, the the, the
mom finally went into labor.
Midwife did a little bit ofprompting with some um, the ways
home birth, the way home birthmidwives do, and labor began.
(08:56):
Um, I arrived there and thehome birth midwife was talking
um to the mom, actually had anapprentice doula with me and she
was talking both of us through.
All right, you're going to seesome stuff we don't see very
often.
Here's what we're going to doand you'll see me maybe do some
maneuvers that we might need todo.
We will just kind of see what'sneeded.
And she said this wasfascinating to me because in
(09:17):
hospitals we don't see this.
But she said and we will never,with a breach delivery, want
her to be on her back.
We want to be up on our handsand knees and have her body in
that position is much better fora breech delivery.
So it was interesting to hearfrom her like, yeah, she had a
plan, she was prepared for this,she had she brought in her very
best assistants, like, who haddeep experience.
(09:39):
We had three midwives there,myself and an apprentice doula.
And labor labor's different,right Like it feels different
with a breech delivery.
The presentation of the bodyparts are different and so for
someone who's had a baby before,she knew this felt a little bit
different, not bad, not wrong,just different.
She was aware of that.
Labor went beautifully, shelabored, you know just this nice
(10:01):
steady pattern.
Things picked up.
She had that urge to push.
She pushed for a while.
I want to say it was about anhour, um, a little more, you
know it was longer than she hadwith her first baby, who was
small.
And, yep, that baby's cutelittle butt came first and
babies like a lot of meconiumgets pushed out.
So you got meconium coming,coming out before the baby does.
(10:22):
And, um, mom was on her handsand knees.
The team was ready with withwhat was needed.
They're ready to resuscitate,they were ready to do some
maneuvers, you know, based onwhere the baby's head, if the
baby's head is extended, andthat was a perfect, slick
delivery.
That baby slid out like butter,and that's what the midwife
called it.
She goes I have butter breaches, I call them, where they just
(10:43):
slide right out.
Others make me work a littleharder, but it was fascinating
to me to see this ancient skillat work in our modern world.
On a little side street in acity, a cute little brick house,
when a baby was born on theliving room floor on a Saturday
night.
Um, it worked, it workedbeautifully.
So taught me again, um, back toroots, old ancient roots, that
(11:04):
birth works right.
Um, because a lot of times wedon't trust that in some
hospital settings.
So that was.
That was interesting.
It was very interesting for me.
So I'm going to flip now and doanother breach story that was a
little bit more recent.
That other one was a couplemonths ago.
This one was a couple of weeksago.
Had a client who was having ababy in a hospital.
(11:25):
She had a great midwife.
She'd chosen this amazingmidwife, amazing hospital.
This client is incrediblyconscientious of health, of
fitness, of what she puts intoher body what she does.
She's very disciplined when itcomes to eating healthy and
exercising.
It's a very healthy lifestyleand so it matched for her
(11:45):
lifestyle to want a simple,uncom, uncomplicated,
unmedicated, low interventionbirth.
That's what.
That was her goal.
She set everything up for that.
She hired a doula.
We were prepared for that andthen we find out this baby is
breech.
I think we're at 36 weeks.
(12:05):
She tried all the things.
Look at my last episode tryingall the things to turn a baby.
She tried them all right.
She did the water, she did theinversion, she did moxibustion,
she did chiropractic.
She did all the stuff to try toturn a baby.
I think she did light soundtemperature.
The last thing to try was anECV external cephalic aversion.
(12:26):
Remember, it's not an aversion,it's just aversion.
I love it when my clients callit I'm having an aversion.
It's just aversion.
We're trying to turn thatbaby's head.
So she goes to the hospital onthe appointed day.
She and I talk through it, walkthrough it.
What would it be like?
What could she expect?
We talked about the sensorythings about it.
It could be pretty intenseThings.
It can be pretty intense things.
(12:47):
They could give her to helpwith that.
She was nervous but feltcomfortable, like prepared,
going in, right.
So she goes in in the midmorning time to get this done.
They did it in a labor anddelivery room.
They had her kind of reclined.
The midwife and a doctor camein to do it.
They're monitoring the baby andshe's like it was intense, like
(13:10):
when they were doing thatversion, like oh my gosh, that
was tough, very, very difficult,painful to try to turn that
baby.
And during the version thisbaby's heart rate tanked pretty
good, like the heart rate wentdown.
I remember we talked about inour last episode whenever a
version is done in a hospitalthey are, they want to do it in
(13:31):
a.
In a way they have a, an ORready, available, open and a
team ready in case things don'tgo great.
This baby's heart rate wentreally low for a while.
Uh, trying to do this version.
Baby did not turn.
They tried for like threeminutes.
I think.
Um, interesting to know.
You can try for up to 16 if thebaby's doing well, 16 minutes,
that is.
They tried for about threeminutes.
(13:51):
They tried three times.
Um, baby didn't budge, babywasn't going to dive forward,
baby wasn't going to divebackwards.
So she knew this was to be apossibility.
Right and aversion has about a50% chance of working.
It's not amazing, um, but it'sone of the the you know an
effective, more effective thingsto try.
So she was like, all right,well, we have our answer.
(14:14):
I was prepared for thispossibility, of course.
I think I'll be having aC-section.
Her midwife said, all right,well, we tried, that was great,
let's plan a C-section for acouple of weeks from now.
So she was at 37 weeks.
This was going to be, you know,a C-section about 39 weeks.
She's like, all right, let's doit.
And her husband went out to getthe car she was checking out at
the nurse's desk.
(14:34):
She took three steps away fromthe nurse's desk when her water
broke.
It was all on its own, right onthe floor.
The nurses heard it.
She's like, whoa, what justhappened?
She's like, wow, my water justbroke.
I said, all right, you know,come on back.
So she had her husband go parkthe car again.
They came back and with hermidwife decided, all right,
we'll do a C-section later today, unless, you know, baby
(14:55):
warrants or labor starts up orwhatever, that we need to do it
earlier.
So her her plan that she gotused to got expedited by a
couple of weeks.
It was happening today Um, thatwas about 11 or 12, I think and
they've said let's do aC-section about five o'clock
tonight.
So we kept in touch.
She had the afternoon to kindof get used to that wrap her
head around that.
She cried some.
(15:16):
You know it was going to be abig day anyway to find out will
this work?
Am I going to have the birththat I've been planning for, or
am I going to have a C-sectionin a couple of weeks?
Well, so we're having it today.
So she had the afternoon toprocess that.
They did the C-section, took herback at the appointed time she
was.
She didn't go into labor, whichwas great during that day and
(15:38):
this was what was fascinating tome Like they got in there and
found that this baby's cord wasabout six inches long.
So he was Frank Breach.
He was kind of sitting up.
He.
This placenta was anterior,which sometimes has something to
do with it.
He just had to be right next tohis placenta because that cord
(15:58):
was so short.
He could not deviate, hecouldn't, he couldn't dive down,
he couldn't move.
There was no tangling in hiscord because it was so very
short.
So interesting to know like.
This was a very good call,right, like and it's a very
common call, right.
But this baby, even if this babyhad been head down the entire
(16:19):
pregnancy, would not havetolerated labor very well, would
not have tolerated thetraveling the path he needed to
go down to go descend into thepelvis.
With a cord that short it wasliterally like six inches short
there's no way he could havedescended.
So this would have been acesarean either way.
It happened to be a cesarean at37 weeks and where the cord was
(16:41):
held him in a position he couldnot dive down with that version
.
There's no way he could haveturned with a cord like that.
That's why his heart rate wastanking and going low during the
version.
It all made sense after we hadthe full picture of things.
So my client, after she knewthat she's like oh, okay, okay,
and she was pretty amazing.
(17:02):
She had to do some shifting andsome processing, but she was
really good at honoring whatthat baby needed Um, she, it
could be easy to be devastatedby that right Like.
She's like this is not what Iwanted, this is not what I
planned or prepared for, but youknow what.
It's what that baby needed andshe was in a good space pretty
quickly.
But you know what.
It's what that baby needed andshe was in a good space pretty
quickly, you know stillprocessing things, but in a good
(17:23):
space to say this is what mybaby needed and she was able to
honor what the baby neededrather than to mourn what she
wanted.
So we had a cute little baby.
As you know, with breech babiestheir little hips are just wild
right.
They have their toes, are kindof by their ears and they're
they have hip.
You know we watch for hipdysplasia, but this baby was
very folded up.
Um help them in their home acouple of times with lactation.
(17:46):
He's doing amazing.
He's adorable, um, and she'sdoing well too.
That as a couple they'rethey're doing quite fine.
They do want to plan for a VBAC, um when they have a second
child and she's a greatcandidate for it.
So so that those are my couplelittle recent breach stories,
very different from each otheryou know one at 41 weeks, one at
37 weeks.
(18:06):
One went smooth as butter, onewas smooth for a c-section right
and a very warranted and supergrateful that that's how it
worked out.
So interesting to know all thedifferent ways things can happen
out there.
So if you or someone you knowyou know has a baby that's
breached, do a little research,do a little digging, see what
you can find out, um, see howyou feel about aversion, See how
(18:31):
you feel about trying to turn ababy, see how you feel about
having a plan cesarean, or whatresources do you have If that's
not the route you want to go,what doctors in your area
whether that's older docs,because some of the articles
that I looked at and preparingfor this said the the doctors
who are trained to deliverbreech babies are going gray
like they're.
They're, you know, they're adying breed.
(18:53):
Really it's not trained anymore.
But there are places you know,in a lot of home birth
communities.
Some areas have very robusthome birth communities.
In our area we have a homebirth midwife who's incredibly
skilled at at breech deliveries.
She has even been asked to comeinto the hospital and work with
an OB to talk him through abreech delivery, which is pretty
(19:14):
fascinating because that's herspecialty is breech deliveries.
So we get a lot of breechdeliveries to get headed her way
and even we have a littlecrossover from home birth to
hospital birth community incollaborating on that, which I
think is fascinating.
Hopefully, I don't know, likepie in the sky, this comes back
as a medical art, a medicalskill that is resurrected
(19:36):
somehow.
But just one generation ago itwas very common and now it is
pretty obsolete in our medicalworld.
Hard for the you know themedical world to wrap their head
around this, the fact that thiswas so common because it's lost
.
It's lost for a variety ofreasons.
Anyway, little, those are mythree breach stories.
Hopefully helps you in some way, if it's, if nothing else,
(19:59):
hopefully just interesting.
Thanks so much for being withme here today on the Ordinary
Dula podcast.
My name is Angie Rosier.
I'm your host, so happy to bewith you and, as always, I want
you to reach out and connect tosomeone important in your life
today.
Reach out and make a differencein their life and see what it
does for you.
Have a great one and we'll seeyou next time.
Speaker 1 (20:36):
Thank you for listening to the Ordinary Doula
podcast with Angie Rozier,hosted by Birth Learning.
Episode credits will be in theshow notes Tune in next time as
we continue to explore the manyaspects of giving birth you.
Welcome to the Ordinary Doula Podcast with
Angie Rozier, hosted by BirthLearning, where we help prepare
folks for labor and birth withexpertise coming from 20 years
of experience in a busy doulapractice Helping thousands of
people prepare for labor,providing essential knowledge
(00:41):
and tools for positive andempowering birth experiences.
Speaker 2 (00:48):
Hello, my name is Angie Rozier and I want to
welcome you to the OrdinaryDoula podcast.
We do this podcast to helpfolks prepare for all things
labor, birth, delivery,breastfeeding, that newborn
phase, that end of pregnancyphase.
I think, yeah, information ispowerful and knowledge is king.
(01:09):
So, hopefully, the betterprepared you are, I want you to
have access, access to knowledge, information and be able to ask
the questions to get a goodexperience for yourself,
whatever your situation isBecause, yeah, you should be
empowered to do that.
Your situation is Because, yeah, you should be empowered to do
that.
So this is a follow up to lastepisode about breach kind of
some breach facts, a little bitof history, where we are with
(01:32):
breach deliveries in the UnitedStates.
I've had a couple interestingbreach deliveries in the last
couple months, so I just wantedto.
This has been on my mind andjust wanted to share a little
bit about those.
I'm going to go back to cause.
This illustrates a lot of whatI talked about in our previous
episode about breach history.
I want to go back about fouryears.
I had a um, a client whose babywas breached.
(01:53):
We didn't know it till the liketowards the end of pregnancy,
Um, kind of a you know,interesting situation.
And she I found myself withthis client.
We were in a hospital and forother risk factors, she ended up
having the MFMs, which ismaternal fetal medicine doctors,
so your high risk doctors werebecame her providers.
This baby was breech and thisclient I mean she was planning
(02:18):
on a home birth.
Things were, you know, changedvery quickly for her, which is
hard, it's really difficult.
So she was really insistentupon's really difficult, Um, so
she was really insistent upondelivering her baby.
After we discovered it wasbreech, she wanted to deliver
breech.
It was not her first baby, Um,so she delivered babies before,
had what we call a proven pelvis.
Um, this baby wasn't termed tobe very big, Um, she was healthy
(02:42):
, she was of low risk factorsfor that.
So the team little team of MFMsmet and they talked to her and
they were awesome as wediscussed it and talked about it
and they said, well, and thisis not a great facility, right,
Like, it was an awesome facilitythat I worked at in North
Carolina and this team ofamazing doctors so I really
enjoyed working with.
They said, you know what?
We don't, we don't know how todo that.
(03:03):
Like, we're happy to you know,given the situation, we're happy
to support you in that, butnone of us have those skills.
Like, we just don't know how todo that.
Um, and they said what we dohave, we have a chance of
finding someone who does.
So.
There's a certain doctor in thearea this was a weekend and if
he is available, if he's homethis weekend this was a weekend
(03:25):
and if he is available, if he'shome this weekend, then we're
happy to try it.
So her chances were on the factthat this doctor would be
available.
And this doctor is older.
He came from a time where hewas taught to do breach
deliveries and he had donehundreds of them in his career.
He was in his 70s.
He got a call from the hospital, they he got a call from from
(03:47):
the hospital and, yes, he wasavailable that weekend.
He was willing to come in,willing to do it.
Um, he came in, he sat with usthrough the night.
So great it was.
Just it was amazing to have himthere.
He made another interestingcomment this is going down a
tiny rabbit hole here, Um,because his career had spanned
several decades, you know.
And he said you know, as wekind of sat there and this, this
(04:07):
baby was born in the morningtime, kind of as the sun was
coming up, and he sat there withus throughout labor and he said
you know what?
This is how it used to alwaysbe Like babies so often were
born as the sun was coming up,like in the morning.
That's when we did so manydeliveries.
It was a very busy time beforewe started taking control of
labor and inducing.
This is kind of a natural timethat babies would be born.
(04:31):
So I thought that was kind ofinteresting too.
So he'd seen shifts in hiscareer and how, how practices
change right, how we managelabor and do inductions and
things.
So I thought it was interesting.
They called this doctor in whohad the skills and he's 74 years
old and he was good at it andhe did have the skills and he he
had a maternal fetal medicinedoctor assist him and they did
some maneuvers, things thatthese younger, newer, very
(04:51):
talented, smart doctors hadnever been taught.
So that was kind of interesting.
Um, all right, so my more recentbreach stories.
What was that?
A couple months ago, and thisperson had chosen an out of
hospital birth.
They were birthing at home witha midwife.
It was her second baby, Um, andshe had given birth unmedicated
(05:13):
before, right she, like in ahospital setting, and um.
So she, she knew what she wasgetting into and she made the
decision to have a home birth.
Great, I love it, Um.
And towards the end ofpregnancy, found that well, I
think we were like a 33, 34weeks the midwife found that
this baby was breech right, Headis up.
So she gave the mom some thingsto do and I'm like all right,
(05:36):
let's try these few things.
And the mom, the pregnant mom,did them and the baby turned,
the baby went head down,cooperated pretty nicely, I you
know I was like, oh good, thatsimplifies things.
And then in time the baby wenthead up again.
So I'm like, oh, here we areagain, where you know babies
breach.
This home birth midwife, um, hadbeen trained in delivering
(05:58):
breach babies, that you know.
That may seem preposterous tosome, but this is a skill that
has been used for think back onit right Centuries, millennia
midwives way before obstetricswas even invented midwives were
delivering breech babies atwhatever rate breech babies were
(06:18):
coming right.
They delivered 100% of breechbabies vaginally over the
millenn, the millennium Um.
So this is an art that's,that's out there, right, it's,
it's.
We have lost it in our medicalcommunity, but it's out there.
So this home birth midwife said, all right, we'll just, we'll
deliver, we'll, do you know,deliver a breech baby.
And, um, I was like, okay,should we try the things again
(06:40):
to turn the baby?
And we did, they didn't work.
So we got, you know, to the duedate and kind of creeping past
the due date and in my mind I'mlike, all right, I wonder if we
need a transfer plan.
Like, where are we going to go,if you know?
And this mom's previous baby,by the way, was born very early
for some medical reasons, Ithink at 34, 35 weeks.
(07:03):
So very little baby, right?
So, yes, she'd had a babybefore, unmedicated, but a small
baby.
And now we are past due date.
Right, we're past 40 weeks witha bigger, theoretically a
bigger baby, like almost surelygoing to be a bigger baby.
So I, like in my mind, wasgetting a little bit nervous.
I'm like, all right, what canthis pelvis accommodate?
We know this pelvis canaccommodate a five pound baby.
(07:25):
Can this pelvis accommodate alarger baby and a baby who is in
a breach position?
And the midwife was just calmand confident about it.
We were getting to 41 weeks.
I think we went a couple dayspast 41 weeks and in my mind I'm
like, all right, what's ourplan?
Like you know, we can't likejust induce labor because
(07:45):
they're at home, not in the sameways anyway, right, the midwife
, home birth midwives have somegentler ways of inducing.
They're not nearly as strong orpowerful as the hospital ways
and that's why they're homebirth midwife ways.
But in my mind I wanted a planlike all right, where are we
(08:09):
going to transfer?
Is this baby going to be bornby C section?
And I wanted my client, on anemotional side, to be prepared
for that.
So I gently explored with herwhat those plans were and, um,
she was fine not to have any.
The midwife hadn't presentedany.
So this was a learning thing forme, right, like years and years
into my um practice, like Iagain, once again, like all
right, cool, like I learned totrust because I mostly work.
I'm about 90% 93% in hospitaland about 7% out of hospital,
(08:35):
and so that's my mainexperiences hospital deliveries,
which in this case would be aC-section, right, A C-section,
probably two weeks ago at thispoint, um, so I was a little had
a little bit of trepidation,but I got to this, the the, the
mom finally went into labor.
Midwife did a little bit ofprompting with some um, the ways
home birth, the way home birthmidwives do, and labor began.
(08:56):
Um, I arrived there and thehome birth midwife was talking
um to the mom, actually had anapprentice doula with me and she
was talking both of us through.
All right, you're going to seesome stuff we don't see very
often.
Here's what we're going to doand you'll see me maybe do some
maneuvers that we might need todo.
We will just kind of see what'sneeded.
And she said this wasfascinating to me because in
(09:17):
hospitals we don't see this.
But she said and we will never,with a breach delivery, want
her to be on her back.
We want to be up on our handsand knees and have her body in
that position is much better fora breech delivery.
So it was interesting to hearfrom her like, yeah, she had a
plan, she was prepared for this,she had she brought in her very
best assistants, like, who haddeep experience.
(09:39):
We had three midwives there,myself and an apprentice doula.
And labor labor's different,right Like it feels different
with a breech delivery.
The presentation of the bodyparts are different and so for
someone who's had a baby before,she knew this felt a little bit
different, not bad, not wrong,just different.
She was aware of that.
Labor went beautifully, shelabored, you know just this nice
(10:01):
steady pattern.
Things picked up.
She had that urge to push.
She pushed for a while.
I want to say it was about anhour, um, a little more, you
know it was longer than she hadwith her first baby, who was
small.
And, yep, that baby's cutelittle butt came first and
babies like a lot of meconiumgets pushed out.
So you got meconium coming,coming out before the baby does.
(10:22):
And, um, mom was on her handsand knees.
The team was ready with withwhat was needed.
They're ready to resuscitate,they were ready to do some
maneuvers, you know, based onwhere the baby's head, if the
baby's head is extended, andthat was a perfect, slick
delivery.
That baby slid out like butter,and that's what the midwife
called it.
She goes I have butter breaches, I call them, where they just
(10:43):
slide right out.
Others make me work a littleharder, but it was fascinating
to me to see this ancient skillat work in our modern world.
On a little side street in acity, a cute little brick house,
when a baby was born on theliving room floor on a Saturday
night.
Um, it worked, it workedbeautifully.
So taught me again, um, back toroots, old ancient roots, that
(11:04):
birth works right.
Um, because a lot of times wedon't trust that in some
hospital settings.
So that was.
That was interesting.
It was very interesting for me.
So I'm going to flip now and doanother breach story that was a
little bit more recent.
That other one was a couplemonths ago.
This one was a couple of weeksago.
Had a client who was having ababy in a hospital.
(11:25):
She had a great midwife.
She'd chosen this amazingmidwife, amazing hospital.
This client is incrediblyconscientious of health, of
fitness, of what she puts intoher body what she does.
She's very disciplined when itcomes to eating healthy and
exercising.
It's a very healthy lifestyleand so it matched for her
(11:45):
lifestyle to want a simple,uncom, uncomplicated,
unmedicated, low interventionbirth.
That's what.
That was her goal.
She set everything up for that.
She hired a doula.
We were prepared for that andthen we find out this baby is
breech.
I think we're at 36 weeks.
(12:05):
She tried all the things.
Look at my last episode tryingall the things to turn a baby.
She tried them all right.
She did the water, she did theinversion, she did moxibustion,
she did chiropractic.
She did all the stuff to try toturn a baby.
I think she did light soundtemperature.
The last thing to try was anECV external cephalic aversion.
(12:26):
Remember, it's not an aversion,it's just aversion.
I love it when my clients callit I'm having an aversion.
It's just aversion.
We're trying to turn thatbaby's head.
So she goes to the hospital onthe appointed day.
She and I talk through it, walkthrough it.
What would it be like?
What could she expect?
We talked about the sensorythings about it.
It could be pretty intenseThings.
It can be pretty intense things.
(12:47):
They could give her to helpwith that.
She was nervous but feltcomfortable, like prepared,
going in, right.
So she goes in in the midmorning time to get this done.
They did it in a labor anddelivery room.
They had her kind of reclined.
The midwife and a doctor camein to do it.
They're monitoring the baby andshe's like it was intense, like
(13:10):
when they were doing thatversion, like oh my gosh, that
was tough, very, very difficult,painful to try to turn that
baby.
And during the version thisbaby's heart rate tanked pretty
good, like the heart rate wentdown.
I remember we talked about inour last episode whenever a
version is done in a hospitalthey are, they want to do it in
(13:31):
a.
In a way they have a, an ORready, available, open and a
team ready in case things don'tgo great.
This baby's heart rate wentreally low for a while.
Uh, trying to do this version.
Baby did not turn.
They tried for like threeminutes.
I think.
Um, interesting to know.
You can try for up to 16 if thebaby's doing well, 16 minutes,
that is.
They tried for about threeminutes.
(13:51):
They tried three times.
Um, baby didn't budge, babywasn't going to dive forward,
baby wasn't going to divebackwards.
So she knew this was to be apossibility.
Right and aversion has about a50% chance of working.
It's not amazing, um, but it'sone of the the you know an
effective, more effective thingsto try.
So she was like, all right,well, we have our answer.
(14:14):
I was prepared for thispossibility, of course.
I think I'll be having aC-section.
Her midwife said, all right,well, we tried, that was great,
let's plan a C-section for acouple of weeks from now.
So she was at 37 weeks.
This was going to be, you know,a C-section about 39 weeks.
She's like, all right, let's doit.
And her husband went out to getthe car she was checking out at
the nurse's desk.
(14:34):
She took three steps away fromthe nurse's desk when her water
broke.
It was all on its own, right onthe floor.
The nurses heard it.
She's like, whoa, what justhappened?
She's like, wow, my water justbroke.
I said, all right, you know,come on back.
So she had her husband go parkthe car again.
They came back and with hermidwife decided, all right,
we'll do a C-section later today, unless, you know, baby
(14:55):
warrants or labor starts up orwhatever, that we need to do it
earlier.
So her her plan that she gotused to got expedited by a
couple of weeks.
It was happening today Um, thatwas about 11 or 12, I think and
they've said let's do aC-section about five o'clock
tonight.
So we kept in touch.
She had the afternoon to kindof get used to that wrap her
head around that.
She cried some.
(15:16):
You know it was going to be abig day anyway to find out will
this work?
Am I going to have the birththat I've been planning for, or
am I going to have a C-sectionin a couple of weeks?
Well, so we're having it today.
So she had the afternoon toprocess that.
They did the C-section, took herback at the appointed time she
was.
She didn't go into labor, whichwas great during that day and
(15:38):
this was what was fascinating tome Like they got in there and
found that this baby's cord wasabout six inches long.
So he was Frank Breach.
He was kind of sitting up.
He.
This placenta was anterior,which sometimes has something to
do with it.
He just had to be right next tohis placenta because that cord
(15:58):
was so short.
He could not deviate, hecouldn't, he couldn't dive down,
he couldn't move.
There was no tangling in hiscord because it was so very
short.
So interesting to know like.
This was a very good call,right, like and it's a very
common call, right.
But this baby, even if this babyhad been head down the entire
(16:19):
pregnancy, would not havetolerated labor very well, would
not have tolerated thetraveling the path he needed to
go down to go descend into thepelvis.
With a cord that short it wasliterally like six inches short
there's no way he could havedescended.
So this would have been acesarean either way.
It happened to be a cesarean at37 weeks and where the cord was
(16:41):
held him in a position he couldnot dive down with that version
.
There's no way he could haveturned with a cord like that.
That's why his heart rate wastanking and going low during the
version.
It all made sense after we hadthe full picture of things.
So my client, after she knewthat she's like oh, okay, okay,
and she was pretty amazing.
(17:02):
She had to do some shifting andsome processing, but she was
really good at honoring whatthat baby needed Um, she, it
could be easy to be devastatedby that right Like.
She's like this is not what Iwanted, this is not what I
planned or prepared for, but youknow what.
It's what that baby needed andshe was in a good space pretty
quickly.
But you know what.
It's what that baby needed andshe was in a good space pretty
quickly, you know stillprocessing things, but in a good
(17:23):
space to say this is what mybaby needed and she was able to
honor what the baby neededrather than to mourn what she
wanted.
So we had a cute little baby.
As you know, with breech babiestheir little hips are just wild
right.
They have their toes, are kindof by their ears and they're
they have hip.
You know we watch for hipdysplasia, but this baby was
very folded up.
Um help them in their home acouple of times with lactation.
(17:46):
He's doing amazing.
He's adorable, um, and she'sdoing well too.
That as a couple they'rethey're doing quite fine.
They do want to plan for a VBAC, um when they have a second
child and she's a greatcandidate for it.
So so that those are my couplelittle recent breach stories,
very different from each otheryou know one at 41 weeks, one at
37 weeks.
(18:06):
One went smooth as butter, onewas smooth for a c-section right
and a very warranted and supergrateful that that's how it
worked out.
So interesting to know all thedifferent ways things can happen
out there.
So if you or someone you knowyou know has a baby that's
breached, do a little research,do a little digging, see what
you can find out, um, see howyou feel about aversion, See how
(18:31):
you feel about trying to turn ababy, see how you feel about
having a plan cesarean, or whatresources do you have If that's
not the route you want to go,what doctors in your area
whether that's older docs,because some of the articles
that I looked at and preparingfor this said the the doctors
who are trained to deliverbreech babies are going gray
like they're.
They're, you know, they're adying breed.
(18:53):
Really it's not trained anymore.
But there are places you know,in a lot of home birth
communities.
Some areas have very robusthome birth communities.
In our area we have a homebirth midwife who's incredibly
skilled at at breech deliveries.
She has even been asked to comeinto the hospital and work with
an OB to talk him through abreech delivery, which is pretty
(19:14):
fascinating because that's herspecialty is breech deliveries.
So we get a lot of breechdeliveries to get headed her way
and even we have a littlecrossover from home birth to
hospital birth community incollaborating on that, which I
think is fascinating.
Hopefully, I don't know, likepie in the sky, this comes back
as a medical art, a medicalskill that is resurrected
(19:36):
somehow.
But just one generation ago itwas very common and now it is
pretty obsolete in our medicalworld.
Hard for the you know themedical world to wrap their head
around this, the fact that thiswas so common because it's lost
.
It's lost for a variety ofreasons.
Anyway, little, those are mythree breach stories.
Hopefully helps you in some way, if it's, if nothing else,
(19:59):
hopefully just interesting.
Thanks so much for being withme here today on the Ordinary
Dula podcast.
My name is Angie Rosier.
I'm your host, so happy to bewith you and, as always, I want
you to reach out and connect tosomeone important in your life
today.
Reach out and make a differencein their life and see what it
does for you.
Have a great one and we'll seeyou next time.
Speaker 1 (20:36):
Thank you for listening to the Ordinary Doula
podcast with Angie Rozier,hosted by Birth Learning.
Episode credits will be in theshow notes Tune in next time as
we continue to explore the manyaspects of giving birth you.
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