Breech Birth: The Lost Art of Breech Delivery
One of the most common myths that I hear claims that vaginal birth is much more dangerous than a planned cesarean for breech presenting babies; but after doing some of my own research, I've noticed most of those claims to be false. So why is it true that most women deliver breech babies with cesarean surgery and why do they often feel bullied into this, like it's their only choice?
I've had many clients who's baby's stayed consistently "stubborn" throughout pregnancy, and presented their tiny butts, or toes, first, on every single ultrasound. For a mother who's baby is found to be breech around 34 weeks, they often start to feel weary. They aren't sure of their options, or how to help themselves. Today we will be exploring the different options for handling a breech baby.
The truth is, the art of the breech delivery was lost after a study in the early 2000's, called the Term Breech Trial. It was concluded that breech vaginal delivery posed a much higher risk for newborns and their mothers. The randomised control trial, which was found later to have many problems with it (including the moral difficulties of assigning mothers to either breech vaginal delivery, or cesarean surgery, if one was considered safer,) greatly effected obstetric education in the turn of the century. Breech birth, which had once been commonly practiced, was no longer taught in school curriculums. Eighteen years later, we're still recovering from what they found to be true years ago, even though we have disproven it, multiple times, as long as a good doctor is on hand.
Especially here in Israel, very few doctors are open to delivering breech babies, because they just don't know how. But what if breech is the safest way for that baby, because of their mother's womb, or because of the space they have inside. It's easy to forget that babies move into the space we make for them, a phrase commonly repeated by Gail Tully, founder of Spinning Babies. One way to handle a baby who is breech, is by trying to help it move into a better recognised position for birth, with doing slight, gentle exercises, to help make space in the pelvis, in turn giving the baby space to move. Spinning Babies has their own Breech Tilt, that can be extremely useful, if you're looking for a natural, physiological way to help encourage your baby into a different position.
Another option for breech delivery is the performance of an ECV, External Cephalic Version. This procedure is ideally done around 36 weeks, in a hospital, in case an emergency delivery is needed afterward. Medication is given to the mother, to help relax her uterus and ease the pain, and then the chosen doctor tries to manually turn the baby, by pushing and pulling, from on top of the mothers belly. This technique can often be successful and help mothers flip a breech baby into a head down position, so a vaginal birth can be attempted, with the doctors more at ease.
While these techniques and theories are effective, I always try to remind my clients that pregnancy and birth are a journey for both mom and baby together, and we need to also keep in mind that babies are very smart and will do what they need to, to stay safe inside. Sometimes they do know best, and there are things in the way that we can't recognise, that do cause our babies to be in different positions. Birth can happen in so many ways, the key is finding a doctor or midwife who you trust, and who believes in you.
Don't be discouraged by your babies position, just look for the right support system!
Dina Devora Jacob is a Lamaze Certified Childbirth Educator and a DONA Certified Birth Doula. She is the founder of BirthBuddy Israel and serves expecting parents in central Israel. If you'd like to find out more about how you can work with Dina, check out this post here!