James's Breech Birth Story

By Sophie S

James was born 23rd January 2001, a week early and a surprise breech. I was pretty gutted initially that I couldn't have my planned home water birth. But Rob and I decided a home breech delivery was not for us. In the end we had a very positive experience, but only after a little reorganisation and manipulation of the system in our favour...And not least because of a wonderful independent midwife who came into hospital with us at less than a day's notice, journeying to the East Midlands from Birmingham to look after us. Thank you Sarah!

James was born after a 5 hour labour, no interventions or pain relief and I feel far better this time round than after my first! (Apart from lack of sleep that is!). We are all doing fine and James is a thriving, hungry and smiley little thing. I've even started to think after 6 weeks, I could do this again...

Our story .....

I kept telling everyone “Ben was 10 days late, this one will be too, probably”. And I guessed he'd be bigger - at least 9 1/2 lbs, I thought (Ben was 9lbs). I planned a serene home water birth, the pool was set up, scented candles arranged and community midwife briefed on my desire for no intervention, water delivery and a natural third stage. So what happens? He arrives a week early, weighs 7lb 13oz and the home water birth goes completely up the spout (excuse the pun). After 3 weeks of being told he was head down, 3/5'ths engaged, the day my waters broke, Monday 22 Jan, I was told he was breech.

It was a shock. A scan at the hospital confirmed it and I was ushered in for a "chat" with the doctor. She said "right, caesarean section". I said no thanks. She then said best she could offer was a vaginal delivery with me in stirrups on the bed, epidural ("to stop me pushing at the wrong moment") and forceps. That was the way she'd been taught to do a breech and anything else was out of the question. We said we'd go home and think about it. I had a hind water leak and my tummy was visibly reducing in size. Baby couldn't be turned in broken waters. I had to give birth in the next 24 hours, I was told. Reluctantly they let me go home, but with dire warnings to return for induction the next day or be chased up.

We got home, me in tears. I started to figure out the best way to handle this one. I rang another hospital, where Ben had been born and with whom I'd been registered before deciding on a home birth. I asked the consultant to ring me. His number 2 on call rang - you need a section, he said. I repeated my request to speak to the consultant, "the Prof". He hung up making no promises.

I then rang an independent midwife I knew, Sarah. By some huge stroke of good fortune, she'd literally signed a temporary contract to practice at the second hospital that day on behalf of another client (an NCT friend). This meant she could do a delivery there. She confirmed she'd done 4 breeches before and preferred an all-fours position on the floor for mother to deliver, which coincided with my preference. She could come in with me the next day.

I hung up and the consultant rang. We had a long chat. He was happy to "allow" a trial vaginal delivery, however I wished, subject to baby monitoring and good signs all the way. In my favour were my height (I'm tall!), good hips and history (had already given birth to a 9lb'er with no intervention), baby wasn't a footling breech, and apparently smaller than the last one. I wasn't in labour though, so he was keen to induce first thing in the morning. I agreed to come in and confirmed things with Sarah. I finally got to bed 1am to toss and turn all night.

Next morning, the consultant met me and Sarah, personally scanned the baby (three times, as he said scanning machines weren't very accurate!), then confirmed his opinion. I was heavily advised to accept induction. By 11.30am, I agreed after the negotiation of a slower rate of induction drip flow and an hour's relaxation first in the water pool - to calm me down and help garner my resources to face whatever was to come. I had a lovely warm bath in the hospital's birthing pool, Sarah used clary sage massage oil and we had soothing music in the background.

Feeling much better, I moved to a conventional delivery room to eat lunch and await an examination and induction. By the time the hospital midwife came in I'd started contractions spontaneously and was 3 cm dilated. Having an independent midwife still meant the hospital assigned someone to check on us, in this case the ward manager. She was lovely and very sympathetic. When she saw I'd started contractions at last, she agreed to wait an hour or two more before setting up the drips. By the time she came back, I was 5cm dilated. I had, miraculously it seemed to me, avoided induction.

The afternoon went by with me dancing through ever more intense contractions to a tape of 70's acoustic music my husband had rummaged out of the car. I'd hang on to Rob, roll my hips and pace the room in between contractions. I joked this was the first slow dance we'd had since the wedding! Sarah gave me a couple of membrane sweeps which worked alarmingly well and I had to sit a few sessions at the monitor (agony whilst I had to try to keep still) to satisfy the hospital.

At one point a midwife rushed into the room announcing I couldn't possibly give birth on the floor - "it's against hospital policy". She stormed out again not waiting for a reply. Sarah and I looked at each other, nonplussed. Sarah left to have a discreet word with the ward manager - we didn't see that midwife again.

At 4pm, the Prof popped in to see how I was and jovially predicted delivery at about 8pm. By 5pm I was finding contractions very intense. By 5.30 I was fully dilated, but still coping on the dance routine. Without gas and air (which I'd used for giving birth to Ben), I could feel the baby moving down the birth canal. I asked for some mats to put on the floor in front of the armchair. I knelt on the mats, grasped the chair arms and buried my head into the vinyl seat.

5 - 10 minutes later, the room suddenly filled with people - Sarah, Rob and me, plus hospital midwife, student, paediatrician and finally, the Professor gowned up for theatre, just in case. I remember thinking as everyone piled in, quickly announcing themselves, - thank God, this means at last it's time. "Do you want to push yet?" Sarah asked. "I don't know" I said -"feels like I want to do something, but I'm not sure it's a desire to push", then after a pause, "yes". "Go on then". The pain hiked up a level and I started an impressive bloodcurdling scream. This converted to a long lower pitched growling as I tried to channel the energy more constructively to pushing baby out.

With Ben, once I got his head out, the rest of him just slithered out easily. But with this one being breech, it was like giving birth to 3 heads one after the other. First a huge effort to get the bum out. As it crowned, a large amount of meconium oozed out. I thought it was blood as I looked down and quickly looked away, thinking, oh my God, is he going to be okay? Finally the bum emerged and his legs flipped down and he dangled half in, half out, a couple of feet from the floor. More determined pushing and growling, and the body and chest started to emerge. The contractions didn't seem much help and I had to gather everything to push on with encouragement from Sarah. Finally I got to the upper chest and rested.

There was a certain amount of joviality in the room at this stage but an urgency too. The Prof joked about finding the baby's heart beat "3rd mole from the left" as people took turns to check the rate with every contraction. The hospital midwife pressed the monitor against my tummy, even though the baby's body was by now hanging outside. She was laughingly redirected. Then I was told firmly, the baby's head had to come out NOW. I was struggling to push by then and girded myself for one last effort. Suddenly there was an unexpected sense of release as baby fell gently into Sarah's hands.

The baby was blue and apparently lifeless. I couldn't see much. Quickly, the cord was cut and the baby passed up to the paediatrician. I couldn't believe I'd got him out and the pushing was over (a 15 minute second stage). "Is he ok, is he ok?" I kept asking. "Yes, he's fine" came the reply and a high pitched newborn cry confirmed it. Rob burst into tears of relief. Everyone was euphoric - there was a real sense of joy from everyone in the room as we were congratulated. The student looked bemused and the Prof told me I was "a star". Baby's apgar score was 9 after 5 minutes. By then I'd pushed the placenta out and splashed Sarah's jersey work kit with blood. I thought, 'why do people use an injection to promote the third stage when this is so easy and quick without?' Baby James was then handed to me to cuddle as I settled onto the bed (for the first time). He rooted for a breast straight away. 'Isn't it amazing how nature guides the baby even now?', I thought.

Because it was a breech delivery following broken waters, I was asked to stay in hospital for at least 24 hours for baby to be monitored. We ended up staying 2 days (1 day waiting for a paediatrician to turn up to sign off James). The first day, I felt like a local hero, as ward staff kept popping in and saying "so you're the vaginal breech - good on you, luv" - or words to this effect. I basked a little in the glory. But in reality, I was dog tired and not a little worried that in spite of it all, James might not be ok. Had I done the right thing?

Just as we were finally getting ready to leave, the Prof turned up. "Thought you'd have left ages ago", he said with a smile. We forbore to explain the lengthy wait for sign off. He then proceeded to talk me through my notes, showing me my file and reliving the delivery for the next half hour. I was impressed he had the time and interest. He again reiterated how amazing the whole thing had been - it had clearly left an impression, though I'm still not sure why - could I send a photo of the baby for their pin board? Finally at 8pm we left, the rain pouring as we proudly loaded James into the car.

I was initially gutted not to have my dream home waterbirth. But I am very happy with the outcome. I avoided all interventions, used no pain relief, didn't tear or even graze. This time there was no terror of going to the loo after delivery! Last time I'd had a bad un-stitched tear, retained product and post-natal infection. This time, the most I suffered was a bruised nasal bridge from pushing my face into the armchair!

James is a lovely looking baby, very like his older brother. I feel untold gratitude to Sarah for being there for me when I needed the right support and expertise.

And Rob? Well, I couldn't have managed things as I did, had he not been right behind me the whole way. He encouraged me to walk out of hospital number 1 before we got sucked into the system, which bought us a vital evening to review our options, talk to people and make our own decision. In the end, it was not where I had the birth that mattered, but who was with me.


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