Heads Up! All About Breech Babies

 

 

 
 Breech Baby on New Years Morning

Note: this is a page that was sent to me and I had on file. I had originally linked to the birth on another website. The website is no longer up at that URL.

I had the story and photos saved and so continue to offer up the pictorial until I can locate this amazing birth at it's new home.

This baby was born at 12:30 AM on 1-1-04.  She was a frank breech born to a third time mom.  Mom was sectioned for breech with her first baby, had a birthcenter vertex waterbirth with the second.  This mom is well-informed, is a doula, and made an  educated choice to have this baby at home.  There were 5 attendants at her birth. No breech should ever be attempted by an inexperienced person.  Anyone attending a breech should be certified in neonatal resuscitation, and carry resuscitation equipment, including oxygen, and know how to use it.  Attendants have to be absolutely positive that the cervix is completely dilated before the mom pushes, to assure that the head does not become entrapped by the cervix. Attendants also must know how to flex the head, and create an airway so that the baby can breathe if the delivery is delayed.  Much damage can be done to the baby by panicked attendants.  This particular birth was very easy and straightforward, but breeches can be extremely difficult.  If complications arise they can be life threatening for baby.  

#1  Mom was completely dilated, but we encouraged her to pant and blow for as long as we could get away with it.  She was finally moving the baby down anyway, and at that point we just let her push which made her much happier.  The mom was wonderful and cooperative.  She is on the birth stool, and could have lain back if need be, to cause the baby's head to flex.  You are seeing the baby's right hip, and part of her labia on the right.  From the very first sight of the baby's butt, til birth was exactly 9 minutes. #2  Left hip is beginning to emerge.  I am supporting the body gently - no pressure or pulling, and no manipulation at all until baby is born to umbilicus.  Many breech injuries are caused by birth attendants who pull or try to forcefully deliver or extract the baby.  Right before we saw the baby for the first time, mom on her own started doing belly lifts, and immediately the baby started coming.

#3  Baby is beginning to rotate, with the back anterior.  If the body does not rotate anteriorly, it must be gently turned by attendant.  Meconium is pouring out of baby.  It is being squeezed out by the birthing process, and is normal. #4  More body -- You can see amniotic sac on the baby's back.  I am very gently supporting the body.

#5  I am very gently freeing the toes of the left foot.  The right foot comes as soon as the left foot is out.  Mom is continuing to push.  From umbilicus to birth is exactly one minute. # 6  I am gently rotating the baby up to the baby's left, to free the baby's left arm.  As soon as I began to do that, both arms came.

# 9  Baby is out and immediately on mom.  Baby has a 60 heart rate when born and has very little muscle tone, is limp and white.  The lack of muscle tone is very common in breeches. Baby was given blow-by oxygen and stimulated, and cried right away.  Her apgars were 7-10. This picture was taken in the moment of birth, and the first apgar is done at one minute. # 10  This picture shows the bruising on the presenting part, the baby's right hip, which is also normal, and was transitory. Mom said it was gone by morning.   This is still in the first minute of birth.  You can see a little of the breech molding on the baby's head.  I will post a later picture of her as soon as I get one.  Immediately after this picture we gave her some blow by oxygen, and stimulated her and she cried right away.  The mom was given oxygen during the pushing stage because of variable decelerations.  The baby was 8 pounds 4 ounces.
Pictures of baby during newborn exam, and at 9 weeks. Trillium Birthing Services

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

This mom's first baby was born by cesarean for breech, and she would have had a cesarean for this baby also.  Since she had already given birth vaginally to her second child, she was a good candidate for a vaginal birth.  Because the cord can be compressed pretty easily in a breech birth, and because a first time mom often has a longer pushing stage, most midwives will not attend first time vaginal breeches at home, with good reason. First time couples considering homebirth for vaginal breech must realize that they can be at a much higher risk for serious complications at home. There are a few physicians around the country who will attend first time vaginal breeches in hospital.  If we are ever going to reduce the cesarean rate in this country, we must increase the number of vaginal breeches and  first time couples should have the option of vaginal breech in the hospital.  Once a mother has given birth vaginally, her risks for vaginal breech, in or out of hospital are much less.  The most complicated breech birth is a feet first, or footling breech.  Most caregivers will not attempt a footling breech, because of the risks of entrapment of the baby's head.  

 

 It is with extreme gratitude to the mom and dad that [Trillium Birth Services] publish this web page.  They were very gracious in sharing their birth with others.  This mother loves birth and wanted others who also love birth to enjoy and learn from her experience. Thank you

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Once again, as web mistress of the Heads Up! site, the above story was posted on another website that is no longer up. Until I find the original family or contact the midwives to Trillium Birth Services, I will post/host this story until further notice.

P. B.