A week before my Great Grandma Wilbanks passed away she shared with me that 7 of her 6 children were born breech. She recounted that a complication during her one head-down delivery was one of the handful of times she’d ever needed to visit the hospital. When I expressed my shock, she laughed it off and said that’s just how her babies came out.
Delivering a breech baby is rare. Partly because so few babies (3-4 percent) have a breech presentation and partly because at most hospitals it is standard procedure to perform a c-section. The ACOG (American College of Obstetrics & Gynecology) has been moving away from its “breech means you must have a c-section” position, but the group also recommends that anyone delivering a breech baby have a lot of experience with that type of delivery since it can be very dangerous for both mom and baby. Thus, breech babies today are usually delivered by c-section.
That is what happened to a close friend whose baby flipped in the last few days before birth. She didn’t even know he was breech, but 40 minutes after arriving at the hospital after preparing and anticipating a long first labor, she was holding her son and recovering from major abdominal surgery. She wasn’t given an option to try and deliver vaginally.
Another friend delivered a breech baby at the hospital, but it wasn’t detected until delivery was imminent. Things got hairy quickly. She was wheeled down to the Operating Room and a page was sent out to find the one doctor in the whole hospital who could deliver a baby breech. She delivered her daughter without having a c-section, but her recovery was quite extensive.
It just makes me wonder if the reliance on surgery has weakened the hospital’s ability to handle these types of birthing situations, or if we’ve decided as a society that vaginal breech deliveries are impossible. This last notion was driven home to me as I watched Grey’s Anatomy last week, when (spoiler alert) one of the main characters performed a c-section in a dirty, unsterile kitchen rather than deliver a baby breech.
For her part, when pregnant mom Raychel found out the son she was carrying was breech 4 days his due date, she wasn’t sure how to proceed. She explored her options: external cephalic version (ECV), transferring her care to a local hospital; but ultimately decided to stay with her home birthing team. Her team was very experienced with breech births.
When birth photographer Karyn Loftesness arrived, she found Raychel already laboring in a birth tub. The room was relaxed and quiet with laughter and jokes being had between contractions. When labor slowed at 5 cm, Raychel got out of the tub and went to take a rest while her team discussed their options.
Before a decision could be made Raychel yelled that something was coming out. A midwife confirmed that she was complete and Baby Silas was ready to come into this world. I love the language that Karyn used to describe Silas’s descent into the world.
“She got into a pushing position on her hands and knees and her water broke almost immediately. She started pushing gently, easing him out. Pretty soon we could see a little bum! It was incredible to watch him be born! First the bum, then one leg popped out, then the next, then the torso, both elbows, then one hand, and then the other hand, and finally the head! It was like watching him fall gently and slowly into a sitting position beneath her on the bed. As soon as he was fully out the midwives caught him and handed him to Raychel.” -Karyn Loftesness
Baby Silas was a whopping 8 pounds, 14 ounces and had an APGAR score of 9 and 10. He was completely healthy and was immediately greeted by his two older sisters. He is now 7 months old and is doing wonderfully.
It’s important to note than every birth carries a certain level of risk. Midwives generally agree that they have at least a 5 percent transfer rate to the hospital (full disclosure: I am doula-trained). Vancouver, Washington, where Silas was born, is near hospitals that work with home birthing midwives to ensure a safe transfer for mom and baby should that be necessary. A strong working relationship between hospitals and midwives is critical to keep birthing at home as safe as possible.
Though Silas was born safely and without complications Raychel was willing to abandon her plans and transfer to a hospital had her team deemed that necessary. Her midwives even called their backup OB to ask about transferring in when she became stuck at 5cm.
Women should have the option to choose how to give birth but because most providers are not trained in breech birth a C-section becomes necessary. Raychel chose to trust her birthing team and their experience with breech births. She has also chosen to share the unique pictures captured by Karyn with the world.
This slideshow will show pictures of Raychel’s birth with the last slide linking to the more graphic images of Baby Silas’s delivery. They are amazing and rarely seen pictures, but they are not safe for work.
It's all smiles between contractions before labor reaches the active stage.
Raychel receives support from her husband as she labors in the birth tub.
Raychel taking a rest between contractions.
Working out the contraction with gravity helping bring Silas down. Her doula is behind her applying much needed counter pressure.
Using the doppler to hear baby's heart rate to make sure labor is being tolerated by baby.
On hands and knees getting ready to deliver as contractions get more intense.
Baby Silas is earth-side. The last slide will have a link to the more graphic images documenting his birth.
Baby Silas with his adoring family welcoming him to this world.
Click here to take a close up look at a breech home birth through Karyn Loftesness's birth photography website.
Feature image photo credit: Karyn Loftesness
