Anna's Amazing Breech Hypnobirth
At 28 weeks pregnant with my first babe, I discovered he was in the breech position. My baby's movements had changed location and there was suddenly a hard 'baseball' under my right rib!
My midwife confirmed my suspicions at my next appointment and reassured me there was plenty of time for this babe to turn head down. By 32 weeks, I decided it was time to be proactive about this babe's position. I tried it all, spinning babies and OMP techniques, acupuncture, chiropractor, moxibustion, started swimming, breech hypnobirths turn track, using ice and heat packs, the works!
My pregnancy had otherwise been completely healthy and low risk. By 35 weeks I started the conversation with my midwife about all my options: an ECV (external cephalic version), an elective caesarean, or a planned vaginal breech delivery. I believed that breech presentation was just a variation of normal in pregnancy and felt strongly that I did not want an elective caesarean without exhausting all other options first.
I felt that it was important for my baby to decide when they would be born, that labour is important in preparing babies for life outside the womb, that I wanted the microbiome impact from a vaginal birth for my baby, that I wanted as minimal drugs and intervention as possible for mine and my baby's body, that my body was built for birth, and that a caesarean would forever impact how and where I birth in future pregnancies. I was happy to have a caesarean for a life saving reason, but just couldn’t accept that a breech presentation in an otherwise perfect pregnancy was one!
I didn’t particularly want an ECV as I felt it was a medical intervention that was manipulating what had until now been an untouched pregnancy, but I also knew it was likely my best chance at a vaginal delivery and hopefully a homebirth.
I felt the procedure was safe and I was well informed so decided to attempt it at 36+6 weeks. The ECV was unsuccessful but I honestly felt relieved as I had not really wanted to manually force my baby into the 'best' position for birth if it's not where my baby felt they needed to be.
Following this, the doctor suggested I have a growth ultrasound at 37+4 (next available time) to confirm the presentation of my baby, rule out the presence of a nuchal cord, and to confirm my baby was growing normally and that if all these things aligned, I would be eligible for a vaginal breech labour and delivery. I felt educated, supported and listened to, filling me with the confidence that my body and baby would work together, as designed, for birth.
At 37+2 weeks I lost my mucus plug and felt like my baby had engaged further into my pelvis. I thought it was a good sign that my baby was positioning itself for birth but also knew that it didn't necessarily mean labour was close.
At 37+3, my husband came home from work and we went for a walk in the national park near our house with our dogs. It was a beautiful evening and we chatted about how we were so excited that we had a baby on the way soon! During the hour long walk, we had to stop about 5 times to wait for what I thought at the time were just strong Braxton hicks to pass. This all calmed down once we got home and ate dinner.
At 10:56pm, I turned out the light for sleep and within 30 seconds my waters broke! Everywhere! It soaked the sheets, my pregnancy body pillow and two towels! I got up and went to the toilet to check the fluid was clear – it was and I could feel my baby moving. I called my best friend Rachel, a midwife, who I had planned would be my birth support along with my husband. She was excited! I then called the triage group practice midwife and she said she would call the hospital to check what the doctors would like to do since I hadn't had the growth ultrasound yet.
By about 11:15pm I started to have mild tightening's every 2-3 minutes. I got into the shower while I waited to hear back from the midwife. I had put up hypnobirthing affirmations on the shower screen in the weeks prior and started to read them allowed while I stepped from side to side. The tightening's were coming regularly and building in intensity.
My husband put our bags in the car, installed the car seat and then at 11:45pm we got the confirmation we needed to make our way into the hospital to confirm my baby's presentation. If all was normal and active labour hadn't started, I would be able to go home to allow labour to establish. I had 5 tightening's in the car on the 12 minute drive to the hospital. I could still breathe through them easily, but they were certainly getting more intense. We listened to a song we had been singing to our baby on the drive and got excited that we were now so close to meeting them!
By the time we got into the assessment room it was 12:30am, they connected the CTG and did some obs. I dimmed the lights and my husband started to play some music. I was able to stand next to the bed and mobilise during the surges while the monitor was on.
At 1:15am, the doctors were still in theatre with another patient, but I was now really needing to focus on each surge to breathe and move them through. We called Rachel again and said we thought things were on and that she should make her way in. I moved to the labour room and at 1:30am the doctor came to check me - she did an internal assessment - I was 2cm dilated, fully effaced and the baby's bottom was well engaged.
We used heat packs and massage on my lower back to distract me from the sensations. At this stage I completely emptied my bowels and knew it was another good sign labour was progressing. My primary midwife was off and the back up midwife had just arrived. She was an experienced midwife who had delivered a lot of breech babies in the UK, I felt glad and relaxed when she arrived – I knew I was in good hands with someone who would advocate for a normal labour and birth.
At 2:30am, things had really ramped up, I asked for the monitoring to be switched to the wireless monitoring and to move into the shower. I then laboured on my knees leaning over a chair in the shower for the next two hours. Rachel was holding the shower head over my back and my husband was holding my hands. The surges were all consuming and I felt as though I wasn't coping very well during them. It felt really hard to stay relaxed and I felt like I was so tense during the surges. I tried my best to relax in between, keeping my eyes shut most of the time. I kept thinking I need to keep my jaw relaxed to help keep everything else relaxed.
About this time I started to beg for an epidural – my brilliant midwife reminded me that as it was a breech labour, my best bet at a normal delivery was to avoid an epidural as if the epidural knocked off my contractions, they wouldn't put up the hormone drip and I also wouldn't have the sensations needed to push effectively. She also knew it wasn’t part of my birth plan and encouraged me how great it was my body was doing everything perfectly. Rachel and my husband reassured me that I was coping well and that I was built for birth.
By 4:30am I started to feel pressure in my bottom, had a few vomits and was quite irrational during contractions. Rachel also noticed that I had a red line at the top of my bottom - all signs I might be close to fully dilated. I felt like I couldn't continue, I decided to get out of the shower and see how far dilated I was. My midwife said she I was fully dilated but that my baby was foot presenting. This explained why I felt like I wasn’t coping – I dilated 8cm in 3 hours! I suddenly felt like I could do it, I knew the pushing stage was meant to be better, I could actively work with the surges. My midwife got the doctor to come and confirm the presentation of my baby. She suggested we may need to go to theatre with an epidural for the delivery as it wasn’t ideal that my baby was not complete breech (bottom presenting) and was foot first.
I was having a strong and uncontrollable urge to push but the doctor didn't want me to until the on call obstetric consultant had come in for the delivery. They gave me the gas and a little bit of IV fentanyl to stop me from pushing until the consultant arrived. Once she arrived, she examined me and said that because the bottom was close behind the foot and well down in my pelvis, she was happy for me to push this babe out in the room. A sigh of relief!
She filled me with confidence that everything was happening as it should and that she was happy for me to push in whatever position I wanted. I moved onto all fours on the bed to start bearing down with the surges. Despite knowing it was a good active position for breech birth, I found it really uncomfortable and preferred pushing laying on my side with my leg supported by my midwife. I quickly got the first foot out in a few surges. As the second leg and bottom was emerging, the doctor suggested we cut an episiotomy as I had a short perineum and it would make it easier to do manoeuvres should the breech delivery become complicated.
I moved positions to having my legs in stirrups and consented to the episiotomy. Pushing out the feet and legs was quite uncomfortable as they put lots of pressure on weird places! Once I got to his body, it was really easy to push him out up to the shoulders. This was the first time (other than the episiotomy) that the doctor touched my baby being born. She did the Lovesetts manoeuvre to birth his arms and shoulders, then let him hang to help keep his head flexed to aid in a smooth delivery. At this point they noted that he had his cord around his neck twice and that it was quite tight. I needed to birth his head fairly promptly now that his body was birthed and his umbilical cord was exposed to the cold air.
At this point I could no longer feel any contractions so I tried to just push his head out anyway. This wasn't working and due to the baby's heartbeat feeling slow and faint through the umbilical cord, the doctor suggested she use forceps to deliver his head. I consented and felt it was the best option since I couldn't feel an urge to push anymore. He was quickly and easily born with one pull at 6:17 - about an hour after I started to actively bear down with the surges.
Due to the low heart rate, the doctors decided to immediately clamp and cut the umbilical cord and pass my baby to the pediatric team. It wasn't long before he started to cry and pink up nicely. They held him up and my husband announced he was a boy!
He did need to go to the nursery for respiratory support for the first 24 hours due to a condition called TTN (transient tachypnoea of the newborn) - which I believe would have happened regardless of mode of delivery (caesarean on arrival or normal delivery) due to being only 37 weeks. I opted to have the oxytocin injection for the placenta delivery, which happened seamlessly 4 minutes after birth. The episiotomy extended a little bit due to the forceps delivery but the doctor was happy to suture me in the room and said that things came together nicely.
At all stages during my labour and birth I felt supported and empowered by my midwife and the two doctors. I was encouraged to push whenever I felt the urge and in whatever position felt best - at no point was it directed pushing, keeping things as natural as possible. The two doctors, whilst sitting at the end of the bed closely watching, never touched me or my baby until the last bit and gave me plenty of time to allow him to be born with as minimal intervention possible.
The consultant obstetrician said that had she known the cord was around his neck twice as would likely have been picked up on the ultrasound planned for later that day, she probably wouldn't have felt comfortable with me having a vaginal breech delivery, however she was really impressed with how it all went.
Due to my son’s TTN, I wasn't able to start breastfeeding until 12 hours after birth. Thankfully, he was ready to be roomed in with me by 24 hours of age and my milk still came in on day 3. He's been a brilliant feeder right from the start!
Although my birth wasn’t the homebirth I was originally planning, I felt, and still feel, really proud of myself, my body, and my baby for labouring and birthing spontaneously, affirming my instinct to believe in my ability to birth naturally. I trusted that my body and baby could do it and it did! Whilst I felt sad that my baby ended up going to the resus cot instead of directly skin to skin with me, I knew this was a likely situation as breech babies born by either caesarean or vaginally often transition a bit slower and need help to start breathing.
Ultimately, I feel my recovery post birth has been smooth and having a relatively drug free birth allowed me to feel that oxytocin high and total love explosion for my baby!
Birth story and photos shared with permission. Congratulations Anna and Sam! Welcome to the world little Henry!