The Lost Art of the Vaginal Breech Birth

Raychel had planned to birth her fourth baby, Silas, at home. Only four days before her due date, she found out he was frank breech. There is a program at OHSU in Portland that allows vaginal breech deliveries, but she was running very low on time to switch providers. She also has a history of short labors and wasn’t keen on the idea of getting stuck in Interstate 5 rush hour traffic. Luckily, her midwives are very skilled and experienced in breech birth, so she felt comfortable proceeding with a home birth.

Raychel’s labor was longer than any of her others, and at one point her midwives were thinking they might need to head into the hospital for an ultrasound to check on things since her progress had seemed to stop, but Raychel gave Silas a pep talk and told him it was time to come on out, now! Inexplicably, he seemed to listen, because right after the midwives got off the phone with the doctor, he dropped down further into her pelvis and she went from 5cm dilated to complete within 10 minutes. The midwives instructed her not to push until she absolutely couldn’t NOT push anymore. As soon as she got on her hands and knees on her bed, her water broke, and it wasn’t long before she couldn’t resist bearing down with the contractions.

To see my blog post of Silas’ birth story, click here.

The photos you’re about to see are graphic, but educational, and we feel strongly that they need to be shared to help spread knowledge and awareness about the normalcy and safety of breech birth with a skilled, knowledgeable, and experienced provider.


 

In this first photo Silas’ bum is “crowning.” He is presenting with his back on Raychel’s left side. On the right is his scrotum. There is some meconium present. This is normal in a breech birth and is caused by the pressure of the legs being pressed into the abdomen while descending down the birth canal, and not due to the baby being in distress.

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In this next photo his bum is fully out, and the midwife’s gloved hand is there to block the stream of urine from spraying her in the face. Ha! She is not touching Silas.

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Next he is even further out, and his torso and more of his legs are starting to emerge.

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As he comes down further, he starts pulling his legs out one at a time. You can now see a little bit of the nice fat, blue umbilical cord. His skin looks a bit purple; this is normal for ALL babies, not just breech ones!

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He continues to pull his foot downward. As he does so, you can see he has shifted a bit. He’s now facing Raychel’s back. This is so he can maneuver his shoulders through the pelvis.

breech5The first leg is out! Now he’s working on that second one.

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The second leg follows quickly and more of that beautiful umbilical cord is now visible. His right arm is also starting to emerge. Still no one has touched him.

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He has now pulled both elbows down and out of the birth canal. He’s working on getting the right arm out first.

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The right arm is out and the left is soon to follow.

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After the left arm comes out, it pulls the umbilical cord down underneath it and you can just barely see that it loops around behind him, then comes back over his right shoulder before looping back up on the left side of his neck. His face is mostly visible and nose and mouth are unobstructed.

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He is now completely out and as he leans forward the midwives catch him and pass him through Raychel’s legs.

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As he is passed to Raychel he opens his eyes, looks around, and then starts to cry robustly.

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The time elapsed from first photo to last is two minutes and twenty-eight seconds (2:28).

Here is a podcast on breech by Maryn Leister, CPM. Visit her facebook page, Indie Birth Association.

Beautiful Breech: Opening the Doors to an Option Many Women Are Told Isn’t Possible

Here is some more info on breech birth from Dr. Stuart Fischbein (Dr. Stu’s website is here).

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