Wanting to tell 44 weeks and breech friend she's risking her baby?

[scottishlass43]

My friend is 44 weeks pregnant with a footling breech. She's determined to have a natural birth at home with another friend of ours who's a midwife. She's been declining all intervention till now and has no cut off point - she wants to let the baby come naturally and doesn't want scans or any monitoring. She refuses to consider a c-section.

She's older (late thirties) and has been waiting for several years for this baby. I have no idea why she'd risk it now.

AIBU wanting to tell her what I think? Am I (and other worried friends) overreacting? Does anyone know of anyone who's done this, and how it went?

@QOD

My sil had a still birth at exactly 40 weeks. True knot in the cord. Terrible terrible time Rest of us actually didn’t get to 40 weeks as it was all so raw and recent that induction was allowed. It was made so clear that the risk of still birth rapidly increased after X weeks (can’t remember details) None of the next generation have gone beyond 41 weeks either. All taken first offer of induction. Why risk it when you’ve lived it

My suggestion of "listening to your body" comes from a knotted cord experience. Thankfully, I ended up having a c-section much overdue but I honestly believe that I didn't go into labour because the cord was preventing DS engaging.

My DS1 was footling breach and my consultant was very clear they wouldn't try and deliver him naturally due to his position and the staff no longer being experienced in those sorts of deliveries anymore. He did say there are some midwives who would but few and far between and it would have to be in hospital due to increased risks. So a footling home birth with just 1 midwife/friend seems really quite risky, not even taking into account the gestation period. Hope all is ok.

@littlemissalwaystired

As a midwife this made my blood run cold. I honestly can't see how there will be anything other than a poor outcome.

Unfortunately we can recommend things until we're blue in the face but we can't force anyone into anything against their will! Midwives also can't refuse care. We are legally obliged to attend home births even if they're against medical advice, regardless of how traumatic the situation may end up for us as well.

I just pray that I'm wrong in this situation and she has a birth that goes smoothly, with a baby that's not affected poorly.

Wow, I didn't know that. Do you get some kind of indemnity? Like if you record beforehand that the mother is proceeding against all advice you've given her, so you can't be held responsible for a bad outcome?

@Pinkywoo

Ozanj I'm on my second pregnancy and unless you're sent for a growth scan or there's another complication you only have 12 and 20 week scans. From having a quick Google I think this is standard in England.

@pinkywoo it depends on trust now. Our trust sends everyone for 36w scan as standard to check positioning. My midwife told me its because they consider it improves birth outcomes. This is a major and high profile london trust. She said that others are starting to do the same.

@SchadenfreudePersonified

Is a "footling" breech the same as a "flexed" breech - where the baby's knees are bent and with feet and bum are presenting?

My son was a flexed breech and I had to have an emergency C-section. He wasn't a very big baby either (6 and1/2 lbs).

She really needs to reconsider her stupid decision.

No, it isn't

I've had a vaginally delivered breech baby - a frank breech (bum as presenting part) delivered in hospital as the risks are high. You need a nice firm bum pressing on the cervix for the dilation to work properly and of course you might fail to progress and it's then straight to section - there are good reasons why they recommend it even if the 'fail' is marginal.

With footling, one foot might come through first, essentially making the baby undeliverable and that really is an emergency and a risky one for both mother and baby

[quote BalladOfBarryAndFreda]@SchadenfreudePersonified, it’s due the placenta. It starts to fail after 42 weeks in most cases. That’s why women aren’t usually ‘allowed’ to go over.[/quote]
Thanks - I knew that something started to degrade, but it's so long since I read about it, I'd forgotten.

Is it her first child? I'm assuming so from your posts.

I really wanted a natural birth but ended up at 40 weeks plus 10 days, then being induced and then had a Caesarian. It wasn't what I wanted but now, 15 years on, it honestly means nothing to me - it was just the start of my life as a parent. I think somehow in the lead up to birth you get fixated on it being a thing on its own right. Which of course it is - but it in reality it's really just the start of something even more important.

I would really try to talk to her but completely understand how hard that will be.

[quote GrealishHairband]@SchadenfreudePersonified no, a footling breech is feet first so even more risky as it doesn’t take much in terms of dilatation of the cervix for the presenting part to come through, it has a much higher risk of head entrapment. As there isn’t a firm head or bum on the cervix it is much less likely to dilate to full dilatation.[/quote]
Thank you - I can see why it would be so dangerous, too.

Thanks to you and to other posters who have explained bits and bobs to me. -I really appreciate it.

I was a footling breech, years before scans were even invented. The doctor knew I was breech through palpation and, after an unsuccessful attempt to turn me, insisted my mother gave birth in hospital rather than at home, as was the norm all those years ago.
Mum’s waters broke at 40 weeks, she went reluctantly to the hospital where it was found my left leg was already down through her cervix.
Too late for a c-section apparently and the consultant told her he had two minutes to save her baby’s life and he certainly did. I was born a bit battered and bruised but otherwise ok. Mum wasn’t allowed to see or hold me for a week, which affected her badly. She also took a long time to recover.
I owe my life to that consultant. I was very, very lucky.
If mum had insisted on staying at home, I’d have probably been a gonner

@Spitspotsput

You can make gentle suggestions but in the end, it just isn’t up to you

OP never claimed that it was 'up to' her.....

Someone from my NCT did this. Her baby was born at about 44 weeks. He was ill and spent time in NICU and she put her back out and couldn't walk for 3 months. Bloody stupid.

She was however monitored daily. To have no monitoring is beyond foolhardy and the baby may die. It is as simple as that.

At 44 weeks I'm amazed the baby is still alive - the likelihood of a positive outcome is quite low at this point

@LoopyGremlin maybe different area do diff

Sure most of my local friends have 28w as well

I had countless scans as was consultant Led so was nice to see baby lots

I think a certain section of the 'women have been doing it for centuries, trust your body' brigade forget just how many women and children died in childbirth as a result of not having the interventions that we have now.

Exactly!

Childbirth was a leading cause of female mortality until comparatively recently.

All the women of my generation in my family would be dead if we had had our birth experiences before modern interventions. And most of the babies too.

The bit about listening to your body is genius!

I'd have to say something so I knew I'd done absolutely everything I could - then yes back off and if she mentions it just say you know my view I can't support you on this I'm too concerned.

@SchadenfreudePersonified the other big risk with a footling bed is cord prolapse. There’s not a nice big head or even a chunky bum acting like a plug over the cervix - there’s much more room around there if there’s only a foot dangling down, so the risk of a cord prolapse increases.

I would always recommend people do their own research rather than just trusting the NHS.

The problem with this is that usually people’s “own research” is random stuff they find on the internet and not proper peer reviewed medical articles, unless they have full access to pubmed articles.

I’m surprised that she has found a midwife to attend her homebirth. Not only does she risk being struck off, how would she feel if one or both of them died? I suspect that most midwives would refuse to do this. Is this friend really a midwife?

Apart from that there is a three hour wait for ambulances where we live.

@scottishlass43 Personally, and I'll likely be attacked for this but it's my honest opinion, if it went on any longer then I'd be contacting social services. HEAR ME OUT - Not just related directly to the birth, but due to her mental well-being. I'd be extremely concerned that she's in the right place mentally to both make the decision and ultimately to care for the child once born. Also, out of concern for the baby right now too, obviously. It's (currently - we hope) still a child. One whom is not being correctly & completely cared for

DropYourSword

Something else that is obvious when you think about it, but wouldn't occur to most of us. No the wonder childbirth is so hazardous.

[quote Blondeshavemorefun]@LoopyGremlin maybe different area do diff

Sure most of my local friends have 28w as well

I had countless scans as was consultant Led so was nice to see baby lots[/quote]
My children are a bit older now as well so maybe we’ll be different now!

• it’ll

At 44 weeks she's risking her life and baby's.

But you can't do anything. As a friend. I'm sure the midwife and consultants are into it. All you can do is express concern to your friend that she's putting baby and her health and lives at risk

Natural birth is fine when all is going well, but natural birth used to end up with high (now unnecessary) maternal and baby mortality - 4 weeks over due date is high risk factor for that .

Some people do "cook" their babies longer, 10 months wasn't uncommon when I was born- but it's a risky strategy all around when modern medicine can intervene. With a breech I would want to be giving birth in a hospital that's equipped for an emergency c section even if I want to try for natural. Both my DD's were born without intervention, second was completely natural no drugs so I get the wanting to give birth naturally but only to a safe point

She is monumentally selfish - risk the baby's life for a home birth experience . The midwife should only see her with a witness present to record her concerns as the possible professional repercussions are huge .