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?

@Glassofshloer

But what is an ‘informed choice’?

To be honest if you think you can weigh up risk better than a medical professional then you’re very unlikely to listen to them anyway.

Doctors can provide information on the risks of something. People receiving care are the ones that are able to weigh up those risks as they apply to their specific situation. It should be a partnership.

@Comedycook

I never understood the obsession with waiting for labour to start naturally. I was terrified when I was overdue with my DD and they wouldn't do anything until I was late by a certain number of days...

Many women want labour to start naturally. Being induced is frankly an awful experience. I declined induction for as long as possible (within the time limit approved by the midwives) because I did not want to go through that. As it was, I ended up with a 72 hour labour in which the baby’s heart rate ended up dropping and I had an EMCS.

It’s well known that with inductions you often end up with an epidural as the drip is so painful, so end up down the chain of intervention with an instrumental delivery or EMCS a very real possibility.

Of course that’s a real fear of many women and why so many want to wait to bring labour on naturally

Your friend needs a C-section immediately.
A hospital won’t induce for footling breech (far too risky).

I reckon she has anxiety around the C-Section/hospitals. Plus pregnancy hormones can make people a lot more anxious. People can get very fixated on birth plans and often irrationally and illogically so. I remember after my C section I regretted it for ages as I was so fixated on natural birth. I think it was just a mild phobia in my case. An elective C section can be a nice calming thing - can have your music on etc. Ideally for your friend she could have your midwife friend present as birthing partner during the C section to calm her down.

@Comedycook

I never understood the obsession with waiting for labour to start naturally. I was terrified when I was overdue with my DD and they wouldn't do anything until I was late by a certain number of days...

It’s not an obsession, it’s the simplest way to give birth for many/most. My obstetrician will induce at 10 days over. But going longer than two weeks over is madness really, why the hell take that risk?

[quote Glassofshloer]**@Teaandcakeordeath83* I didn’t mean to be condescending but home vbacs are discouraged. After 2 caesarians one would think the risk would be even higher. So how did you know it would be safer than any* hospital?[/quote]
"A multivariate analysis of the NICHD study showed that there was no significant difference
in the rates of uterine rupture in VBAC with two or more previous caesarean births (9/975,
92/10000) compared with a single previous caesarean birth (115/16 915, 68/10000).46 These
findings concur with other observational studies, which, overall, have shown similar rates of
VBAC success with two previous caesarean births (VBAC success rates of 62–75%) and single
prior caesarean birth.47–50 It is notable that more than half of the women with two previous
caesarean deliveries had also had a previous vaginal birth and 40% had a previous VBAC.
Hence, caution should be applied when extrapolating these data to women with no previous
vaginal delivery."- RCOG GTG45 birth after previous caesarean birth guidelines.

The evidence level for this is considered a 2+ which is pretty decent for maternal research seeing as it's chronically under-researched and people would rather make assumptions than actually determine the best course of treatment.

I can see why others wouldn't be happy taking the decisions I made- however they weren't made with "woo" or a desire to have a "perfect insta birth" like some of the comments on here are judging the woman in the original OP to have made. They were made after reading absolutely every research paper about vbacs/ systematic reviews/ guidelines etc that I could lay my mitts on. After conversations with doctors who refused to acknowledge the data and risks in the guidelines they should be working to. Hardly trust building.

How do you know I live within a safe distance of any other hospital? Or that if I did if that hospital wouldn't be "worse"/ failing/ under special measures/ had a report against its maternity department? If you're repeatedly lied to by doctors, coerced into treatments you don't want and are generally subjected to poor outcomes surely the question is why would you opt for that again? You only have to read through this thread and see that there's a substantial group of posters who think that home birth shouldn't be an option anyway regardless of "risk".

Fwiw I'm a scientist and work in the NHS. I've had extensive experience as a patient and worker in many areas of the NHS. I've never been spoken to or treated so poorly as my experiences in maternity- you can see it in the responses of posters on here "I didn't think they'd let you" as though women are supposed to be compliant and just do whatever the doctor says with no personal choice allowed. I can fully see why the current maternity set up has some women running for the hills.

@EveryFlightBeginsWithAFall

My oldest is nearly 27. By the time induction worked I was 43 + weeks, not something I'd have chosen! He wasn't breech though and he weighed 11lb 2. It wasn't pleasant

11lb 2!!!! 😮

I don't know how she can not be totally fed up by now.

I wouldn't risk a natural birth with a known breech, c-sections are not great (had 2) but if it's safer for baby it's worth doing.

I agree with almost everything PPs have said. The only issue I have is people saying this decision is selfish. Not because it isn't a really terrible decision but because I'm sure the friend is being told by the natural birth community that it's selfish to do anything that isn't natural and because 'selfish' has become an overused term using guilt to force (especially women's) behaviour.

I had planned a perfect waterbirth after avoiding all alcohol, caffeine and even paracetamol for the whole pregnancy in order to do everything 'right'. I then had to be induced by drip at 37 weeks due to reduced/no movement with epidural and only narrowly avoided forceps/section. I had so much guilt that eventually manifested as PNA/PND for being so 'selfish' for putting a 'comfortable', 'medical' birth for me above doing things 'as nature inteded'. To be honest this thread has got rid of the last of that guilt as many people have pointed out here perhaps 'nature intended' me and DS to die.

I'm really just hoping for a positive update from OP or that her friend somehow got her dates wrong.

I just found out that she went into labour early yesterday morning, but kept it very quiet as she didn't progress and was transferred for a c-section in the afternoon. Mum and baby both fine.

Very relieved they're fine. A little worried the overall positive experience means she'll continue telling people to trust their bodies and wait as long as possible. By the anecdotal evidence of lots of the stories in this thread it sounds like it could have ended very differently.

To be honest this thread has got rid of the last of that guilt as many people have pointed out here perhaps 'nature intended' me and DS to die.

I don't think anyone has said that? What they've said, in essence, is that "natural" doesn't mean safe or good. In fact it's often the exact opposite, and therefore we shouldn't place too much value in what's "natural" over what's actually a good outcome.

Well I'm very glad they're both OK.

Surprised but glad they are both fine

I'm sorry, @RainbowCrayons, I think I might have misread your point. Didn't get much sleep last night!

I completely agree with you @Teaandcakeordeath83 and I’ve had an induction and whilst I didn’t feel traumatised after, I was routinely lied to about the most innocuous things and made to feel like I was ridiculous for even asking, and it was things like basic decency I was denied and it was out of ease of life for the staff. Lied and told the birth pool was broke even though on the earlier shift they’d said someone else was using it, not allowed skin to skin because she needed to be weighed then and there, no delayed cord clamping because i had an induction, OB who did an internal didn’t ask for consent and was so rough he had me in tears and when I asked him to be more gentle i was told to grow up. I can’t think of another field of medicine where the patient is so routinely disrespected. I was terrified at the thought of another induction as id gone past my due date and induction has been brought up since 37 weeks. Luckily baby was born at 41 weeks.

Fact is birth is overly medicalised, midwives and consultants do use coercive language (generally midwives are better) and there is a vast difference between a midwife on a MLU/ home birth midwife and a delivery suite midwife. The care in post natal wards is often atrocious and leaves women traumatised and women are so often not given the opportunity of informed consent options are routinely presented as if they have no choice and if they voice concern or question the decisions they are immediately shut down.

However in the case of this friend they’re taking things to the extreme in the other sense, it’s a shame but its an extreme (free birth woo) reaction I bet to the birth industry

Thank goodness they're both ok

@Namechangetimes100

Had a very similar experience to you with my first, which is why I opted for a homebirth with my second. I agree completely about birth being medicalised and feeling lied to, I was definitely tricked a number of times re the induction and promises made to me. Currently fighting the same battle I did last pregnancy where they move my due date forward a week due to baby’s size (not taking into account that my babies are just large), so that I will be “overdue” when I’m actually not. It’s very irritating and upsetting.

However, the only way to get to the stage where you can have a safe birth is to actually do all the monitoring and accept that they like might need a c section or anything else. I’m hoping for a homebirth this time but that utterly depends on my baby and what’s best for him.

@scottishlass43

It’s great that they are ok, and even better that she had a c section to ensure baby was safe!

@Theregoesmyhomebirth that's awful and not standard. My twins are two today, MCDA so the middle level of risk. Midwife was open about early delivery because of the placenta failing later on and I chose a planned C Sec for various reasons. In hindsight I wish I'd gone for natural / induction as I had a C Sec at 36 and I feel l should have waited longer but none of the consultants ever spoke to me how you have been and my midwife was amazing. I'm sorry you're having this experience, twins are amazing x

Thank goodness they're okay.

I am really glad the outcome was good.

I very much hate the word 'natural' when it comes to birth, I use the word vaginal. Not having a baby 'naturally' is such a negative statement and leaves women feeling guilty. Vaginal or c-section, who cares, as long as baby and mum are safe.

Completely agree @Justheretoaskaquestion91, I hope you get the birth you want ❤️ I’d wanted a home birth too due to childcare and to avoid my experience last time but the service was suspended due to staffing. I wasn’t willing to take the risk of someone not showing up or showing up too late so I went to the MLU and still had a very positive experience. I felt listened to and was made to feel like an agent in my birth rather than a passive vessel that things just happened to.

I can’t fathom a logic whereby you reject all means to check on the wellbeing of your baby.

Glad to hear this story had a happy ending, although it’s not surprising it was a section, that frankly was the best care scenario here. Curious to find out how big the baby was OP?

That's a relief

@BlueJay12

Hi OP, I'm so pleased your friend has delivered safely but your post made my blood run cold. My DD was a footling breach and my consultant (who moved to Harley Street not long after - such was his reputation) told me in no uncertain terms that to try to deliver naturally would result in the death of both me and DD, even in a clinical setting. If this was indeed a genuine post then the medical 'professionals' involved need to take a good look at themselves

It’s just not true that a footling breech WILL result in a death for anyone. Is it more risky? Yes. Should you take precautions? Of course. But there is no WILL about it. My second was an undiagnosed footling breech and by the time anyone realised he was half way out. It was a bloody risky situation and had I known I would more than likely have opted for a section, but we both survived just fine. In your situation there may have been different circumstances but it’s just as irresponsible to say people will die when you don’t know that.