ADVICE FROM MIDWIVES NEEDED PLEASE

[bez]

I am desperate for a home birth and have an independent midwife but have just found the baby is posterior and breech. Will I have to go into hospital to give birth if the baby remains in this position?

I'm not a MW but going to throw in what I've heard about breech, anyway. The official clinical guidance is that breech means you should have an elective C-section. This is based on a study of many breech births in the USA, where "experienced" clinicians attended either vaginal or elective C-section births, and the conclusions were that the C-sections had better outcomes. Lower incidence of stillbirth, for instance.

BUT
The homebirth movement reply to that is that the study is flawed because all of the vaginal births were subject to a considerable degree of intervention, and the interventions themselves affected the outcomes. The proper way to handle a breech labour/birth, it's argued, is to monitor it to make sure it's steadily progressing. If it doesn't progress (and also, babies have been known to turn in labour itself!), then go to hospital for emergency C-section. The homebirthers argue that this would have outcomes equally good to the C-section cohort.

Ultimately, of course, decision is yours where you have your baby. What does your IMW say?

Bez - there are independent midwives who are experienced in vaginal breech birth (Mary Cronk is one). It this your first baby? What stage of your pregnancy are you in? All suitable low risk women with breech presentations should be offered a cephalic version (baby turned to head down). The experts on breech all agree that as long as the labour is progresing well all should be fine. However, if labour does not progressing well then the baby should be delivered by C/S.
You will need to discuss the options with your midwife.

Mears, this is my first. Is it best for me to go in hospital in case I need a caesarean or will it be okay to transfer in labour

Depends what skills the midwife has to be honest. How many weeks are you?

Mears, I am due in 5 weeks

Bez - I've just started a thread in Pregnancy topic under Breech Babies. My sister is having a breech baby, her second, in 4 weeks time. She's due to go into hospital tomorrow to get it manipulated, but I've since been told there is only a 50% chance of this working. Is the baby engaged yet? If I were you, if the baby is not yet engaged I would invest in a Birthing Ball which you can either hire from your local NCT or get from any sports store (also known as an Aerobics Ball). For 10 mins, 3 times a day, lean over the ball whilst rocking either forward or side to side, this will encourage the baby to move into the right position.
Also, try to sit upright at all times, go belly down when you have a bath and do lots and lots of walking. Gravity should ensure that the heaviest part of the baby goes down into your pelvis i.e. the head.
Good luck and check out that other thread!

Bez - I read a mad thing when I was pregnant last time about something called Moxa sticks. I can't remember it very clearly but it seemed that you had to sit on a chair with your feet on books. your little toes had to be over the edges of the books and then you light these moxa sticks and put them under your little toes (not burn the toes tho).

The document I saw seemed to say they had a fairly good success rate at turning breech babies. It sounds completely MAD but I read it in something I was given at NHS parentcraft classes which made me think it might be a bit less mad. Worth a try tho. Also have you tried reflexology? I am not really a new-age hippy gumbo person but the thing said it did actually work.

Still time for baby to turn or be turned. I have heard of the moxa sticks too. Try Rhubarb's suggestion as well. Would be much better all round if baby turns rather than worrying too much about breech birth as it might not happen.

moxa sticks do sound completely loony, don't they? but a great friend of mine used them about 3 weeks before her 1st baby, and it turned right the way around by a couple of days later. she had a great birth in a pool at hammersmith hospital with no drugs in the end.

Moxa sticks are part of acupuncture, and have had good results at Derriford Hospital in Plymouth, where trained acupuncturist midwives use them. About 20 per cent more of the babies turn than you'd expect ordinarily at that stage. (I wrote an article on complementary medicine on the NHS last year and talked to the midwives for this. They were really good and had assessed their results properly, they didn't just say 'oh it's great' in a woolly sort of way.) You will need a trained acupuncturist - check the British Acupuncture Society website which will give you lists of accredited practitioners in your area. Where are you?