Breech Births Independent Midwives

[RicePuddingwithApricotJam]

I am 37 weeks and a half weeks with my first and baby is breech. I doing all I can to encourage little one to turn and considering the options. The hospital (UCH) mentioned breech delivery as an option but it sounds very medical - stirrups, forceps etc. which is not my ideal. I am wondering about a home birth with a midwife with experience of natural breech births who is more about being on all fours rather than forcing things. Any one know of a such a mid wife in London?

I don't have any experience of MWs in London, but I'm sure there are IM's there with breech experience - have you had a trawl through the IMA website "find a MW" section?

DD was my first and was born as a breech baby at home with IMs (and was very much an birth rather than a delivery - I do believe that having confidence in my MWs (and their competence) was key to things going smoothly. It's well worth calling around and talking to a few as you may well not gel with all of them.

Are you a member of the homebirthUK mailgroup? There are quite a few IMs within the active membership and they may well be able to point you towards colleagues local to you with suitable skills.

Good luck

I have no experience or qualifications, but whatever you decide I would say do some proper research (NICE guidelines, WHO recommendations, MIDIRS etc). MN, good as it can be, often has posters who trot out quite emotive anecdotal stuff which isn't going to give you the sound evidence base you need to make the right decision for you. I wish you good luck!

Its good that the hospital have given the option of natural breech delivery... perhaps you can speak to them about having a more natural breech experience there before you jump to the homebirth idea? Might be an idea to speak to the senior midwife there to see what she thinks.

I know someone who had a natural breech delivery in big London teaching hospital in an upright position - hands and knees on operating table - she was fasting though as she didn't want epidural (as she didn't want the stirrups and forceps) and this meant she could have a GA quickly if necessary. She had the midwife from the birth centre supporting her but also doctors in the room.

The baby came out in great condition and she didn't tear at all - she was able to climb off the operating table and walk out of the theatre carrying her baby!

1. An IM will cost you about £2500-£3500 for just a few weeks.

1. I think you would be much safer in a hospital but that is just my opinion.

1. 15 minutes on all fours, four times a day may help.

my sister in law had a breech baby with her first and the consultant when she was about 37 weeks basically moved baby around ( i was with her) He pushed on her belly in particular ways and forced baby round yntil head down. It was amazing. My sister in law found it very uncomfortable but decided it was better than giving birth breech. the doctor was sweating with the amount of pressure he used and also since they do the procedure on the labour ward and its warm in there.
Perhaps something worth looking into ?/

Hey Ricepuddingwithapricotjam..phew! Have you also taken a look at the spinningbabies.com website? There's a few good techniques to look at which may assist with naturally turning your baby. If the hospital mentioned a breech delivery, can they allow you to have an active birth, where you are free to move around?

I believe Mary Cronk is the acknowledged UK (world?) expert, but don't know if she could cover you in London. You could try calling her though, and she may be able to recommend someone closer to you ( here)

You definitely need an IM with lots of experience doing this, of which there are not many these days, so you may not have the option. Good luck, hopefully the baby will turn in time anyway - bum in the air, nose to the computer!

Some experienced osteopaths are able to 'turn' breech babies, and some older, more experienced midwives - however, there is a favourable time window (not sure exactly when, sorry) which she may be coming to the end of, so she should get on the phone, quick.

An external cephalic version (ECV), where a practitioner tries to turn the baby whilst still in the womb, can cause the baby distress to the point that an immediate CS is required. It isn't common, but it is possible and my understanding is that, in consequence, it is now only considered appropriate for an attempt at an ECV to be made on a labour ward with a prepped operating theatre, just in case. NICE guidelines do recommend offering a woman with a breech baby an ECV at about 37 weeks (late enough that a CS isn't a big problem from development, if required, hopefully enough room left for them to turn but not so much its easy for them to turn back) - if that hasn't been done (and you're interested) it would be worth calling the hospital and asking for an appointment.

Chiropractors have a thing called the Webster Technique - which starts from the premise that the baby cannot turn due to a stress on the uterus which is stopping it relaxing. This stress can be caused by an asymmetry in the mother's spine/pelvis - by using chiropractic techniques to release the asymmetry, the stress on the uterus is removed and so it relaxes, allowing the baby to turn of its own volition. (or at least that's my understanding)

I'm not sure if Mary Cronk has retired now - I know she used to operate within a 1 hour drive of Chichester, so unlikely to be able to help unless you are in the SW suburbs and near the A3.

The book "Breech Birth" by Benna Waites is very good, if you can get hold of it. As is "Breech Birth: What are my options" by Jane Evans.

Hi,
I had a homebirth with an IM with my DD1, in Kent - depends which part of London you're in whether they could come to you, but they were from Kent Independent Midwifery. They also co-copted an IM colleague from Essex to assist. Good luck with your decision, and please don't be frightened by any horror stories. NICE/WHO guidelines are all very well, but you don't need to follow them slavishly. Find out why the guidelines are in place, and see if they're applicable to your specific situation and circumstances. And be ready to fight your corner with the hospital if you decide to go that way.
I chose an IM at home, because I was so convinced that the hospital doctors would have their own adgenda (following guidelines rigidly, terrifed of malpractice suits etc) that they would rush me in for a C-Section at the first opportunity, whereas I knew my IM would support my choices, and if she suggested a transfer, I would believe her and go.
I had a very speedy delivery at home (less than 6 hours), but DD was born a bit shocked, so we transferred to hospital after the birth. She spent a few days in SCBU for observation, but she was actually fine. Not of that was as a result of her being born at home.
FWIW, I would do exactly the same again.

Thank you so much everyone. That was my first post and I was touched to get so many responses. I had the ECV yesterday but as I suspected baby wouldnt be persuaded. DH says its a stubborn creature like its mother! We have decided that switching to a home birth at 38 weeks is a bit much so now deciding between attempting a natural breech and the recommended planned c-section whilst continuing with acupuncture/ moxybustion and my upside down routine! Thanks again. x

Tangle - ECV is common, they perform at least 5 every week on a dedicated list on one afternoon a week in the large obstetric unit I work in. Women sign a consent form as it is a procedure and are informed that there is a 1% chance of fetal distress leading to a Grade 1 CS. ECV's should only be performed in a unit with a theatre (ie not a MLU), but the theatre and staff aren't on standby by any means.

So Ricepud, please consider ECV is you are suitable as this would alleviate all your concerns.
Good Luck

malteser - sorry if I confused. What I was trying to say was that a CS being required as a direct result of an ECV attempt wasn't common, not that ECV's themselves are rare. But RicePud has been there already, now, so fairly academic

So do we have great minds or are we fools?

Think it's me that got the wrong end of the stick.....

the last time i saw Mary Cronk she said she was retired and only delivering babies for mums she'd already helped before

Good luck RicePudding, whichever way it turns out, you're in the home stretch now!

PS Also meant to say - I've had one of each, CS and 'natural' birth. Can't say either of them were a piece of cake, and you never know what problems you might encounter either way, so don't feel like taking the CS route is somehow 'inferior'. Sorry if I'm projecting a bit there...