Mum-to-be with breech baby is shunning hospital for home water birth

[TheHerald]

A mum-to-be who has been advised to have a C-section because her baby is breech is instead raising £2,000 for a private delivery at home in a birthing pool. www.plymouthherald.co.uk/Plymouth-mum-determined-breech-baby-boy-home/story-25901543-detail/story.html

A C section isn't a guaranteed safe delivery, though.

Hooby not at the expense of their baby no I don't.

You can't call SS on her because legally it is her choice.

It's a stupid choice, however. I think breech birth can be OK if it meets the necessary standards (hospital delivery with second-time mum with proven pelvis, frank breech, baby expected to be average size or below).

But a home water birth is insane, and from what the article says it looks like she is a first-time mother. She wants to risk underwater head entrapment with hospital assistance an ambulance ride away? What an idiot.

"The blanket advice on c-section for breech is based on a widely-discredited study."

Erm, yes... but even the studies which say "breech birth should not be an automatic cesarean and vaginal breech can be okay" have pretty strict standards that breech presentation has to meet before vaginal breech is considered a valid option---as I outlined in my previous post.

"It's important that doctors and midwives learn to manage a breech delivery."

They do. It is covered in all medical training courses related to obstetrics. People watch videos and use dummies, and attend breech births to observe whenever it is possible for them to do this. The issue relates not to the training itself, but rather to lack of hands-on experience, because doctors and midwives are just not seeing that many breech births in person any more.

However, there is no practical way round this, because even when vaginal breech is offered as a choice, most mothers don't want to give birth this way, and you can't force them to do so.

personally I wouldn't risk it, but it is her decision at the end of the day.

Her decision .... What would the baby decide?

Why is The Herald just linking to their own article? Weirdos

It is her decision, but very risky. Other women make decisions that can harm their unborn baby and are referred to SS. Also people don't think of the staff attending the home birth if very risky. As an NHs midwife, I have collegues who have had to attend "risky" home births and awful things have happened, midwives have left the profession, and their health has suffered because they thought they should had done more. We all want lovely birth stories and happy endings but sometimes they are not.

This is possibly an ignorant question but aren't breech births mega painful? I just can't imagine delivering either of mine bum first- just so much wider than head first? Or does breech usually mean feet first?

There are four types of breech so it could be feet or bum first or a combination.

The bottom is smaller and softer than the head - in fact that is the main risk factor with a breech, especially in a first time mother. The risk of head entrapment - as the bottom is able to pass through a cervix that isn't fully dilated, but a head is not - is a rare but real possibility.

However any type of birth can harm a baby. The poster who talks about a 'guaranteed safe delivery by CS' made me choke on my cornflakes. There are no guarantees, ever, and we do women an enormous disservice by pretending that hospital birth is risk-free.

It is her choice and it's a valid one. She is not an 'idiot' or 'insane'. By choosing this method she is taking full responsibility for the outcome. I would feel extremely privileged to attend a birth like that.

Good point by the poster who mentioned different types of breech births- some are more risky than others and the article doesn't mention which type this is.

I'm pregnant and if my baby is breech I don't want a c section. But I've already had 2 easy births so I imagine the risks in my case would be lower.

The problem here is the lack of suitable trained staff. The mother shouldn't be the one getting the blame for an inadequate nhs. There are countries where breech vaginal births are more common- can we not encourage midwives and obs from these countries to move here to improve our skills base?

Breech isn't automatically a risk factor in itself. Different kinds of presentations in breech can be, but they occur with head down presentations too.

Breech is a variation of normal and its a shame the flawed study that recommended c section has led to a decrease in practitioners experienced in breech birth.

I wonder if this particular woman is opting for home because she doesn't feel supported in hospital?

Just re-read the article again and it seems she is past 39 weeks, therefore her baby could come at any time. But she hasn't 'raised' the funds to have the independent midwife yet! She may have done her research and want a breech birth but this doesn't seem very thought out! What if she goes into labour today.....guess the NHS will have to do then!

I think this is a good example of how certain types of birth are romanticised and fetishised as so much better than others. So a home water birth is better than a hospital water birth which is better than a hospital birth in a bed... and so on.

I had some naive, rose tinted ideas about how I would give birth for the first time as well. As it was, I did the hospital water birth thing and came to the conclusion that natural childbirth is sooo overrated. I didn't find it amazing or empowering. It was painful and awful.

So when the woman in this story thinks it's a good idea to attempt a breech delivery in water, and is decorating the room with fairy lights and photographs to "keep her calm", I'll reserve the right to say she's lost sight of what's REALLY important.

But it's her body, her choice, her risk.

"Breech isn't automatically a risk factor in itself. Different kinds of presentations in breech can be, but they occur with head down presentations too."

Yes, it IS a risk factor in itself. If the head is too big in the case of a vertex delivery, well, you do a cesarean. With the breech birth, by the time you discover that fact, the body is already out.

You have two choices if that head is really not coming out; you either shove the body back in and do a cesarean, or you cut into the cartiledge which holds the mother's pelvis together and open out her pelvis so that you can yank the baby out. Serious risks to both mother and baby.

seaoflove I'm with you on the romanticized birth thing. I had a natural hospita bed birth and it was awful, the gas and air made me unreasonable and aggressive like I'd drank half a bottle of whisky, my labour was a painful back to back and too late for an epidural. it was just awful and painful, there was no sudden rush of love I was in shock physically and mentally, it was arduous painful and just awful. I neither felt empowered or strong just disheveled and shell shocked to be honest.

I think it's really dismissive to assume that women want vaginal births out of some kind of romanticised idea of 'blissful birth'. I wanted vaginal births because they are safer for mum and baby.

The maternal death rate for a c section is 4 times higher than for a vaginal birth. Women don't need to apologise for not wanting to die!

jackie that is because whatever it is that has led to a c-section happening means that birth is riskier in the first place, so your 4-1 comparison is meaningless.

I think this woman is being highly irresponsible. I hope that she doesn't come to regret her choices.

Her body, her choice.

I've had a breech baby at home with NHS midwives. We didn't realise she was breech until I was pushing and it became obvious the presenting part was not her head! All was fine and I pushed her out in a few minutes with no drama.

However, if we'd known she was breech I'd have certainly been strongly discouraged from having a home birth and probably been advised to have a section.

I'm sure someone will be along to correct me.

But as I understand it (from midwives I know); midwives are not supposed to plan to deliver a breech baby if they haven't attended one before. But as more women who are likely to deliver breech are able opt for C-sections then fewer training opportunities are available and fewer midwives qualified/trained in breech deliveries. A breech delivery used to be an infrequent, but not uncommon, occurrence and now it is quite rare.

The problem here seems to be the shortage of an experienced midwife, not the inherent danger of a breech birth.