Breech babies

There are a variety of reasons for babies to be bottom down.  Babies can flip head down late in pregnancy.  This is more likely if this is not your first, but can still happen with your first.  There are things you can do to help turn your baby (see links below) and/or you may be offered manual turning by the doctor, called External Cephalic Version (ECV).

 

As far as breech birth goes, you have three options: caesarean, managed vaginal birth (legs in stirrups, epidural to relax you, doctor guides baby out) or 'hands off' vaginal birth, sometimes known as a midwife led birth or all fours birth, because that is the position that is recommended. Consultants, who are surgeons with very little understanding of normal birth and no training in a physiological breech birth, prefer the control that caesarean gives them.  Have you come across the 'Hannah trial' also known as the 'Breech Term trial'?  This came out about 13 years ago showing much better outcomes for breech babies born by caesarean, and suddenly all breech babies were to be born this way.  However there were huge criticisms of the trial and eventually the researchers printed a retraction, but in a little known journal and anyway the damage had been done.  Many consultants don't even know about a hands off breech birth.  There may be some community midwives who are skilled and experienced.  However, it is independent midwives who, generally, have more experience.  However in April 2017 the Royal College of Obstetricians and Gynaecologists published updated guidelines for breech, which included, for the first time, the acceptance of all fours birth.  For those of you who are local, one of the obstetricians on the guideline committee was Malcolm Griffiths, a senior obstetrician at Luton and Dunstable Hospital.

Before the 1970s and the big move to hospital breech was considered a variation on normal, part of every midwife's skills and experience. It was not considered enough reason to suggest hospital birth.  Mary Cronk always says that breech birth either progresses well or it doesn't.  If it is progressing well then you leave it alone.  If it doesn't progress then go for a caesarean.

The two leading UK midwives for breech birth are Jane Evans (Dorest) and Shawn Walker (Norfolk). They deliver training around the country and overseas.  If you don't feel you are getting what you need from the NHS you can employ an independent midwife who is experienced with breech births.  

You can also request your NHS trust provide you with competent and experienced midwife.  If they don't have someone you can ask that they contract an IM to provide it. 

 

A client had a vaginal breech birth, on all fours, at Milton Keynes Hospital in July 2016 so it is possible.

 

Websites

www.breechbirth.org.uk - wonderful UK midwife Shawn Walker, based in East Anglia.

http://breechbirth.org.uk/2016/06/the-birth-of-leliana/ is a photo story of a vaginal breech birth at home, attended by Shawn.

http://spinningbabies.com/ - US site all about turning baby into optimal position.

https://www.facebook.com/groups/371624862918154/  UK breech facebook group, very supportive

Books

Breech Birth: what are my options? by highly respected UK midwife Jane Evans.  Available from AIMS as book and ebook. http://www.aims.org.uk/pubs.htm#breech

Breech Birth; Woman Wise by Maggie Banks

Breech Birth by Benna Waites - this is a very comprehensive book covering all the research including natural turning, ECV and different birth potions.

Articles

http://www.aims.org.uk/Journal/Vol10No3/handOffbreech.htm

http://www.aims.org.uk/Journal/Vol15No4/BreechBirthMidwiferyApproach.htm

Videos

Turning breech babies:

sidelying release:https://www.youtube.com/watch?v=I_kMy5MWy8Q&list=PLdaMWc34oR-z6NEZOvHj8r8osNadXmKiS

Mechanisms of breech birth by Jane Evans: https://www.youtube.com/watch?v=l16dPHaOGj0

Research/guidelines

Latest guidelines from the RCOG: https://www.rcog.org.uk/globalassets/documents/guidelines/green-top-guidelines/breech20bfinal.pdf

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© 2017 Cathy Williams, 41 Preston Rd, Toddington, Beds, LU5 6EG