Friday, March 20

Adventures in Breech

Two weeks ago, during an otherwise normal appointment at the Midwives, where we expected no new news (and therefore were unprepared for any), we learned that the baby was breech.  Earlier that week we had completed our 7-week Birthing class, hired a doula, and were generally feeling strong and confident about an unmedicated, natural delivery.  Plus, the baby had been head down a few weeks earlier so breech wasn't something we were even thinking about.  This was not welcome news.

In this country today, nearly all breech babies are delivered by cesarean, a major surgery and the complete opposite of what we hoped for.  Not only that, but the recommendation is to take the baby early in order to avoid spontaneous labor.

All this might not sound so bad, and it probably wouldn't have to me before this whole pregnancy experience, but what I've learned over the past 8 months it that it is worse for the baby, worse for the mother, and carries its own set of very real risks.

So I did what I do, and sped into action.  The midwives gave me a card for a chiropractor, told me to go to acupuncture, directed me to a website dedicated to "spinning" babies in utero for more favorable positions.  I went to massage and acupuncture that same day and the chiropractor the next.  I read the dreadful website, published by someone who may know her field but does not how to design a website.  I called the midwives again because I read about hip dysplasia, distorted heads, and other possibilities for breech babies.  They told me to do handstands in a swimming pool (one of my favorite activities in life, who ever thought it would be prescribed?!)  I read about cesareans, anesthesia, needles in the spine, pain medications post-surgery, and recovery from this major surgery while tending to a newborn.  And I started to cry.

I cried at least once a day for 12 days.

During this time, I did all these suggested things, running from one appointment to the next, we did voodoo moxibustion for 20 minutes morning and night, Karl read a baby book to the lower part of my uterus, quietly so the baby would turn to hear him better.  I learned the theories behind all these efforts, and I studied the statistics, which looked good.  Except the baby didn't turn.
Karl with moxibustion at my little toes
By the end, I needed to call someone who would simply let me cry without trying to "fix" it.  (We all need someone like this in our lives.  And we should strive to be this for friends when they need it.)  I also talked at length with a friend who had had a breech baby that simply wouldn't turn and a necessary cesarean.  This conversation gave me the peace I needed because I grasped some acceptance of this outcome for the first time.

On Day 13, we went in for an attempt at External Cephalic Version.  This procedure is done by an obstetrician who tries to manually rotate the baby 180 degrees.  It has a roughly 50% success rate, and low risk.  However, the "low" risk it does present is that the baby will need to be delivered then and there.  At 36 weeks and a day, for only a moderate success rate, we weren't sure about taking on even a small chance of emergency delivery because it was simply too early to be born.  But we knew we could back out at any point.  (One lesson through all this is the important fact that we remain in charge of our medical decisions.  Sometimes it feels like we lose this power, but we don't, and no one should be allowed to take these decisions from us.)
Waiting for ECV, post-handstands and staying non-vertical
We talked for 2 hours to nurses, the obstetrician, an anesthesiologist (in case of surgical delivery that day), our doula, and each other.  Then, we did it.  Specifically, the doctor did it.  But I helped, a lot.  It hurts to have somebody jam her thumbs into your uterus and push the baby!  In the first attempt, she got the butt up a bit and started to guide the head around, made it from about 12 o'clock to 2 o'clock with the head where it became really painful, and my muscles were clenching terribly, and the baby slipped below her thumbs back to where she'd been.  OW!  And the doctor said, "I'm willing to try again if you are."  This was a clue that there wouldn't be too many attempts, and this might be the last.  She started again pretty quickly and got to that same spot, but this time I went to some kind of la-la place, rolled my eyes back in my head, clutched Karl's hands and simply made my muscles relax.  The baby went and kept on going, right to where she was supposed to be.

I couldn't believe it.  It was maybe a 5-minute procedure.  We stayed in the hospital another 3 and a half hours while they monitored the baby and me until they felt safe letting us go home with all sorts of instructions about when to call or come back in during the night.
This is from the midwives office; thankfully Karl skipped snapping any of me in the hospital gown for the ECV!
24 hours later and the baby is still head down and actively kicking.  Hurray!  I believe that all our efforts at the chiropractor, the pool, and elsewhere helped make the version successful.  It set up my body in the most open way possible.

Through all this, I learned that when people say you will have the birth you will have, despite your plans or hopes, they mean it.  So much happens in pregnancy and delivery that being flexible and open-minded truly is the best plan.

We are far from done here, but I am walking every day to encourage the baby to stay down and drop lower.  I know that if something else arises, I will feel upset but we will also be able to make the decisions that are called for and accept the birth we are given.

I am done with handstands for now, but you may all keep them up.

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