As soon as we found out that all was well with my hemoglobin, another surprise hit....of course!! At 28 weeks it is not totally unusual for a fetus to still be breech (head up) instead of vertex (head down), but at 33 weeks (which is when our next prenatal appointment was), it is becoming less favorable!
The deal with breech, a position that many Midwives still call a "variation of normal", is that the longer the baby stays breech, the less likely s/he is to turn. Why do you want for a baby to turn vertex (usually by 34-35 weeks)? Well, if the mother is planning to birth in the hospital, chances are that she will not have the option of a vaginal birth because OB are simply not trained any longer to help deliver a breech presenting baby, thus necessitating a cesarean section. If the mother is planning to birth at home, she may have difficulty finding a Midwife who has breech experience because the incidence of such a presentation is only about 3-4% of term pregnancies. Since Midwives attend about 1% of the births in the US, her chances of getting to work with a breech mama/baby duo is nearing unlikely. However, if you are fortunate enough have a Midwife with breech experience (of if your Midwife knows and is willing to work with another Midwife who does), then a vaginal birth may be in the picture for you!
There certainly is fear, some realistic, some not, regarding vaginal breech birth. First off, there are more complications associated with breech birth, such as a damaged brachial plexus (could cause temporary or permanent paralysis), skull damage, or meconium aspiration...but these only occur in a small portion of the women who decide to have a vaginal breech and can happen in a vertex vaginal birth as well. As long as the mother is prepared emotionally and physically and in the company of an experienced Midwife, then a vast majority of the time the baby is perfectly fine.
The decision the plan a vaginal breech birth at home is not an easy one however. At 36 weeks, a time when the light at the end of the pregnancy tunnel is beginning to shine, our little one was still head up (I think he like to listen to my heart!). So I started doing all the usual breech turning tricks! I did moxabustion , many, many inversions, swimming, headstands in the water, pulsatilla, meditation, talking with baby and so on. It seemed like there were a few times that he tried to flip but just couldn't.
So we decided to get an ultrasound to rule out placenta previa (when the placenta covers the cervix, thus not allowing baby to turn down and also necessitating a c-section), a short cord or some other fetal anomaly such as hydrocephaly. Luckily, all was well! My uterus looked great, baby looked beautiful, cord was long (though it was a nucal cord, meaning around his neck) and placenta high! We were ecstatic!
Although our fabulously wonderful Midwife does not have experience with breech delivery, she knows a Midwife from Minneapolis that does and evidently that loves to teach! So we contacted her and she made a special two and a half hour trip to Duluth to meet with us and our Midwife. It was an excellent and enlightening meeting. We left feeling totally confident that if our baby did not turn, that we would go fourth with a vaginal breech home with with the help of our Midwife and the Midwife from Minneapolis. It felt good to make the decision, because the possibility of a scheduling a cesarean was on the back of my mind. Needless to say, we did not give up hope that our babe would turn down.
Though deliberations with our Midwife we decided as a last attempt to schedule an External Cephalic Version (ECV) at the local hospital. This is where the Doctor manually tries to move the baby to a vertex position. It has a 65-70% success rate and at 38 weeks and still breech, we figured we had nothing to lose!!!
Last night we went in for the version.......(will return tomorrow to finish the story and to let you know the results of the version so stay tuned!!).
