The Doula Files: A Breech Baby
What's a Mom to Do?
Introducing a *new* piece for the MOTHERLANDS newsletter called The Doula Files which highlights real life experiences providing education and hands-on support to birthing clients. All of these stories hold complexity and are beautiful, lived-in illustrations of how the birthing process uniquely unfolds for each body.
It was a cloudy, crisp winter day in Los Angeles. I was meeting a couple who was preparing to have their first baby together in the spring. I sat down and patiently waited for them to arrive at the coffee shop.
When Anjelica and Neil sat down I could tell how genuinely excited they were to have a child. They both enthusiastically shared their goal of having a birth experience with the least amount of medical interventions. I was personally familiar with their chosen OBGYN who I felt would be receptive to this goal.
Around 32 weeks of pregnancy, Anjelica found out that her baby had turned breech. She wanted to do everything in her power to encourage the baby to flip as she learned that there are very few providers willing to support a patient’s attempt to have a vaginal breech birth. Some older seasoned doctors say that delivering a breech birth vaginally is a lost art as the new providers are not taught or exposed to breech deliveries during their medical training; it was decided that it poses too much of a liability as it can lead to unwanted litigation.
Anjelica went to great lengths to see several practitioners that specialize in optimal fetal positioning through movement. During a session, the baby was able to turn vertex (head down). She went home that day feeling accomplished and relieved that the baby was not breech anymore and she could continue on the path of having a vaginal birth.
As we approached the final weeks of her pregnancy, her doctor measured her fundal height and said it was tracking larger than the corresponding week of pregnancy. This meant that her baby theoretically might be a little bigger than the average size. I could tell that Anjelica was beginning to doubt how she could birth her baby safely and confidently. Her doctor explained that she felt more comfortable planning an induction but was leaving it up to her to decide. Anjelica and Neil were not too keen on an induction, especially since they learned that having a big baby might not be a legitimate medical reason to induce. Still, they went home to think about it together.
Around 38 weeks, we spent a great deal of time discussing together the real preparation for birth comes from within; feeling calm, open, and flexible to what her body and baby need. She said “I’m not sure what to do! There are so many variables to consider”. I told her earnestly that “giving birth is not an exam that you cram for the night before. It is not a pass/fail experience. This is far more complex - it is both an emotional and a physical experience for you and your baby. You do not need to decide right now. But I am going to invite you to practice relaxation every day so that you can trust that this process will unfold exactly the way that it needs to”.
At 39 weeks Anjelica was exhausted and over being pregnant. This is such a common experience that I think it is worth the validation. Her and her husband decided after much consideration, that they were interested in setting a date for an induction. She was ready to meet her baby. Although this choice was a detour from their original hope of giving birth with the least amount of medical interventions, they came to a place of peace and acceptance that was all their own. As their doula I was not only able to pivot and adapt to their decision but also help them feel empowered for making this choice.
The day before her scheduled induction, Anjelica went to see her OBGYN for a routine visit. In the exam room her doctor said she wanted to do a quick ultrasound to make sure the baby was in a good position. “Your baby is breech again!” the doctor said. Anjelica and Neil once again were caught off guard. The doctor said that they have an option to try an External Cephalic Version (ECV) which is a procedure where the doctor manually attempts to rotate the baby externally on the mother’s uterus. It has a 50/50 success rate and every doctor has varying degrees of confidence in performing the procedure.
After their appointment, Anjelica and Neil called me. "Are you ready for the plot twist?”she said, “Baby is breech again”. Despite the unfavorable news, Anjelica’s tone seemed optimistic and steady. She informed me that they had privacy to discuss their options together:
1. Try the ECV. If successful, proceed with the induction as planned.
2. Elect a Cesarean.
Anjelica said “while none of this is what we wanted, I feel really good about it. We decided to have a cesarean tomorrow. We are excited to finally get to meet our baby!” I told her how impressed I was with her ability to be open and flexible, and for listening to what her gut is telling her feels best for her body. I reminded her that babies have a lot of say in how they choose to come into this world. Just ask any mother of a breech baby, and they’ll likely agree.
She could have chosen the ECV. The ECV could have been unsuccessful and led to an emergency cesarean. The ECV could have been successful and she could have gone on to have an induction that either went smoothly, or not. The truth is we will never know. Instead she chose what felt the most empowering to her. She got to enjoy one last night with Neil… relaxed, calm, and confident.
What we do know is that Anjelica gave birth to her baby via cesarean the following day at 1pm. Besides a nuchal cord wrapped around the baby’s neck (a surprisingly normal occurrence), and the baby swallowing a bit of fluid at delivery, the baby was born a healthy 9lbs and 9oz.
While she may have warranted feelings of grief for the experience she longed to have, there is a greater sense of peace and accomplishment. My intention as her doula was to make sure Anjelica felt seen, heard and held by her birth team throughout the process. I felt an overwhelming sense of relief for both of them. The baby was here safe and sound, and Anjelica was beaming with joy, love and admiration.
This is why I am a doula; not only to champion the births that seemingly go according to plan, but also to celebrate the mothers that persevere despite adversity. Because the journey matters just as much as the destination.
If this isn’t the heart of motherhood, I don’t know what is.
If you know someone that is pregnant who may be seeking guidance through their pregnancy and birthing experience, feel free to share this with them.
I offer 1-1 birth preparation online worldwide. You can find out more here.
I already appreciate this series.
I found out my baby was breech at 37 weeks and this story resonates so much. I planned a vaginal birth and had to make hard decisions with very little time to consider everything. I opted for a scheduled c section. And the grace that has to come with that decision isn't easy, but it comes.
Hearing from other breech birth momma's in those weeks and even after helped to ease the transition.
I hope this story continues to land to the mommas that need it. It wasn't something I heard about it throughout my pregnancy and I know having some information would have helped me.