Lucy 2010 and Nick 2012 – A tale of two breeches
My first pregnancy started pretty smoothly. We had good results from our nuchal test and 12 week scan and the baby was very active. At 18 weeks we moved home to Adelaide from Canberra so that we could be near our families when the baby arrived. We had our first appointment with our OB soon afterwards, and then our 20 week scan where we found out we were expecting a girl. We went to antenatal classes at the private hospital we had chosen from around 24 weeks and after hearing about all the different options I was quite determined to attempt birth without pain relief if possible.
From about 30 weeks my OB let me know the baby was breech. As the weeks went by he would attempt to turn her in my regular appointments, but she would not budge. I had a sizing scan at around 33 weeks as he was concerned she was quite big- and at that stage measured around 90th percentile on the scan. He encouraged me to try to get her to turn by talking to her about it and by using inverted positions. I also read up on other turning options and ordered some moxi sticks. I was already swimming a fair bit as I was having a lot of pelvis trouble and I would feel her moving while I was in the pool – especially after doing my tumble turns. I always felt as though she would start to move with all these spinning techniques, but there wasn’t enough space for her to turn. We had a weekend away and during the 3 hour drive home I was really uncomfortable, and it was quite obvious to me that I had a foot kicking me in the bladder and cervix.
Each visit my OB would ask ‘turned yet?’ and I’d say no – he’d reply ‘doing my job for me again?!’ We had a good rapport and I was very comfortable with his recommendations. At 36 weeks he did a PV exam as he was wanting to check the type of breech position and was concerned about the size. At that time a footling breech was confirmed. My OB (by chance) is one of the only ones in Adelaide who will deliver breech babies and twins naturally, but even he was not happy to deliver a footling breech. He explained that had she been frank breech we could have tried, but he felt footling was too risky for the baby. We trusted his advice and the process for booking in a caesarean was begun. The next day his receptionist called with the date.
Of course I went home and did some Dr Googling, mostly about caesareans, their risks and recoveries. I was very upset that I would not be having the birth I had envisaged, and it took about 48 hours to come to accept that I would have a surgical birth. As a vet who has completed multiple caesarean sections on dogs I tried to look at it as understanding how my patients feel!
4 days later on a Saturday, at 37 weeks exactly, I felt a sharp pain in my lower abdomen/cervix area when I bent over to pick up something off the floor in the morning. Nothing seemed to come of it, so we continued our day. Off we went to IKEA to get a small desk so we could finish turning the study into the baby’s room. After having some Swedish meatballs for lunch and waddling through the whole display, we picked up our items and I was waiting in the pick-up bay for my husband to bring the car around. I felt a very strange sensation - was I wetting my pants? I didn’t think I had lost that much control! I got into the car and as I did I could feel burst after burst, gush after gush, of fluid. ‘Um, I think my waters have just broken!’ We were totally unprepared – 25 minutes’ drive from home, no towels or bag in the car, not even my OB’s phone number. It was a very stressful drive home, getting every red light of course. I couldn’t really feel any contractions so I knew we had time, I was just quite excited and nervous that we were about to meet our baby.
When we got home I lost more fluid (still nice and clear luckily) in the driveway, hallway and shower. We called my OB then the hospital called me back to check they had the right details. I quickly finished packing my bag and by 3.30pm we had arrived at the hospital. We were taken to our room and the midwife examined me and confirmed I was 3cm and she could still feel little toes. Soon after my OB arrived then once they had managed to find a paediatrician (those on call were busy already so my OB pulled one of his mates out of semi-retirement!) we headed down to theatre.
I was starting to feel the contractions a little bit by the time the spinal block was placed, but they weren’t painful. After a bit of ‘washing the dishes’ in my abdomen, at 5.28pm, Lucy Claire was born, perfectly healthy and pretty small after all – 2.72kg/ 6lb. My OB was quite embarrassed that he had got her size so wrong, but noted a bicornuate uterus during the caesarean – meaning she really was wedged in one side and that was why she couldn’t move. Her Apgar scores were 9 and 10, so I was able to hold her while I was sutured up. It was freezing in the surgery so she was all bundled up, but so alert.
From about 30 weeks my OB let me know the baby was breech. As the weeks went by he would attempt to turn her in my regular appointments, but she would not budge. I had a sizing scan at around 33 weeks as he was concerned she was quite big- and at that stage measured around 90th percentile on the scan. He encouraged me to try to get her to turn by talking to her about it and by using inverted positions. I also read up on other turning options and ordered some moxi sticks. I was already swimming a fair bit as I was having a lot of pelvis trouble and I would feel her moving while I was in the pool – especially after doing my tumble turns. I always felt as though she would start to move with all these spinning techniques, but there wasn’t enough space for her to turn. We had a weekend away and during the 3 hour drive home I was really uncomfortable, and it was quite obvious to me that I had a foot kicking me in the bladder and cervix.
Each visit my OB would ask ‘turned yet?’ and I’d say no – he’d reply ‘doing my job for me again?!’ We had a good rapport and I was very comfortable with his recommendations. At 36 weeks he did a PV exam as he was wanting to check the type of breech position and was concerned about the size. At that time a footling breech was confirmed. My OB (by chance) is one of the only ones in Adelaide who will deliver breech babies and twins naturally, but even he was not happy to deliver a footling breech. He explained that had she been frank breech we could have tried, but he felt footling was too risky for the baby. We trusted his advice and the process for booking in a caesarean was begun. The next day his receptionist called with the date.
Of course I went home and did some Dr Googling, mostly about caesareans, their risks and recoveries. I was very upset that I would not be having the birth I had envisaged, and it took about 48 hours to come to accept that I would have a surgical birth. As a vet who has completed multiple caesarean sections on dogs I tried to look at it as understanding how my patients feel!
4 days later on a Saturday, at 37 weeks exactly, I felt a sharp pain in my lower abdomen/cervix area when I bent over to pick up something off the floor in the morning. Nothing seemed to come of it, so we continued our day. Off we went to IKEA to get a small desk so we could finish turning the study into the baby’s room. After having some Swedish meatballs for lunch and waddling through the whole display, we picked up our items and I was waiting in the pick-up bay for my husband to bring the car around. I felt a very strange sensation - was I wetting my pants? I didn’t think I had lost that much control! I got into the car and as I did I could feel burst after burst, gush after gush, of fluid. ‘Um, I think my waters have just broken!’ We were totally unprepared – 25 minutes’ drive from home, no towels or bag in the car, not even my OB’s phone number. It was a very stressful drive home, getting every red light of course. I couldn’t really feel any contractions so I knew we had time, I was just quite excited and nervous that we were about to meet our baby.
When we got home I lost more fluid (still nice and clear luckily) in the driveway, hallway and shower. We called my OB then the hospital called me back to check they had the right details. I quickly finished packing my bag and by 3.30pm we had arrived at the hospital. We were taken to our room and the midwife examined me and confirmed I was 3cm and she could still feel little toes. Soon after my OB arrived then once they had managed to find a paediatrician (those on call were busy already so my OB pulled one of his mates out of semi-retirement!) we headed down to theatre.
I was starting to feel the contractions a little bit by the time the spinal block was placed, but they weren’t painful. After a bit of ‘washing the dishes’ in my abdomen, at 5.28pm, Lucy Claire was born, perfectly healthy and pretty small after all – 2.72kg/ 6lb. My OB was quite embarrassed that he had got her size so wrong, but noted a bicornuate uterus during the caesarean – meaning she really was wedged in one side and that was why she couldn’t move. Her Apgar scores were 9 and 10, so I was able to hold her while I was sutured up. It was freezing in the surgery so she was all bundled up, but so alert.
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We did our first breastfeed while in the recovery area, and then as I was taken back to my room, my husband stayed with her and the midwife as she had her Hepatitis and vitamin K injections and further checks. She stayed in the room with me during our whole 5 night stay. The rest of my recovery was pretty standard – the wound pain gradually improved over months, but even 12 months later if I wore the wrong pants I would still feel an ache.
Lucy is a now a very healthy and happy little girl, with no hip problems, developmental delays or other potential ‘breech problems’. Soon after Lucy’s 1st birthday we decided to try for number 2. Within 2 months I was pregnant. This pregnancy everything seemed to come on so quickly – the varicose veins picked up where they left off and the sacroiliac pain was quite bad from 9 weeks. I was pretty exhausted with a toddler to chase after, and could only manage a small amount of work with my pelvic pain.
I could feel the baby moving much earlier – from about 14 weeks. We learnt that we were expecting a boy at our 20 week scan, and were excited but a bit apprehensive after Lucy had been such a gentle and easy to manage baby! From about 18 weeks onwards I could tell the baby was breech. He never changed position, and was head butting me from early on. As the pregnancy progressed I wasn’t getting the kicks to the cervix as often, only some in the bladder sometimes, so I was hoping he would not be footling.
My OB continued to try to manipulate the baby into moving from about 28 weeks, but with no luck. After about 34 weeks we decided not to bother. I was much better prepared this time around, with a bag packed and towels in the car from 33 weeks. But the weeks dragged on and on. The initial plan was decided that if I went into labour before my ‘planned’ caesarean at 39 weeks then we would have a try at a VBAC, but that we would book the caesarean in with the hospital. I assumed the baby would ‘run out of room’ as Lucy had, and come early, but the weeks kept passing. At my 38 week appointment I started to ask about why I needed the caesarean booked in. I really didn’t want one as Lucy still wanted to be picked up all the time, which I wouldn’t be allowed to do, and I wanted to avoid the prolonged recovery. Obviously I wanted to attempt a normal birth as well, but my recovery for the sake of looking after our family was most important.
As we discussed it more we realised it had been a communication breakdown. My OB had never had someone who had a first breech by caesarean want a VBAC for a second one, and I had assumed the risks were too high past 39 weeks. I asked him if I had a cephalic presenting baby whether he would be recommending I attempt a VBAC, and he said yes. We discussed the risk of uterine rupture and need for monitoring, my OB’s preferences for epidural and lithotomy position. There weren’t really any breech risks that he was concerned about other than non-progression leading to caesarean. At that point, although I had read all the information and papers on the breechbirth.net website and would have preferred an upright, active birth, I was willing to do whatever it took to avoid surgery. And just like that, we cancelled the ‘planned’ caesarean!
I did have to do some work to convince my husband that this was the best way for our family to go, but once he had come to the appointment with the OB and had his reassurances as well he was ok. We felt some external pressure from a few of the people we told but it is lucky I am extremely stubborn! It seems very easy for some to forget that a caesarean is a major abdominal surgery when women are so good at ‘getting on with it’.
At 39 ½ weeks I woke at midnight with some twinges. They very quickly progressed and became more uncomfortable. Because I hadn’t really felt pain with my first labour, I wasn’t sure how serious they were. For about 3 hours I walked around and used my TENS at home, but when they were every 3 minutes I thought I had better call the OB as I knew they would want to monitor me as a VBAC patient. Mum came over to stay with Lucy and we went into the hospital. In the car, the contractions stopped, but once I got out of the car they started again. We were taken to one of the delivery rooms and I was hooked up to the monitor. The contractions were quite sporadic and varied a lot, then they stopped for an hour. The OB came in at about 7am and checked me, and said it was a false labour. I was quite worried that he would say I’d have to have a caesarean because I was already there, but he was happy to send me home with some sleeping tablets and strict instructions to stop nesting! He said we’d take it one appointment at a time assessing how the baby was going as to any change in the plan. My cervix had softened so he felt we were still on track to attempt the VBAC when labour started.
A week later, I woke at 3am to the same feeling. ‘Here we go again,’ I thought. I continued with the TENS and walking around the living room until 6.30am when I called my OB, Mum and woke my husband. Once again the contractions stopped in the car, even though they were getting quite painful and regular at home. In the delivery room, the midwife said she wasn’t sure if I was in established labour, but my OB was in soon after to check me. I was 1-2 cm but the contractions ‘weren’t that convincing’. He said that I’d be having this baby one way or the other today, he wasn’t happy with the risks of uterine rupture increasing if I kept having false labours.
He wanted me to have an epidural so over the next few hours the anaesthetist came and placed it, and I was bed bound. The epidurals seemed to wear off quite quickly, and despite not really wanting to, I thought if I had to have it I wanted it to work! So I needed to be ‘topped up’ quite regularly. At midday my OB came back and I had progressed to 4cm, and he ruptured my membranes. He said he’d be back at 5 to check on me unless the midwife called sooner.
At 4pm I had my 4th ‘top up’, the 2nd dose of the stronger cocktail. 5 minutes later my OB arrived to check me and I was fully dilated. ‘OK, let’s go!’ he said. I was pretty upset, because I could not feel a thing, my legs were heavy like tree trunks and completely numb, and I felt totally incapable of pushing at that point. He came back an hour later, and nothing much had changed. Another hour later and I could feel the contractions quite strongly but the whole lower half of my body was still completely useless. He asked me to try to push, and obviously not much happened, as he started making noises about going to surgery.
We kept waiting for the effects of the epidural to wear off over the next few hours, fortunately it was dinner time and my OB went home for a while! As 8pm approached I was starting to get a few pushing urges as I worked through the contractions. My husband didn’t want me pushing as no one was around to help, but I sneakily had a little try! When the OB came back I could hear him telling the midwives not to let the surgical team go home when they called every 15 minutes or so and it was a little disheartening. However, he left the room and asked my midwife to get me pushing, and I started to make some progress. My stubbornness came out again and I was thinking ‘I’ve bloody well made it this far, I am NOT going to surgery!’
After 50 minutes of pushing with legs held up by my husband and midwife and resting in between in stirrups because they were still totally ‘dead’, I was able to lean down and touch baby’s bottom. The OB was getting the nurses to run around to try to find the paediatrician, who had been waiting nearby but was sent off to do his rounds in the nursery when things seemed to be taking a while. I was then given an episiotomy and a few pushes later the bottom came out, and my OB helped to release the legs (according to my husband). He hung there until the next push when my OB rotated him to release the arms, and then at the next contraction he was flipped over as his head came out. Nicholas Dawson was born at 8.55pm weighing 7lb 10oz/ 3.45kg.
Lucy is a now a very healthy and happy little girl, with no hip problems, developmental delays or other potential ‘breech problems’. Soon after Lucy’s 1st birthday we decided to try for number 2. Within 2 months I was pregnant. This pregnancy everything seemed to come on so quickly – the varicose veins picked up where they left off and the sacroiliac pain was quite bad from 9 weeks. I was pretty exhausted with a toddler to chase after, and could only manage a small amount of work with my pelvic pain.
I could feel the baby moving much earlier – from about 14 weeks. We learnt that we were expecting a boy at our 20 week scan, and were excited but a bit apprehensive after Lucy had been such a gentle and easy to manage baby! From about 18 weeks onwards I could tell the baby was breech. He never changed position, and was head butting me from early on. As the pregnancy progressed I wasn’t getting the kicks to the cervix as often, only some in the bladder sometimes, so I was hoping he would not be footling.
My OB continued to try to manipulate the baby into moving from about 28 weeks, but with no luck. After about 34 weeks we decided not to bother. I was much better prepared this time around, with a bag packed and towels in the car from 33 weeks. But the weeks dragged on and on. The initial plan was decided that if I went into labour before my ‘planned’ caesarean at 39 weeks then we would have a try at a VBAC, but that we would book the caesarean in with the hospital. I assumed the baby would ‘run out of room’ as Lucy had, and come early, but the weeks kept passing. At my 38 week appointment I started to ask about why I needed the caesarean booked in. I really didn’t want one as Lucy still wanted to be picked up all the time, which I wouldn’t be allowed to do, and I wanted to avoid the prolonged recovery. Obviously I wanted to attempt a normal birth as well, but my recovery for the sake of looking after our family was most important.
As we discussed it more we realised it had been a communication breakdown. My OB had never had someone who had a first breech by caesarean want a VBAC for a second one, and I had assumed the risks were too high past 39 weeks. I asked him if I had a cephalic presenting baby whether he would be recommending I attempt a VBAC, and he said yes. We discussed the risk of uterine rupture and need for monitoring, my OB’s preferences for epidural and lithotomy position. There weren’t really any breech risks that he was concerned about other than non-progression leading to caesarean. At that point, although I had read all the information and papers on the breechbirth.net website and would have preferred an upright, active birth, I was willing to do whatever it took to avoid surgery. And just like that, we cancelled the ‘planned’ caesarean!
I did have to do some work to convince my husband that this was the best way for our family to go, but once he had come to the appointment with the OB and had his reassurances as well he was ok. We felt some external pressure from a few of the people we told but it is lucky I am extremely stubborn! It seems very easy for some to forget that a caesarean is a major abdominal surgery when women are so good at ‘getting on with it’.
At 39 ½ weeks I woke at midnight with some twinges. They very quickly progressed and became more uncomfortable. Because I hadn’t really felt pain with my first labour, I wasn’t sure how serious they were. For about 3 hours I walked around and used my TENS at home, but when they were every 3 minutes I thought I had better call the OB as I knew they would want to monitor me as a VBAC patient. Mum came over to stay with Lucy and we went into the hospital. In the car, the contractions stopped, but once I got out of the car they started again. We were taken to one of the delivery rooms and I was hooked up to the monitor. The contractions were quite sporadic and varied a lot, then they stopped for an hour. The OB came in at about 7am and checked me, and said it was a false labour. I was quite worried that he would say I’d have to have a caesarean because I was already there, but he was happy to send me home with some sleeping tablets and strict instructions to stop nesting! He said we’d take it one appointment at a time assessing how the baby was going as to any change in the plan. My cervix had softened so he felt we were still on track to attempt the VBAC when labour started.
A week later, I woke at 3am to the same feeling. ‘Here we go again,’ I thought. I continued with the TENS and walking around the living room until 6.30am when I called my OB, Mum and woke my husband. Once again the contractions stopped in the car, even though they were getting quite painful and regular at home. In the delivery room, the midwife said she wasn’t sure if I was in established labour, but my OB was in soon after to check me. I was 1-2 cm but the contractions ‘weren’t that convincing’. He said that I’d be having this baby one way or the other today, he wasn’t happy with the risks of uterine rupture increasing if I kept having false labours.
He wanted me to have an epidural so over the next few hours the anaesthetist came and placed it, and I was bed bound. The epidurals seemed to wear off quite quickly, and despite not really wanting to, I thought if I had to have it I wanted it to work! So I needed to be ‘topped up’ quite regularly. At midday my OB came back and I had progressed to 4cm, and he ruptured my membranes. He said he’d be back at 5 to check on me unless the midwife called sooner.
At 4pm I had my 4th ‘top up’, the 2nd dose of the stronger cocktail. 5 minutes later my OB arrived to check me and I was fully dilated. ‘OK, let’s go!’ he said. I was pretty upset, because I could not feel a thing, my legs were heavy like tree trunks and completely numb, and I felt totally incapable of pushing at that point. He came back an hour later, and nothing much had changed. Another hour later and I could feel the contractions quite strongly but the whole lower half of my body was still completely useless. He asked me to try to push, and obviously not much happened, as he started making noises about going to surgery.
We kept waiting for the effects of the epidural to wear off over the next few hours, fortunately it was dinner time and my OB went home for a while! As 8pm approached I was starting to get a few pushing urges as I worked through the contractions. My husband didn’t want me pushing as no one was around to help, but I sneakily had a little try! When the OB came back I could hear him telling the midwives not to let the surgical team go home when they called every 15 minutes or so and it was a little disheartening. However, he left the room and asked my midwife to get me pushing, and I started to make some progress. My stubbornness came out again and I was thinking ‘I’ve bloody well made it this far, I am NOT going to surgery!’
After 50 minutes of pushing with legs held up by my husband and midwife and resting in between in stirrups because they were still totally ‘dead’, I was able to lean down and touch baby’s bottom. The OB was getting the nurses to run around to try to find the paediatrician, who had been waiting nearby but was sent off to do his rounds in the nursery when things seemed to be taking a while. I was then given an episiotomy and a few pushes later the bottom came out, and my OB helped to release the legs (according to my husband). He hung there until the next push when my OB rotated him to release the arms, and then at the next contraction he was flipped over as his head came out. Nicholas Dawson was born at 8.55pm weighing 7lb 10oz/ 3.45kg.
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I was able to hold him on my tummy as his cord was clamped, and he started crying straight away. The paediatrician had just been found so he was able to check him over, and despite a very bruised bottom and scrotum, he was fantastic and had Apgar scores of 10. I was able to hold him quite soon after, and once the post birth spectators had departed, I gave him a feed.
Nick has also been a very happy baby with no breech-related problems.
I was really happy with my birth experience in general and recovered so much faster – a shower as soon as my legs were a bit stronger, walking the corridors the next morning and I only needed Panadol as pain relief. I was a little surprised at the lack of people wanting to take part in the birth – I offered for my OB to invite any younger doctors to come to watch and learn, but he dismissed it saying ‘no-one wants to learn these days’. I do hope he was wrong and things continue to change.
As I was discharged, the midwife looking after me that morning was one I hadn’t seen during my stay. She read my notes and said ‘Oh, you’re THAT one! I was on the shift before you came in, and one of the obstetricians answered the call about your arrival. He told us ‘you have a breech delivery, previous section, on the way’ – we all thought he was joking! Good on you’.
If we do have a next time, I think there is a high chance of another breech due to my anatomy. Next time I think I would accept an epidural being placed, but would leave it to wear off and be more active. I was very ready to blame the epidural had I gone to surgery. I would also sneak some sugary snacks in – I really felt sick because I was not allowed to eat between 5.30am and the birth finally at 9pm, and I don’t believe it was helpful to my energy levels for the pushing stage of labour.
But who knows, maybe if we have a 3rd it will be cephalic and I will have tried it all! I hope this helps others to know that anything is possible, even in a private hospital with a private OB.
Thanks Breech Birth for having all the up to date papers available in one place and a balanced and supportive team.
Nick has also been a very happy baby with no breech-related problems.
I was really happy with my birth experience in general and recovered so much faster – a shower as soon as my legs were a bit stronger, walking the corridors the next morning and I only needed Panadol as pain relief. I was a little surprised at the lack of people wanting to take part in the birth – I offered for my OB to invite any younger doctors to come to watch and learn, but he dismissed it saying ‘no-one wants to learn these days’. I do hope he was wrong and things continue to change.
As I was discharged, the midwife looking after me that morning was one I hadn’t seen during my stay. She read my notes and said ‘Oh, you’re THAT one! I was on the shift before you came in, and one of the obstetricians answered the call about your arrival. He told us ‘you have a breech delivery, previous section, on the way’ – we all thought he was joking! Good on you’.
If we do have a next time, I think there is a high chance of another breech due to my anatomy. Next time I think I would accept an epidural being placed, but would leave it to wear off and be more active. I was very ready to blame the epidural had I gone to surgery. I would also sneak some sugary snacks in – I really felt sick because I was not allowed to eat between 5.30am and the birth finally at 9pm, and I don’t believe it was helpful to my energy levels for the pushing stage of labour.
But who knows, maybe if we have a 3rd it will be cephalic and I will have tried it all! I hope this helps others to know that anything is possible, even in a private hospital with a private OB.
Thanks Breech Birth for having all the up to date papers available in one place and a balanced and supportive team.
