This post is written in honor of the upcoming Heads Up Breech Birth Conference scheduled for November 9-11, 2012 in Washington, D.C. Anyone can attend, so feel free to pass this on to your midwife or doctor so that we can keep the skills of breech vaginal birth alive!
10 years ago, the Midwest. I was a brand-new midwifery apprentice, having seen maybe 2 other home births other than my own.
The call from the midwife came in, late afternoon...first-time mama was in early labor, her waters had opened and, surprise... there was fresh meconium. Breech.
I remember the moments of decision making between the midwife and the parents. Birth certainly wasn't imminent, but there was an urgency to the situation to decide whether this would proceed as a breech birth at home...or a c-section upon arrival at the local hospital.
What followed was trust in birth. Breech as a variation of normal; a mom's choice to stay home and birth her baby in whatever way he would come. In the then (and current) political climate (both in birth and the legalities of midwifery), a decision that would likely be judged as risky, or stupid or dangerous. A real-life lesson that a mama must birth where she feels safe and with whom she feels safe, making as an informed choice as is possible. And an attendant that would support her no matter what.
The clinical details are fuzzy because I didn't know enough to know what I didn't know. But perhaps more important, as an observer, I have a very clear emotional memory of this experience. One that would change me forever, and set me on the path of becoming a "birth trusting" midwife.
My own memories are of sleeping on and off on this woman's carpeted bedroom; she labored quietly on her bed throughout the night, and a couple of us (there was another student and 2 midwives, total) took turns listening to the baby. I remember the waiting for her body to completely open and the reminders to not push until it was clear this had happened.
Early morning and the birth pool was being filled. I felt excited and giddy for the birth (as I had for all of them so far!) and did not feel fear from anyone in the room. At the time, I didn't know how special this was; to allow this mama to birth her very first baby, in an unexpected way, without the energy of fear or disbelief that she could do it. Of course she could do it!
As we all looked on, her sweet husband supported her in the pool, and by the dim light of a flashlight I remember seeing more meconium...and then a tiny butt crown into the water. My most distinct memory of this birth was the butt, and then the little legs kicking in the water while the body remained inside. Quiet, peaceful. Only the whisper of the elder midwife to the other, "Now, don't touch it!"
And there he was. All of him, birthed into the water. No panic, no emergency, no pulling. The perfect emergence of this special babe, birthed by his special mama, in a birth pool at home. No hands, only the water to support him. Breech.
To think that many people never see a natural, physiological birth; never mind a home birth. And to think that we all had the honor of witnessing this "physiological breech birth" at home is a gift. It wasn't until recently, as a midwife myself, that I realized what a profound gift this was. And continues to be, as I serve women.
Because what this mama and baby did for me is plant the seeds of what birth is; breech or not. I respect birth, very much, but I am not scared of it. The decision to birth in a certain place or in a certain way or with a baby in a less-common position is the woman's to make. As attendants, we are aware of our strengths and limitations but we do not let fear guide us. We let the woman guide us.
Because birth will happen. BREECH birth will happen, and we must be prepared in our hearts and minds to let it.