My breech challenge.

My uncle was born breech. My grandmother has little recollection of the experience. "In them days," as she would say, "the doctors knocked you out with drugs." She does recall "it was quite an ordeal," and says she almost died. Little did I know that 57 years later I would be faced with the amazing challenge of my own breech birth. I had been prepared for a homebirth. Everything was in place, and it was sure to be a beautiful experience. My first birth was in the hospital with the care of my wonderful midwife, Nancy. It was a fast, natural birth with no undesired interventions. I was confident in my birthing body and felt sure that my future children could be born at home with no foreseeable complications.

However, at 38 weeks of my 2nd pregnancy, when Nancy examined me she took an unusually long time palpating my belly and then asked where I felt the baby kicking. When I told her I felt it in the middle, Nancy told me she was 98% sure the baby was in a breech position and then helped me feel the difference between the baby's head and bottom. She discussed the option of turning the baby using an external version and gave me some articles about women who had birthed breech babies.

I went to an obstetrician who confirmed her diagnosis with an ultrasound. One of the doctors explained the different types of breech positions and the risks associated with breech births and with external version. My baby was in the "'frank" breech position, which meant his feet were straight up by his head, which is the most desired position for a breech to be born in. However, they might be able to turn him before the birth. The version was not without risks: there was a possibility of fetal distress, shearing of the placenta, a cord accident, or the membranes might be ruptured and labor would begin. And of course he could always turn back again before his birth

I went home to think this through and discuss it with my husband, Mike. My initial reaction was fear and an emphatic feeling that "no doctor is going to touch MY baby!" Then I called Nancy and asked for more information. She told me there were risks, yes, but I had excellent doctors, doctors with experience. What really made me finally risk the version was that I didn't want to have any regrets. If I labored my breech unsuccessfully and ended up with a cesarean birth I might look back and think, if only I had attempted the version. What if ...

I prayed and had tremendous peace about it. I felt relinquished to their care yet pleased with the choices I had made. The day of the version I packed a small overnight bag with a baby outfit (just in case) and stopped eating and drinking at midnight.

As the medication to relax my stomach muscles began to have an effect, my breathing became short and my heart was racing. As I was lying on my back on the table letting the doctor turn my baby, I clung tightly to Nancy and Mike's hands and intensely gazed into Mike's eyes, attempting to breathe through the pain, clenching back the screams. A second doctor also started turning the baby as the first doctor attempted to lift the baby from the inside.

My baby's feet kept getting caught when they tried to move him. It didn't look like he was going to budge. They let me rest and kept me under observation for a couple of hours. I felt very vulnerable and just needed to be held. Now all I could do was wait and see if my baby would turn himself or if I could birth him naturally.

At 2 a.m., Tuesday, May 18th, I started labor. It was four days past my due date. It was more intense more quickly than my first child was and I wanted to get to the hospital early, for the staff's peace of mind more so than mine. Nancy was already there with another woman in labor. I requested a hep lock instead of an I.V. to allow freedom of movement. My nurses were both well experienced in breech births. I labored mostly on the toilet or clung to Mike unless I was in bed for monitoring. The monitoring did not interfere with my labor, but I did find it uncomfortable. My support group was wonderful! My whole church was praying. Nancy talked me through every contraction while Mike loved me through each one by stroking me and speaking encouragingly.

At one point my labor seemed to slow down a little so one nurse recommended a change in position. While monitoring me I got on my hands and knees for about 4 contractions. Did that ever help! Things started really speeding up. Nancy wanted me to get in the shower. The hot water on my back felt great, very relaxing. I screamed, "I can feel the baby!" I knew he was descending! Nancy told the nurse but she said, "I don't like to check breeches too often." Oh well, too late. My water broke in the shower. Because the bottom was first there was a lot of meconium in it. I felt so excited that my baby would soon be here. I was also scared, as this hurt more than anything and I was frightened that all might not go well from this point on. What if he got stuck, or his head didn't rest chin down but flexed upward?

The most uncomfortable part was also the shortest. They had me leaning back. Most of the work in a breech birth is done by the baby, letting him descend rather than actively pushing him out. There's nothing for a doctor or mother to do but let the birth happen. The nurses pressed on my uterus to keep his head leaning forward rather than flexing back. In less than ten minutes my son my lying on my tummy, his legs flexed back towards his head, as he had been in utero.

Nathan nursed immediately. Postpartum was peaceful, depression free. One nurse asked me at the hospital if I was disappointed because it was a "failed home-birth." I smiled and matter-of-factly explained that it wasn't a "failed homebirth." I planned the whole thing and wasn't the least bit disappointed. Everything went just the way I had hoped it would. Nothing could spoil my joy. I have never felt so confident as I did after my breech birth, and never so exhilarated as after the birth of my three sons.

Michelle lives in Midlothian, VA with her husband and three sons.