Upright complete breech birth (USA)

This is an upright complete breech birth with a grandmultipara (baby #7). Baby was 41 w + 6 d and weighed 9 lb 6 oz (4250 g). Labor lasted 1.5 hours.

The birth will be shown three times:
  1. Unedited with dialogue
  2. 2x slow motion with commentary
  3. 8x slow motion of the baby's final emergence

Questions for discussion & reflection:
1) The baby's rotation to sacrum anterior is delayed. What might explain this?

2) The baby does several "tummy crunches" before she rotates to sacrum anterior. Consider how tummy crunches might help the baby lower or free a trapped arm.

3) How long is it appropriate to wait for rotation to sacrum anterior before deciding to help the baby? Consider factors that might lead the birth attendant to continue to observe (such as multiparity, rapid progress, steady descent, and baby's excellent muscle tone) versus factors that might lead the birth attendant to intervene sooner.