Vaginal breech birth in Western Australia

by Raya Tangchai

At 34 weeks pregnant we discovered that our baby was breech, I believe she had been in this position for a while, this was my second pregnancy and my first was relatively easy and straight forward. I had an anterior placenta and felt that the two pregnancies were quite different, I could feel the kicks and movements of my son a lot more. My midwife at Fiona Stanley Birthing Centre warned me that the OBs would strongly recommend a c section but I can still have my baby vaginally if that's what I wanted, however the hospital itself was apparently very inexperienced with this and usually referred breech births to another hospital who it seems had recently stopped taking these referrals as they felt Fiona Stanley needed to gain the experience themselves being a tertiary hospital.

So with that in mind we tried everything to turn our baby, moxibustion, spinning babies, acupuncture, and I had an ECV booked in, hopeful that we wouldn't have to make that decision. The ECV at 37 and 2 was unsuccessful, and straight away the doctor told me that now they book me in for an elective c section, to which I replied "well that's not my only option?", I recall the doctor looked taken aback that I would even suggest a vaginal birth. 

Anyway, I felt they clearly did not support it and said if I was adamant I wanted that they'd like to book me in to speak to a senior consultant which I agreed to, and they never even actually organised. I also booked in for a c section at 39 and 2 but still felt like this was not the route we were meant to take, just felt pressured into it. And on top of that when I tried to push this back a week the hospital told me I couldn't do that as their waitlist was full. We knew this hospital was not for us for this birth.

I did a deep dive into breech births because I wanted to make sure I was making the right decision for both of us and I was fully informed about all of my options. I was not going to be pushed into anything just for the convenience of the doctors or by them projecting their fears onto me. However, I wanted to make that choice for the right reasons too and knew that if anything went wrong it would be fully on me, and as so many people were unsupportive, I needed to be at peace with that. I spoke to many midwives, read many studies and listened to podcasts that really cemented my decision. Breech is just a variation of the norm and what the medical world did after TBT2000 was infuriating.

Anyway, my partner and I decided to change hospitals as that was the recommendation from everyone we had spoken to and we would both feel more comfortable in the hands of people who we felt actually had experience with breech babies. I had no doubt in myself but so much doubt in the people around me.

It was a very stressful week after going in and speaking to one of the consultants who said I couldn't have our baby at the alternative hospital due to my postcode, but we eventually managed to get a referral and was able to have a planned breech birth at King Eddie's. We also booked in a c section as back up on 25th Sept where I would have been 40 and 2.

The morning of 24th Sept my husband, myself, our son and dog made our way to a park near a blood bank so I could do bloods for the cesarean the next day, as by this point I had accepted the fact that this was probably the route we were now going to go down. As we pulled up at around 9:45am, I felt like I was starting to get contractions. I started timing it as I wasn't sure, we'd had a few false alarms and my labour with Caspian went in a different order with my waters breaking first. The blood bank was full of people waiting and I decided I was in labour and there's no need to wait in that line now! 

We walked around for half an hour and then headed back home, certain that I was in labour and organised for my mother in law to come over to look after our son. Once she arrived we made our way to the hospital, getting there at 12pm by which point my contractions, that started at 1 in 10, was at 1 in 7. 

At 12:35pm we were seen by an OB who checked the position of our girl, confirming that she was still in a complete breech position, and I was 4cm dilated. Within minutes my contractions ramped up to 1 in 2 and I knew she was ready. They were putting a cannula in my hand as a precaution and once that was done I said we needed to go, she's coming! As I swung my legs off the bed to get into the wheelchair my waters dramatically broke everywhere. I felt what I thought was a leg dangling out or the sensation of it and we rushed to the delivery room. 

When we got there I just got out of the wheelchair and climbed onto the bed. The midwife who wheeled me over was still turning on the monitors, and my husband was catching up to us because he was grabbing our stuff when we rushed out. The room was not quite ready yet, but I didn't have time to wait, I knew I needed to push so as soon as I got on the bed, I got on my knees, held onto the back of the bed and starting pushing at 1:05pm, before the consultant and OB and midwives even got there. 

I could hear people slowly arriving with someone shouting "A leg's already out!" but I was just solely focused on what I needed to do. I told my husband he had two jobs: make sure I don't try to change positions and don't let anyone try to interfere with the baby during the birth. I was lucky to have a wonderful consultant whose calming presence really put me at ease. Apparently he was very experienced with breech births and even supports it! 

As I pushed I could feel every part of her coming out, this was such a different experience in comparison to my first, there were no contractions in between pushes, it was just constant pushing with big breaths whenever I could get one in. The most intense thing I've ever gone through! Especially as we got to her neck, the midwife was commenting as each part was coming out and I could hear her saying ok there's no chin yet, and the consultant saying in his tranquil tone come on now the biggest push of your life. Our baby was born at 1:13pm, after 8 minutes of pushing, and I knew my instincts were right, she wanted to come the way she wanted which was feet first. Our baby's apgar scores were 8 & 9, she's perfect and healthy, born into a room full of applause and high spirits.

The more I looked into breech births the angrier I got at the medical model and system in general. I believe Western Australia is meant to be one of the worst places when it comes to supporting breech births and the lack of education around it. They should be looking at each individual case, present you with your options and give reasons as to why you would be a good or bad candidate for it. It's disappointing the lack of knowledge around breech birthdays and I hope that these doctors start to try and make a change.