Milla’s Birth – Brow Presentation

millabeautifulFrom the start, my second pregnancy wasn’t as smooth as my first. At thirteen weeks I was diagnosed with hypothyroidism. My thyroid hormone levels were dangerously low, which explained my extreme fatigue and mild but unshakeable depression. So right from then we were worried about how my low thyroid levels had already affected our baby’s growth and development. I wanted to give birth in the birth centre at Flinders Medical Centre and eventually got the go ahead for this, in spite of the slight – very slight – complication of my thyroid disease. But at my 20 week scan we were given the frightening news that our baby had a congenital malformation in her lungs. If it spreads CCAM II can be fatal for the baby in utero and the most dangerous time is between 20 and 30-something weeks. The concern was that the cystic mass would spread and put pressure on her heart, which would cause a fatal fluid build-up in her chest. If this happened even a pre-term emergency caesarean wouldn’t have saved her because her lungs would have already been so compromised. Upon hearing this news I was shunted out of the birth centre and put into the ‘high risk’ pregnancy clinic.

This was a really scary and worrying time. The high risk clinic was awful. No midwives, just impersonal, seemingly uncaring male obstetricians who were only interested in my blood pressure and how I was ‘measuring’. I longed to see a midwife. The midwifery care I received during my first pregnancy had been warm, supportive and reassuring. My first daughter’s birth had been long but also calm and ultimately completely brilliant. The second time around I just wanted to talk about what was happening with my baby and how I was coping with the worry of her perhaps not making it to birth. But I wasn’t allowed to see the midwives through the hospital system. So I hired my own.

From my first meeting with Lisa I knew I’d made the right decision. Thank goodness for someone who cared, and even more importantly was prepared to advocate for me and give us an alternative opinion of the medical advice we were getting. I was able to miss a few visits to the hospital clinic and instead have my antenatal visits at home.

By 36 weeks, at one of the regular ultrasounds we were having to check the size of the mass in our baby’s lungs, it was found to have largely resolved. The sonographer could hardly see anything there. We were relieved. And I walked out of that room thinking that perhaps a home birth was possible after all. Then we saw the neonatologist who was monitoring our baby’s progress and he strongly advised against a home birth in case the baby needed respiratory support immediately after birth. I wasn’t brave enough to go against this medical advice. Even though it wasn’t supported by evidence. (CCAM babies are almost always fine at birth but in severe cases have difficulty thriving.) But I understand now that from the neonatologist and obstericians’ perspective, the hospital was the safest place to have my baby. But from my perspective, home would have been the safest place for Milla to be born.

millabirth1At spot on 40 weeks my waters broke after a couple of weeks of strong pre-labour contractions. In the morning we rang Lisa and she came over and slept on our couch (having come straight from another birth) while we went for a walk and I kept on hanging out washing to keep the contractions coming. We went to the hospital at about midday and I continued having strong and regular contractions. The labour ward room was horrible, really uncomfortable with no ensuite toilet and the screams of other labouring women clearly audible through the walls. I laboured on and on without feeling like the baby was really coming down. I eventually refused to have any more internal examinations by the hospital midwife after a particularly painful and clumsy one (that may have pushed the baby into the wrong position). I moved into different positions and tried to ignore what the hospital midwife was telling me and focus on what Lisa was saying. It was really a less than ideal situation. My first baby had come reasonably quickly after I started pushing, but this baby just wouldn’t come, no matter how hard I pushed. After six hours I was getting exhausted and thinking more and more that I couldn’t do it. Then the hospital midwife left the room to go and tell the registrar that I ‘wasn’t progressing’. That’s when I clearly heard Lisa say, ‘Okay, let’s get this baby out. Can you stand up?’ A drink of lemon cordial gave me the energy to stand up with my foot up on a stool, as Lisa suggested. Then, with Lisa and Ben completely holding me up, my baby finally came out, brow first.

The hospital midwife came back into the room at some point and found us set up like that and finally making some progress. She had never attended a woman giving birth standing up before and finally let Lisa give her some directions about what to do. When she saw the baby’s head she panicked again, telling Lisa to hit the emergency button and yelling ‘It’s breech, it’s breech!’ To which Lisa replied, ‘No it’s not!’ (Insert scornful Welsh accent here.)

millasfirstday_v001The atmosphere was panicked. I was asking what was wrong but nothing was wrong. Milla slipped out brow first, I fell back into a beanbag and blew gently into her face to get her breathing more strongly and all the people from the neonatal unit waiting outside the door for an emergency were sent away. I had a physiological third stage, no tearing at all, and Milla was a healthy 3.5 kilograms with no evidence of respiratory distress.

We spent an uncomfortable night in hospital and came home first thing in the morning. That evening Lisa came over, had a beer with us and talked through a somewhat unnecessarily traumatic birth. Next time, if there is one, it will be home birth all the way. No scans, no doctors, no hospitals.

8 responses to “Milla’s Birth – Brow Presentation”

  1. Heidi

    What a powerful story, it really speaks to the importance of calm, patient, knowledgeable support. You should be so proud of yourself, what a lot of hard work it was to bring your baby into the world!!

  2. Pamela

    this is a great birth story. this is only the second story I’ve ever heard of with a brow presentation at home. I would love to hear more!

    Here is a story from my practice (in my words) of a brow presentation for a primip:

  3. Rebekah Costello

    Oh she’s just beautiful. Fantastic!

  4. Julie

    So wonderful to read about birth being empowered instead of pathologised.

  5. Shruti

    Absolutely amazing I am a victim of this attitude as well. You are a great inspiration for me, Im planning a VBAC for my next birth.

  6. The Plewrights

    Your conclusion was exactly the same as mine after my hospital vba2c! But I know that a next time will happen and when it does my hb will be perfect :) Thanks for sharing, Sarah :D

  7. erinmcpatrick

    Thanks for sharing. I also had a brow presentation baby (via c-section after a really long, hard, impersonal, not allowed to get out of bed hospital labor). It is very good to hear about a brow presentation baby born vaginally!

  8. Tanya_Russia

    Hello! I am from Russia. I also gave birth vaginally in a brow presentation. It was exactly a year ago. It was very hard to bear, until recently, doctors did not know that a child gives birth to a brow presentation. Doctors have learned about it only when the baby came out, was born. I have a boy, 3, 500 g. He had a huge bump on his forehead, left, as in your photo!!
    The child was in intensive care for 4 days.
    Tell me how it is developing with your baby?