Once more I am compelled to write about Breech. After the study proving vaginal breech to be as safe as a section you’d think the whole world would be back on board. After all it only took a matter of months after the flawed Hannah trial for almost every Obstetrician to be convincing women that a major operation was safer than a normal birth. But NO. In Australia at least it is worse than ever and with the NHMRC guides saying that only “singleton cephatic 37 to 42 weeks with no other complications” should stay home, they could not be trying any harder to stamp out normal, unhindered birth in all it’s variation of normal.
You can find lots of other breech posts on this blog but I would once again like to talk you through the mechanism of a Breech birth.
Most important rule is HANDS OFF THE BREECH no matter how tempting it is just to pull on that leg DON’T. It’s the easiest way to create nuchal arms and a completely deflexed head. When you pull on the leg you create a morro reflex in the baby.
You can see the way the baby is coming down by looking at the way the heel is pointing. Heel to the front of the woman (photos are from the back here) tells us the baby has an anterior lie.
Once one leg is out the baby has to rotate to the other side for the next leg to come through. In the next picture the baby has completely changed position, rotating to get the left leg to the optimum position. The left foot appears along with the testicles and the bottom
When the second leg has come through the baby is out to the abdomen.
You can see nice chunky cord and mother cupping the baby’s body from behind.
Next shot shows that baby’s left arm is down and the baby is trying to rotate to the right to release the next arm
you can now see the baby has done a full rotation to release the right arm
The baby is now more central as the head tucks forward to be born. You can see nose and mouth already. Hand gently watching the forward tilt of the baby
How amazing and how graceful
Thanks to the wonderful woman for sharing. Excellent shots showing the mechanism of breech when hands off.
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What a lovely birth. Thanks to the woman for sharing! And excellent description of the mechanisms, very fascinating.
oh wow, that is amazing. Babies really do know how to get themselves born don’t they? We are so bombarded with messages that they don’t know how to get out that you start to believe it in all cases except the most straightforward.
AMAZING photos! thankyou to the mumma for sharing- what a fantastic teaching tool, for midwives, women, students, obstetricians to see how a breech SHOULD be born.
that is amazing. but shame it seems too incredible to those who can’t believe in baby/mum instinctive birth
just wonderful pics. thank you for sharing and thank you to mom!!!
Lovely photo montage of birth process Lisa. So cute seeing that little mouth and the cord draped like a scarf with the baby sitting like that – would have to be the very best photo of birth I’ve seen in a long time
Thanks for sharing and thanks to the mother and her family for sharing this journey. So precious.
Thanks Carolyn, They are a great set of photos, taken without knowing they would show so much.
What a beautiful photo set of such a beautiful birth. Thankyou to both the proud mamma and to you Lisa for sharing
Brilliant. Have been reading horror stories about breech presentation at Bub Hub and am petrified my baby will not turn in time.
I did not think it was possible to have a breech birth without complications.
I am far less anxious now. Thank you.
Grace, I just delivered my son vaginally 7 months ago with no pain meds or interventions – he was a BREECH presentation and is my 1st child. I was in labor for 52 hours and had the best birthing team (husband, doula, midwives) who maintained the faith that I could do it even in the midst of transition when I felt I might not. As I journeyed through that normal phase of labor they were able to hold my vision and as I peaked out at them from time to time I was reminded of my own faith in myself, my son and the process of birth. Truly the most amazing experience to have birthed my son breech at a time when it is believed impossible. My hospital room was filled with OBs and nurses that had heard there was going to be a vaginal breech birth. They could not believe it and wanted to see it for themselves. My husband overheard one saying “but they don’t teach this in school!” Exactly!! And why not?
I had a baby sitting sideways at due date. went online for natural turning techniques. Spent time on all fours rocking on the bed, and went for a warm swim at the local YMCA. Ben turned and was born two weeks late at 8lbs 5oz with no problem even though I was diagnosed with Gestational Diabetes! I Delivered on all fours in the hospital inspite of the on call Dr.s request to asume the reclining position. Maybe they don’t know everything! =] Best Wishes
Ah! Thank you Lisa! Words and pictures provide a very nice way to understand something that most of our textbooks leave to words alone.
Gorgeous what happens when we leave mom and baby alone.
Amazing! Thank you to the mother for sharing her birth pictures, and to you for your thoughtful and insightful post!
This series is a real gift. Was it a first birth? How much did this baby boy weigh, Lisa? When did the membranes release? I notice the membranes are snowy white, did he not discharge mec all through? Only notice a bit at the end there on the pad.
Wow – those pictures, and that birth, are fantastic! Thanks to the Mom for sharing them! My son was a breech home birth, 17 years ago, but the video I have is not from this angle, and I actually don’t know exactly how my son was born! This gave me an idea and is excellent to show the process … bookmarked!
Thank you for this. I can’t get a perspective in the last photo. What part of the mama are we seeing here? Has baby been brought up to mama’s front at this point? He looks pinked up really nice!
yes the baby was passed through her legs.
The babe is lying on mum’s chest with his head at her armpit, her hair dangling over as she’s gazing at him
I love your site and all your photos/videos. Good job!
Question about the picture of the torso being delivered: It looks as if the baby pooped (black mound behind baby). Would this be a sign of distress … the kind of distress that OBs freak out about in a hospital setting?
Beautiful birth. Makes me mourn my frank breech unnecesarean.
it is normal for a breech baby to poop when the buttocks are compressed, it is well recognised as part of the physiological process.
I love these pics! Thank you sweet Mama for sharing!!
Lisa: Would you be interested in Skyping this as an instructional opportunity (for midwives)? Maybe build a class around the videos/photos? Spinning Babies here in the US is doing something similar with shoulder dystocia. Very effective. We are not taught to monitor a breech birth in this way. So refreshing.
I do talks on breech explaining this. I also did this at the trust birth conference and am doing it again in 2012. email me on lisa@jelikin.org and lets chat
Absolutely amazing!! They know exactly what to do themselves! hands off (or of, hehe) the Breech!
Just wanted to say “Thank You Lisa”. You were not my midwife in my 2009 HBAC, but I was able to access your site and the beautiful and explicit photographs which helped me understand what my body would be doing during the birth. By being able to see the mechanisms, stretching, and yes, poop, before hand, I was able to be at peace with my body while it worked. My husband also benefitted from this knowledge and was not caught off-guard or grossed-out during the process. If more women and their partners were able to have access to such important images, instead of just the typical line drawings you see in birth books and pamphlets, then there’s probably be less stigma attached to vaginal birth.
Too bad that OBs refuse to offer this type of hands off delivery.
This is such a wonderful explanation. Pictures really ARE worth a thousand words. Thank you to the mama for sharing!!
Wow, these pictures are amazing!!
Imagine that – “hands off the breech.” Shoulda known! Just like so many other things with birth, if you leave it alone, it will work out!
Incredible photos
Lisa dear Lisa – thank you for your ongoing posts showing the beauty of breech. Love and support & appreciation coming at you always from waaaaay up here. xo R
Grace, I just delivered my son vaginally 7 months ago with no pain meds or interventions – he was a BREECH presentation and is my 1st child. I was in labor for 52 hours and had the best birthing team (husband, doula, midwives) who maintained the faith that I could do it even in the midst of transition when I felt I might not. As I journeyed through that normal phase of labor they were able to hold my vision and as I peaked out at them from time to time I was reminded of my own faith in myself, my son and the process of birth. Truly the most amazing experience to have birthed my son breech at a time when it is believed impossible. My hospital room was filled with OBs and nurses that had heard there was going to be a vaginal breech birth. They could not believe it and wanted to see it for themselves. My husband overheard one saying “but they don’t teach this in school!” Exactly!! And why not?
That woman was so brave to trust the process enough to be hands-off. What an amazing gift to share it for us to learn. I’m a women’s health advocate and researcher and it takes my breath away to see such beauty.
Thank you so very much to the mother and baby, and to you for posting it.
Is there a chance you could post links to the flawed Hannah study, as well as the Canadian one? Thank you! This was awesome!
Wow Lisa…these are about the best pictures I’ve seen of a breech birth. Please thank the mother for letting you share them.
Can you give me the reference to the Canadian study you referred to? thanks, Sarah
Thank you!!!
What an beautiful,incredible series of images. Thank you to the mother and Lisa for sharing.
Cool pics although if they were mine I would have covered up the poopy part of mama.
Why cover the poop? That’s just birth… normal, raw, powerful birth
Beautiful pics! Thanks to the mumma. Thanks for the explanations Lisa
Oh my – what a gift to see this. And it makes me sad that I had to sacrifice myself (yet again) due to double footling breech presentations from both twins at term. My baby A flipped breech at 37 weeks! My OB says he used to deliver breech but his insurance doesn’t allow for it any more. Breech is not part of the CNM or CPM scope of practice in my state either. It’s going to take a LONG time to overcome the Hannah study.
Amazing photos…thank you for sharing, and for continuing to teach that birth, including breech birth, is simply a normal variation.
Beautiful! I must say the pic of the head tilting forward was amazing! I always thought the head just came straight out with the body pulling over it like a turtle neck. It was very educational and enjoyable.
It was also so lovely. And, those little tootsies…soooo cute!
Honey
Sorry if I missed the info, but what is the time frame of the picture sequence??
It is only about 10 min from first to last shot, foot was out a a short period before the first picture. The woman is multigravid
Olá, não tem problema o bebê não estar de cabeça para baixo, isto é, quando o corpo sai antes da cabeça, oferece riscos?
Amazing photos of this birth. Thank you to this mama and you for sharing the photos. I’ll be sharing this with others who love birth. Blessed be
Why is the world of Obstetrics so afraid of a breech presentation? They need to get back to thinking outside the box and be as flexible with their thought processes as the woman and the midwife!!!!!!!! So glad you posted this series of photos, brilliant!!! The mother did an awsome job to birth her baby, more power to her
Wow! What an amazing breech birth! So very natural – the way it is meant to be! Thank you for sharing!
wow! Thanks for such a interesting and amazing story. As a student midwife in a hospital it is very refreshing to see midwives doing such a great job in promoting the amazing normal process of birth!
SO AWESOME! Thanks for sharing!
Wonderful pics! Have never seen a breech delivery with the woman on her knees before. Amazing! (One pet peeve: As midwives we still have to debunk myths about our lack of training, about the “cleanliness” of homebirth, etc. As in “The Business of Being Born”, I think it behooves the midwives participating in exposés like this to behave in a manner that promotes the profession well in the eyes of our medical colleagues and detractors. It bothers me that the midwives are not wearing gloves. Yes, I understand that this may be an agreement between the client and the midwife, especially in this case where the photos were maybe not originally intended for public consumption, but not all viewers of that film or these photos will be supporters. Detractors will pick up on the slightest deviation from “acceptable” practice and use this against us, suggesting that this midwife was not using universal precautions and is therefore untrained and “dirty”. Please, my dear colleagues, let us continue to be Ambassadors to our profession.
I have no interest in acceptable practice only in evidence based woman led birth. gloves are not for the benefit of the baby as we all know the birth canal is not sterile and the mothers body is not sterile, so freshly washed clean hands far outweigh latex as the first thing to touch brand new skin. We are not ambassadors of our profession but servants to the birthing women. Only when midwives and birth attendants understand this will the gross medicalisation of birth and butchery of women stop.
Medical colleagues butcher and damage women daily and NEVER care what midwives or any other profession thinks.
Pizza’s are delivered babies are born.
Awesome photos and blog. Though I don’t dig your generalized disdain for “medical colleagues” – there are good and bad ones.
Regarding hand-washing- the rings you have are potential sources of infection – this has been studied – and hand-washing is minimally effective for decreased bacterial count (especially the non-smooth ring). Yes, the outside environment is not sterile, but we’re talking about degrees of sanitation. I think it would be more beneficial for the baby to by colonized with the mother’s bacteria, rather than any the care provider might come into contact with.
This is how I will practice. Just wanted to share my perspective. Even if you don’t wear gloves, I think not wearing your rings would be better – that is what I would want if I was your client. Thanks for the blog!
I hardly ever touch the baby and as you can see from the pictures on the blog. the picture here i am only really supporting the back of the head. It is always more beneficial to have the mother colonize the baby. If any of my clients ever asked me to remove my rings of course I would. I have attended hundreds of births over the past 25 years. I find it mildly amusing that people who do not know anything about me feel free to make comments on my practice and how you would improve on it. Have you ever seen a Dr do this to another? This is a lot of the trouble with midwives . You see I think not wearing gloves would be better for you, wash your hands, let the woman catch the baby. . In degree of sanitation really everything is a potential problem but latex is the biggest problem of all. I will let you know if I get problems with babies dying of terrible infections from my rings and I can reflect on why it happened.
I have seen far more complications from hospital infections were gloves (of course non-sterile and of course with and without infection) than I have ever seen with well-washed, ungloved hand of a midwife. I do think it is a mutual agreement between client and patient, but this midwife isn’t nearly as contaminated or colonized as someone who is in the hospital or regularly is at the hospital.
But, Please God, if you work in a hospital, wash your hands and wear STERILE gloves and DON’T touch that baby unless it’s implicitly necessary!!!
If I was birthing a baby, I’d hope that my attendant was more concerned about my and my baby’s wellbeing than looking “professional”. I hope that midwives realise that the people they should be impressing are the women, and not the system. This is how women find themselves being betrayed.
This is so beautiful, thank you so much for sharing!
I was honoured to deliver my undiagnosed breech baby boy at home in water. He was born after a 2.5 hour labour, weighing 4.9kgs and is now a happy and healthy 2 year old. I was so happy it wasn’t diagnosed during my pregnancy otherwise I wouldn’t have been able to use the public funded homebirth team here in WA. The thoughts of having to fight to vaginally deliver would have scared me. Thank you for your continued work on teaching variations of normal.
Très intéressant, cependant pourquoi garder toute une batterie de bracelets et de bagues nécessairement pleins de germes et vulnérants?
What do you mean. There were no hand in her vagina, they were freshly washed and as soon as the baby is born nothing is sterile. It’s the same old thing, midwives are practitioners and experts. Hand washing is important and there is yet to be research to say bracelets cause anyone to have an infection.
I was searching mechanizm rotating arm … but im suprise what i saw . Thanku for sharing this images and part of life . A hope that child is healthy and be wonderful human some day =]
This is exactly how I birthed my baby girl. I had an unassisted breech birth. I had no idea my baby was breech at all either, my husband didn’t tell me until after the baby was out LOL I listened to my body and got into that exact same position. Just so happens that my hubby re-read the part on breech birth in “Emergency Childbirth” about not pulling on the baby, wait until the baby is out past the navel then ease the head out. He said all he did was move the cord a bit and the baby was so slimpery she came right out…I didn’t tear and it was a pretty fast labor…It can be done!
Did you have a midwife or just your husband deliver?
This is wonderful!! Fabulous pictures– should be required viewing for all those “I don’t do breech” care providers. Thank you!!
I am crying while watching this birth. My very close friend’s baby died during a breach birth at hospital – the doctor has reached inside her to tie a bottle of water to baby’s leg, because they thought it must be pulled out. So very sad, compared to this birth, so, so, so sad!
That is horrific. I am so sorry for your friend’s loss
HOLY COW that was amazing. WOWOWOWOOWOWOW. That’s all I can say.
Thank you SO MUCH for sharing your birth with us.
Every midwife in my area that I have talked to about this topic say they don’t do breech and wonder why I’m asking. When I tell them breech birth is a huge topic circulating around, including Ina May advocating for midwifes and medical professionals to bring breech vaginal birth back, they’ve got dumb looks on their faces. It is SO frustrating that they’re not doing their homework. Do they just stop after the 100th baby and think they know it all? Or are they all still afraid of litigation? Arg! Just a frustrated momma here. I’m almost 16-weeks so I’m not worried about breech at this point but getting upset that everyone in my area thinks breech = cesarean.
I’ve never seen anything like this! Thank you to the mother and midwife for sharing these photos. Thank you for the education.
Incredible and beautiful. Thank you so much for sharing!
Hi Lisa,
FANTASTIC photos thankyou for sharing these. I am also a midwife originally from the UK now living in NZ. I have attended 7 women now birthing their babies who have been breech and all with good outcomes too! Like you I take the stance of hands off and watch. I supported a primip breech a few weeks ago in hospital. She was amazing, no pain relief and birthed her daughter while on all fours beautifully totally hands off birth. I am in the process of compiling a folder for clients who have a baby presenting breech in order for them to have informed consent in their decision making. The folder will consist of breech births ( hands off, all fours, kneeling etc), assisted breech delivery ( medical delivery using the manoeuvres) and LSCS. I have pictures from another midwife Mary Cronk and was wondering if I could print your pics of footling to add to the folder (all credit of this birth and your website will be added to the folder). I think this would be an excellent way of promoting breech births especially now evidence is available in supporting vaginal breech births.
Once again thanks for the amazing piccies and your website. They are trully a breath of fresh air to midwifery and the women we serve. I look forward to your reply.
Another fine example of the old adage – “leave things well alone”, for the design is inherently good.
I have just completed my BMid and it is THIS I would have loved to have seen in the flesh… not standing in scrubs next to the resus cot awaiting the baby to be passed to me (a stranger) Lion King style. That teaches me nothing valuable about breech birth.
When I have questioned the need for breech caesars (even for primips – gasp!) I have been told breech birth is dangerous… I replied the only danger lies in a lack of skills and knowledge, interfering when we shouldn’t, creating the problems you mentioned (nucal arms, morro reflex). I know what I will be doing if I ever care for a woman with a breech baby… letting the baby do what it so cleverly knows how to do, and keeping my hands to myself.
This is incredible! My first son was a breech c-section (sigh) and my second son came as a second breech twin (homebirth.)
Fantastic photos Lisa.
What a lovely experience for mother and baby. Fortunate nothing went amiss, but no doubt this is in part to “hands off the breech”.
Thanks to the mother for allowing her photos to be published.
I know breech births can be done successfully but I would rather have my baby in the right direction to birth if all possible.
Is there a way to get your baby to turn the right direction? Like gravity or positions to help the baby be in the anterior position with the head down?
If I was ever to have a breech baby, I have always known I want a normal birth. My first and only son was head down. This is amazing seeing the cute little footsies arriving first and how the baby adapts. Homebirth midwives in my area I know won’t do breech and neither the midwife center I went with my son. So if I ever come to this point I will think long and hard. Thank you for sharing
Thank you so much for sharing this!!! And thank you to the beautiful momma and babe that allowed the pictures, they are to be treasured and I feel honoured to have seen them
Amazing and beautiful! I would also like links to the two studies you mentioned, please! The one about vaginal breech being as safe as a section and the Hannah trial. I’m especially interested in the first one.
WOW!! Fabulous shots – thanks to you and mom for sharing!
I’m new to this site, and expecting my first baby sometime in November. He’s a wiggler, and is in a new position just about every week, but I have a psychological fear of breech b/c as my mother’s first child, I was labled as such (I was, however, under 6 lbs at birth, which means I likely had plenty of time – and space – to assume the ‘proper’ position had I been left alone), leading to the first of 3 cesareans my mother had to endure. I am also planning a UC for this birth, b/c I live in the US and prenatal care is dismal…and I simply can’t afford a midwife out of pocket. I hadn’t started to think about what I might do if baby is settle into a breech position when I get to term, but reading about breech as a variation of normal is making me feel that trusting my body and listening to my baby is the way to go. If I do go to a hospital, it will almost definately be a cesarean…I don’t actually think any OB’s in the US are still trained to handle a vaginal breech birth…I’m not sure that’s a choice I’m comfortable with.
Thanks a million for the wonderfully informative posts!
I hope you can keep us informed. You have far more likely hood of your baby deciding to be head down. Good chiro and a healthy life style can help and only 4% of babies are breech at the end of pregnancy anyway. I wish you love and clear thinking for your decisions on helping your baby to be born the best way you can.
Hey, Lisa,
Why are your hands on the mom’s bum in some videos and pictures? I can’t remember what you had said about this. Thanks for keeping breech normal!
In the frank breech video i did it to help expedite the birth of the head. Sometimes it’s to help with position.
Here’s the information on the Hannah Trial and subsequent re-thinking.
From the Canadian Family Physician:
http://www2.cfpc.ca/local/user/files/%7B37DA70EF-A0F8-42F9-BCA7-2BCF67BB7329%7D/Term%20Breech%20Trial.pdf
Thanks for the photos and your enduring heart, dear Lisa.
You make such a difference in the world.
Gloria
These are the most amazing photos! Thank you so much for sharing. I am pregnant with my fourth (first three all water births, second and third at home) and just have this feeling it will be born breech. I am trying to soak up everything I can to prepare for a successful (possible) breech birth. Love reading all your site has to offer – thanks again!
I really love this blog and visit frequently to learn more. I am currently a student of midwifery in nz. I hope things go well for you Lisa, you deserve to be treated well. I hope the homebirth situation improves in Aus one day!
Thanks so much for sharing this!
My youngest was breech, and although I insisted on a vaginal delivery, I wasn’t allowed one. And this infuriates me, even more so when I’ve seen so many successful breech birth stories since. She was born 14mo ago (Jan 2011) via c/s, and although it went well, it was not really what I wanted. But in the end, I of course obliged after the Doctor encouraged me to and fed me scare tactics. In the end we wanted a healthy baby, which is what we got, but why do they have to be so eager to push for a c/s? They even pulled out the Canadian breech trial too.
I am once again pregnant, and due in July. If this baby is breech, I will be pushing for a VBAC breech birth. This will be my 4th baby and I had 2 normal vaginal deliveries with my first 2, and then the c/s with my youngest (and she was only 6lb 5oz!). Funnily enough, the Midwives & OB I have spoken to this time around, are all surprised I had a c/s, they believed I should of given a chance. (I birthed DD2 in ACT, and having this baby in NSW). The OB this time mentioned the breech trial, but added that is wasn’t successful and shouldn’t be paid attention to. He did say I may have to have another c/s if this baby is breech, but I won’t be letting that happen.
Ugh I get so annoyed at times knowing full well I could of had a successful vaginal breech birth
They really need to pull their finger out and educate on breech births! (sorry for the rant, lol).
Anyway, thanks again for this blog post!
Incredibly amazing. So cool. Congratulations! Perfect! Job well done.