Tate’s Birth February 12, 2013
Planned home birth turned Cesarean due to breech presentation

We knew from the very beginning of our pregnancy that we wanted to have a natural home birth with midwives.  For our entire pregnancy, everything was completely normal and healthy and baby was doing great.  We took our wonderful natural childbirth classes with Rhonda at Healthy Birth Choices and both of us were feeling informed, prepared and excited for our home birth!

At my 39 week midwife appointment  (4 days before my due date), our midwife Carol decided to send me for an ultrasound just to double-check that he was head down.  For months, all three of our midwives had been sure that he was head down and it was his bum sticking out under my ribs, so I wasn’t even concerned on the way to the appointment, and then the ultrasound tech dropped the bomb – baby was frank breech (bum down, head up under my ribs and legs straight up with feet by his face).

Needless to say, we were shocked and didn’t know what our options were.   Our midwives explained that because the baby was breech, we would have to deliver at the hospital.  However, because of the type of breech position baby was in, a vaginal delivery could still be possible and our midwives said that there were a few OBs at Foothills hospital who had experience with them and would attempt them.  However, our only chance for attempting vaginal delivery would be if one of those OBs was the attending surgeon when we arrived at the hospital in labour.  So our options were: (a) go into labour with the intention of attempting a vaginal delivery if there was a breech-friendly OB on call when we arrived at the hospital, (b) go into labour with the intention of having a c-section upon arrival at the hospital, or (c) schedule a c-section.

Our heads were spinning trying to deal with the fact that our dream home birth had gone flying out the window, and now not only were we going to have to deliver at the hospital but we were dealing with the very real possibility of a c-section, which was the last thing we ever wanted to happen.  Our midwives offered to schedule a consult with an OB at the hospital the next day to discuss the risks involved with attempting a vaginal delivery, and so off we went.  It was explained to us that the biggest risk with vaginal breech delivery is that the baby’s head is the biggest part of its body, so once the baby’s body was out, the head could still get stuck in my pelvis.  If this were to happen, it would become an emergent situation where they would either have to crack open my pelvic bone to get his head out, or try to push the baby’s body back up into me and do an emergency c-section.  However in the meantime the cord would be compressed between the baby’s head and my pelvis, which means he would be getting deprived of oxygen.  Now, the risk of baby’s head actually getting stuck is very small and vaginal breech births happen all the time, but that risk is still there no matter what.

Dave and I both agreed that no matter what, we definitely wanted for me to go into labour on my own, as we learned in our prenatal classes the importance of the hormones involved with labour for both me and the baby.  After that we had to decide whether we wanted to attempt vaginal delivery, which we really really really struggled with.  We googled and googled and talked and talked, and ultimately we decided that even though the risk of a catastrophic outcome was very small, we just could not live with the possibility of something happening to our baby when there was a safer option, so we decided we would have a c-section after going into labour.

On February 12, 2013, two days after our due date, I had been having some menstrual-type cramping and lower back pain through the night whenever I woke up to go pee, and by 7:00am when Dave’s alarm went off to go to work, the cramping and back pain was getting quite painful and I thought maybe they were contractions.  I told Dave I thought I was having contractions, and as soon as I said that, I felt my water break.  Another unfortunate thing about baby being breech was that if my water broke we had to go straight to the hospital instead of labouring at home until I was in active labour.  So I called our midwives to let them know my water had broken and off we went to Foothills – we couldn’t believe we were finally going to meet our baby!!!

Once we got to the hospital my contractions were about 5 minutes apart (we never really had enough time to properly time them) and getting stronger.  Turns out the attending OB was not one of the ones who is comfortable with attempting delivery, so it was going to be a c-section whether we had decided that or not.  The operating room was already in use so we would have to wait and labour for a while, which is what we wanted anyway.  Meanwhile, my labour was progressing quite quickly, and by the time they told us the operating room was ready for us at around 11:30 (about 3.5 hours after my water broke), I was having long strong contractions every 1-2 minutes without a break between – I was almost in transition already!!  The resident surgeon who would be assisting with my c-section didn’t believe me that my contractions were so strong and close together and actually double-checked by looking at the chart coming out of the monitor…!

We went into the operating room and I got my spinal (I have to admit, as pro-natural as I am, it really was like heaven on earth when that crazy contraction pain just all of a sudden magically went away!!), and then Dave was allowed in the room.  It was really weird not being able to move my legs, and feeling my body getting pulled and tugged on, but I knew it was almost time to finally meet our little man!  Within 10 minutes, at 11:50am, our little Tate was out, weighing 7 lbs 13 oz and measuring 21 inches, and the sound of him screaming brought tears to my eyes.  Dave went over with the midwives to look at him and get him all cleaned up, and then Dave brought him over for me to meet him – it was such an amazing unforgettable moment and he was so beautiful, and I realized that it didn’t matter in the least how he chose to come out, he was here and healthy and beautiful and that was all that mattered.

In the end, we are incredibly happy with how our labour and delivery ended up happening, and all the staff who attended us during labour, surgery, and post-partum were amazing, warm, kind people.  When Tate was born in the operating room, the surgeons and nurses and everyone were all so excited saying how beautiful he was and congratulating us and really making us feel special and making the moment a really beautiful one, even though they do those surgeries all day every day.  It really had an impact on us, and we no longer view the hospital as the scary evil place we had built it up to be in our minds before.

As an aside, it turns out that little Tate’s head is actually quite big, and was squished up against my ribs/diaphragm in the breech position for so long that it was shaped sort of like a bike helmet when he came out (long in the back), making for an even bigger circumference at the biggest part of his head.  This would have dramatically increased the risk of his head getting stuck in a vaginal delivery, and so we know without a doubt that we made the right decision.

Another interesting side story that unfolded through my labour was the state of my cervix.  About 5 or 6 years ago, I had a LEEP procedure to remove pre-cancerous cervical cells, which is known to possibly cause scar tissue on the cervix.  When I had my 39 week midwife check-up (when I was sent for the ultrasound), my midwife performed an internal exam and said she could definitely feel scar tissue on my cervix and we would have to monitor that in labour, as it could prevent my cervix from dilating.  Sure enough, even though my labour progressed very quickly and I was fully effaced, even when my contractions were one on top of the other and I was nearing transition, my cervix was still fully closed.  The OB who performed my c-section said that by the time they delivered Tate, the scar tissue had broken and I was 1 cm dilated at the time of delivery.  So if our little man had been head down and I didn’t have cervical scar tissue, he would have been born vaginally and at home with no problem, and most likely within 4 hours of my water breaking.  Good news is that the cervical scar tissue has been broken now, so that will no longer be an issue if we decide to have any more babies.   Our midwives have said that I can absolutely have a vaginal birth after c-section (VBAC) but that they aren’t allowed to do VBACs at home so it would have to take place at the hospital with them.  So the dream of home birth is no longer an option for us, but we have come to terms with that, as we know now how wonderful and positive a hospital birth can be, and we know that our incredibly amazing midwives would be by our side the whole time.

Welcome Tate – Cesarean for a Breech Baby
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