Home » The Safe Breech

The Safe Breech

Is breech safe?

If you, dear Reader, have a breech baby in your belly and you are researching what to do, we suggest you read Henci Goer’s chapter on full-term breech babies.

And forget what you read here or elsewhere about the link between breech babies and brain damage.  Because the link is small.  Being born male increases your chances of abnormalities more than being born full-term breech.  So don’t worry.  The boys are alright.

And watch some inspiring YouTube videos of people giving natural breech birth,  and read stories such as Katrina’s Musings of a Redhead,  and  Laura Shanley’s story, too.

And then start asking around.  You may find friends or relatives who can tell you their positive breech stories.

Had we done that before Miriam’s birth we would have learned that our Nicaraguan maid’s mother gave breech birth twice, at home, unassisted, and reported that it was easier than her other, “normal” births.

We would have heard from our wonderful pediatrician, Carlos Orozco, that when he was born breech, 50+ years ago in a rural village, he wasn’t breathing and was assumed to be dead, and put in a bassinet by the fireplace. Three hours later he gave out a cry.

And that our friend in New Mexico gave breech birth at home while waiting for an ambulance that got stuck in the snow, arriving half an hour after the birth.  Everyone was fine.

We would have learned that my aunt was born breech, in a hospital, eighty years ago, back when doctors were trained in breech birth.

There are more stories, and more and more. The only bad reports we heard involved hospitals and doctors.  But remember to ask only for good stories.

The standard fear of a breech birth is that the cord will be compressed by the head against the “birth canal.”  Cord prolapse (the cord coming out before the baby) is also statistically more common in breech birth.

But our favorite obstetrician, Rodrigo Arcia, the one we planned to be with for Miriam’s birth, and who attends  home births regardless of presentation, doubts the compressed cord theory.  He says the cord, in theory, could be compressed just as easily in a cephalic presentation, and besides, the cord has strength, it isn’t flimsy, it won’t compress so easily.  Similarly, he is not so worried about cord prolapse.  Since quitting his hospital practice (after 20 years), he has seen eight years of home and small private clinic practice.  He has seen various cord presentations that, according to the textbooks, are always fatal, yet each time they weren’t.   We have heard similar tales from home midwives.

What almost everyone agrees about is that fear is bad for birth.  We’ve come to agree with Dr Arcia that fear is the SINGLE most important factor in birth.  As Gregory White, MD, wrote in his classic, Emergency Childbirth:

“The fact is that more breech babies die of injuries received at the hands of their would-be rescuers than die of smothering.”

And why are those rescuers problematic?  Because in their fear, they panic, they pull, and they scare the laboring mother. And if cord compression is a problem, you want the breech baby to move quickly through the canal.  Fear, because it diverts the body’s energy towards “fight-or-flight” muscles and away from the birth-giving muscles,  usually slows birth.

So your best bet is to figure out how to have a fear-free birth.  It doesn’t matter where or how.  We are now convinced that even a C-section will be safer if you aren’t afraid.  (And a C-section is certainly better if the surgeon isn’t afraid!) So if you feel safest with a surgical birth, you must choose that, because it will bring you the least fear.  If you feel safer in the woods by yourself, you will be fine.  Vaginal or Cesarean, as Henci Goer says, either choice is reasonable. Just make sure that you, and the people around you, are not afraid.

Oh, and spouses, partners, friends:  if your safe place is somewhere different than hers, go where she feels best.   Do whatever you have to stay calm, quiet, and humble and leave her alone if she asks you to. You won’t regret it.