Recently, I was reflecting on my second pregnancy and the anxiety I felt at having a breech baby at 32 weeks. As a midwife I knew that there was still “lots of time for the baby to turn”, as I’d told so many expectant mothers over the years. But as a mother longing for a natural homebirth, I couldn’t help but worry. The reason for my worry was because all women in Australia that have breech babies are suggested to have a caesarean section. Thankfully the baby turned himself around (possibly aided by my yoga and positioning at home) and I was able to live my dreams.
A web search revealed the blog called “In My Mother’s House” by a Canadian midwife named Sheila Simms Watson. I have linked to her post on February 7th, 2011, where she forwards a link to a post from another blog from 2009, commenting on the change of policy in Canada to now allow vaginal breech births as an option instead of automatically suggesting every woman with a breech baby have a caesarean. The original blog also talks about how there was going to be training set up to equip obstetricians to competently assist in vaginal breech births. I wonder how Canada is going 2 years down the track?
In Sydney there are only a handful of obstetricians that will “allow” women to “attempt” a breech birth. By accepting their help, women are forced to birth on the doctor’s terms, which, at least in my experience, usually includes a mandatory epidural, syntocinon and episiotomy. It is well documented that supine positioning is the worst for facilitating normal birth, why should a breech birth be any different. It seems obvious that movement and gravity would help and that the body’s own oxytocin is sufficient for labour and birth, but the doctor’s fears of a bad outcome irrationally override the normal processes of labour. So if women want a normal vaginal breech birth they have no option but to have a home birth with a private midwife. I have no problem with this except that they can be expensive, with most not covered by medicare, so not accessible to all women. This could lead to an increase in unassisted home births, where no skilled people are present to provide emergency care if needed.
The highly controversial, flawed and 11 year old “Term breech trial” formed the basis for the Australia-wide policy of suggesting Caesareans for breech births. If only RANZCOG could hurry up and review their guidelines in a similar way that Canada did in 2009, Australian women may too be allowed the opportunity to have a vaginal breech birth. Here’s hoping!