A friend's pregnant belly at 36 weeks 2 days gestation (As always, this blog post is based on my experiences in life. I am not a midwife or medical doctor, so please consult with your caregivers when making decisions regarding your pregnancy and birthing decisions.)
I am a strong believer in the ability of women’s bodies to naturally birth babies in 90+% of situations without medical assistance and intervention. There are times when Western medicine is truly needed in childbirth, but I feel the current profit driven and legally dominated medical practices greatly skew the way childbirth occurs in the US. The c-section rate should be between 5-10%, not the 30-50% that is happening in our nation.
However, despite my strong beliefs in childbirth as a fundamentally natural and normal process, I seem to have been a poster child for unusual births. This post is about my second and third births of my twins. Because I was an educated and determined woman plus I had luck on my side, they were unmedicated vaginal breech births. That’s a situation that rarely happens in the US any more.
My twins were bothtransverse (lying across my abdomen) at 36.5 weeks though they were still very active and they were rotating their heads from the left to the right side of my abdomen as confirmed by ultrasound. Previous, Twin A, the twin who is lowest in the womb and will be born first, had been breech and fully engaged in my pelvis. She dropped at 28 weeks, popping back out twice but never rotating to a vertex position. We began doing moxibustion just before the twins were born in an attempt to rotate her into a vertex position. I had also been doing many of the recommended home techniques for rotating babies. The moxibustion worked: Twin A dropped violently into my pelvis from the transverse position, breaking her water in the process. Unfortunately, she dropped in the breech position yet again, not the vertex we had hoped for. The short version of my labor story is that two hours after twin A’s water broke, she was born, and fifteen minutes later, her brother joined her on the earth plane, both without problems.
The longer version of my pregnancy labor involves a story of a lot of frustration. My original practitioner quit handling deliveries when I was 20 weeks pregnant (only two weeks after I found out I was carrying twins), so I had to find another OB who would handle twins. Unfortunately in Austin at that time (2000), there were less than a handful of doctors who would consider letting a woman labor without an epidural during a twin birth, and I refused to have an epidural due to my medication sensitivities and my phobia of having people stick needles in my spine. None of the homebirth midwives in town could legally deliver twins at that point with the exception of one, and because of our relationship, she did not feel she would make a good, objective practitioner for us though she was present as a doula at my twins’ births. Those restrictions narrowed my options dramatically.
Once I finally found an OB who was a relatively good match for me, I started having to deal with the fact twin A was breech and engaged. My obstetrician had experience in delivering breech twins vaginally when Twin A was breech though most OBs do not. He could not legally tell me that he would deliver the twins if they were breech due to the medical/legal situation in the US; he actually made us schedule a c-section date at around 38.5 weeks gestation (which I had no intention of showing up for, but it was on the records). What he did say was that if I showed up with a baby on my perineum, there would be nothing left for him to do but catch it. So that was our original breech birthing plan: I would labor outside of the hospital as long as possible monitoring the babies with fetal dopplers and then show up at the last minute.
During the end of the pregnancy I did a LOT of online research; most of the studies I found were based out of foreign countries. What I discovered was that the US was one of the only nations where breech births were treated as an anathema and that breech births can be safely done if mother, baby, and doctor are all good candidates for the process. I especially appreciated the works of Henci Goer which helped me to see that my situation made me an ideal candidate for breech births. I had a proven pelvis with a baby who was likely larger than the twins I was expecting (and they were 1-1.5 lbs smaller than her). Twin A was in a frank or complete breech position during labor; her head was tucked properly. The twins were of a good gestational age and weight. And most importantly, I had a practitioner who was experienced in vaginal breech births, and based on my questioning of him, he truly knew what to do and was not afraid to do it.
The way the birth actually played out was not as we had originally planned. My labor started unexpectedly when we weren’t sure what position the twins were in. We never planned on my water breaking before labor actively started. And most frustratingly, my OB was out of town. However, the OB on call trained outside of the United States in a rural community and also had a great deal of experience with vaginal breech births. So luck was on my side in that regard.
I arrived at the hospital labor and delivery ward an hour after my water broke, but I wasn’t feeling contractions yet. When the nurse checked me, I was at 7 centimeters and she could tell it was a butt presenting. All hell then broke loose at the hospital as everyone but me went into a panic about a breech twin presenting with a mother who refused an epidural and wanted to have vaginal births. In between contractions while I was in transition (by which time I was feeling the contractions quite strongly), I argued medical studies with the OB on call. He ascertained that I did know what I was consenting to, though he still made my then-husband sign AMA (against medical advice) paperwork. The labwork that they needed to put the epidural in place still had not shown up when it was time for me to start pushing, and they never found my paperwork that my OB’s office had sent over: Again, luck was on my side.
I only pushed for two minutes with Twin A: She was my smallest baby and by far my easiest birth. Twin B was a breech extraction, a totally different situation that I think could have been avoided entirely had I been working with midwives rather than a Western doctor. However, breech extractions are not uncommon for Twin B births though more and more doctors are refusing to perform them as well. Since I was unmedicated, I was able to feel the entire process of the OB shoving his hand up my vagina, past my cervix, and into my uterus where he played chase with my son who was really not keen on the whole idea of being forced to be born when he had just gotten the whole uterus to himself for the first time in almost nine months. That was nowhere near as painful as it might seem, but it’s still not a procedure I recommend doing for fun.
Despite the fact that both my twins were born healthy and vaginally, it was not a positive birthing experience for me. I spent the entirety of labor arguing and fighting with the staff about the births. I repeatedly had to refuse to let the hospital do unnecessary procedures and they still did several without my consent. The birth was sterile in an OR filled with about 20 people whom I did not know and did not want there. It essentially became a freak show for anyone and everyone to come watch. I was forced to labor flat on my back with my legs in traditional stirrups though I asked for other positions. I was ignored repeatedly during the birth. I was treated as no more than a birthing machine, not a human.
After the birth, both my OB and the OB on call got chewed out by hospital administration for my refusal to consent to a c-section in a situation that clearly turned out for the best for me and my babies. The legal risk was just too high for the administration to handle even though I would have sued had they done a c-section without my consent as that is medical assault. The head nurse at the hospital even reprimanded my OB then next time she saw him, placing blame on him for me being an educated woman who wanted the best thing for me and my children. Fortunately my OB knew she was off-base and ignored her.
While I’m grateful I was able to have these births, they aren’t what I would want for most women. It is legal now in Texas for certified professional midwives to deliver breech babies and twins at home, and that increases the options for women if they can find midwives who are trained in breech births and are willing to assist them. While there are several more naturally oriented obstetricians in Austin than there were in 2000, the options for women wanting to have vaginal breech babies, especially vaginal twins where twin A is breech, are still VERY limited. This is a situation that makes me very sad. The greater Austin area has almost two million people at this point, and women should not have to go to other cities and other states in order to have safe, natural births.
(The photo above is of Jodi Egerton of Write Good Consulting. The henna artwork was done during a Blessing Way ceremony when she was about 35 weeks pregnant. This photograph was taken when she was 36 weeks and 2 days pregnant. Her beautiful baby boy was born four weeks and two days later in a vertex homebirth.)
© 2014 Green Heart Guidance
I am a strong believer in the ability of women’s bodies to naturally birth babies in 90+% of situations without medical assistance and intervention. There are times when Western medicine is truly needed in childbirth, but I feel the current profit driven and legally dominated medical practices greatly skew the way childbirth occurs in the US. The c-section rate should be between 5-10%, not the 30-50% that is happening in our nation.
However, despite my strong beliefs in childbirth as a fundamentally natural and normal process, I seem to have been a poster child for unusual births. This post is about my second and third births of my twins. Because I was an educated and determined woman plus I had luck on my side, they were unmedicated vaginal breech births. That’s a situation that rarely happens in the US any more.
My twins were bothtransverse (lying across my abdomen) at 36.5 weeks though they were still very active and they were rotating their heads from the left to the right side of my abdomen as confirmed by ultrasound. Previous, Twin A, the twin who is lowest in the womb and will be born first, had been breech and fully engaged in my pelvis. She dropped at 28 weeks, popping back out twice but never rotating to a vertex position. We began doing moxibustion just before the twins were born in an attempt to rotate her into a vertex position. I had also been doing many of the recommended home techniques for rotating babies. The moxibustion worked: Twin A dropped violently into my pelvis from the transverse position, breaking her water in the process. Unfortunately, she dropped in the breech position yet again, not the vertex we had hoped for. The short version of my labor story is that two hours after twin A’s water broke, she was born, and fifteen minutes later, her brother joined her on the earth plane, both without problems.
The longer version of my pregnancy labor involves a story of a lot of frustration. My original practitioner quit handling deliveries when I was 20 weeks pregnant (only two weeks after I found out I was carrying twins), so I had to find another OB who would handle twins. Unfortunately in Austin at that time (2000), there were less than a handful of doctors who would consider letting a woman labor without an epidural during a twin birth, and I refused to have an epidural due to my medication sensitivities and my phobia of having people stick needles in my spine. None of the homebirth midwives in town could legally deliver twins at that point with the exception of one, and because of our relationship, she did not feel she would make a good, objective practitioner for us though she was present as a doula at my twins’ births. Those restrictions narrowed my options dramatically.
Once I finally found an OB who was a relatively good match for me, I started having to deal with the fact twin A was breech and engaged. My obstetrician had experience in delivering breech twins vaginally when Twin A was breech though most OBs do not. He could not legally tell me that he would deliver the twins if they were breech due to the medical/legal situation in the US; he actually made us schedule a c-section date at around 38.5 weeks gestation (which I had no intention of showing up for, but it was on the records). What he did say was that if I showed up with a baby on my perineum, there would be nothing left for him to do but catch it. So that was our original breech birthing plan: I would labor outside of the hospital as long as possible monitoring the babies with fetal dopplers and then show up at the last minute.
During the end of the pregnancy I did a LOT of online research; most of the studies I found were based out of foreign countries. What I discovered was that the US was one of the only nations where breech births were treated as an anathema and that breech births can be safely done if mother, baby, and doctor are all good candidates for the process. I especially appreciated the works of Henci Goer which helped me to see that my situation made me an ideal candidate for breech births. I had a proven pelvis with a baby who was likely larger than the twins I was expecting (and they were 1-1.5 lbs smaller than her). Twin A was in a frank or complete breech position during labor; her head was tucked properly. The twins were of a good gestational age and weight. And most importantly, I had a practitioner who was experienced in vaginal breech births, and based on my questioning of him, he truly knew what to do and was not afraid to do it.
The way the birth actually played out was not as we had originally planned. My labor started unexpectedly when we weren’t sure what position the twins were in. We never planned on my water breaking before labor actively started. And most frustratingly, my OB was out of town. However, the OB on call trained outside of the United States in a rural community and also had a great deal of experience with vaginal breech births. So luck was on my side in that regard.
I arrived at the hospital labor and delivery ward an hour after my water broke, but I wasn’t feeling contractions yet. When the nurse checked me, I was at 7 centimeters and she could tell it was a butt presenting. All hell then broke loose at the hospital as everyone but me went into a panic about a breech twin presenting with a mother who refused an epidural and wanted to have vaginal births. In between contractions while I was in transition (by which time I was feeling the contractions quite strongly), I argued medical studies with the OB on call. He ascertained that I did know what I was consenting to, though he still made my then-husband sign AMA (against medical advice) paperwork. The labwork that they needed to put the epidural in place still had not shown up when it was time for me to start pushing, and they never found my paperwork that my OB’s office had sent over: Again, luck was on my side.
I only pushed for two minutes with Twin A: She was my smallest baby and by far my easiest birth. Twin B was a breech extraction, a totally different situation that I think could have been avoided entirely had I been working with midwives rather than a Western doctor. However, breech extractions are not uncommon for Twin B births though more and more doctors are refusing to perform them as well. Since I was unmedicated, I was able to feel the entire process of the OB shoving his hand up my vagina, past my cervix, and into my uterus where he played chase with my son who was really not keen on the whole idea of being forced to be born when he had just gotten the whole uterus to himself for the first time in almost nine months. That was nowhere near as painful as it might seem, but it’s still not a procedure I recommend doing for fun.
Despite the fact that both my twins were born healthy and vaginally, it was not a positive birthing experience for me. I spent the entirety of labor arguing and fighting with the staff about the births. I repeatedly had to refuse to let the hospital do unnecessary procedures and they still did several without my consent. The birth was sterile in an OR filled with about 20 people whom I did not know and did not want there. It essentially became a freak show for anyone and everyone to come watch. I was forced to labor flat on my back with my legs in traditional stirrups though I asked for other positions. I was ignored repeatedly during the birth. I was treated as no more than a birthing machine, not a human.
After the birth, both my OB and the OB on call got chewed out by hospital administration for my refusal to consent to a c-section in a situation that clearly turned out for the best for me and my babies. The legal risk was just too high for the administration to handle even though I would have sued had they done a c-section without my consent as that is medical assault. The head nurse at the hospital even reprimanded my OB then next time she saw him, placing blame on him for me being an educated woman who wanted the best thing for me and my children. Fortunately my OB knew she was off-base and ignored her.
While I’m grateful I was able to have these births, they aren’t what I would want for most women. It is legal now in Texas for certified professional midwives to deliver breech babies and twins at home, and that increases the options for women if they can find midwives who are trained in breech births and are willing to assist them. While there are several more naturally oriented obstetricians in Austin than there were in 2000, the options for women wanting to have vaginal breech babies, especially vaginal twins where twin A is breech, are still VERY limited. This is a situation that makes me very sad. The greater Austin area has almost two million people at this point, and women should not have to go to other cities and other states in order to have safe, natural births.
(The photo above is of Jodi Egerton of Write Good Consulting. The henna artwork was done during a Blessing Way ceremony when she was about 35 weeks pregnant. This photograph was taken when she was 36 weeks and 2 days pregnant. Her beautiful baby boy was born four weeks and two days later in a vertex homebirth.)
© 2014 Green Heart Guidance
RSS Feed