WWYD: have a home birth with a breech baby?

Rebekah1021

A girl in my church is pregnant and due the same time as my sister (March3rd). She sees an midwife and a doula exclusively. She had her first baby at home and everything was fine. last week at a checkup - the doula thought she heard 2 heartbeats so she went in for an u/s. There is only one baby, but the baby has a transvers breech presentation. The baby still hasn't changed positions at all. She's still planning on a home birth, which I can't wrap my mind around. I understand, that her first experience was great, but can't help but be a little worried about a potential risk she is taking. The doula says that they have taken special classes and there is nothing to worry about.

I just don't know, I'm a chicken

 

jorie

I think she's being utterly irresponsible and selfish.

MrsSledge

I'm not against having a homebirth (DH is), but only if everything was completely normal.  I wouldn't be able to do it if there is any chance things aren't normal.  Maybe she is planning on going to a hospital if the baby hasn't changed position by the time labor starts.

KoriBrett

Only about 3% of births are breech/transverse so chances are good that hers will flip, she can have an external version to try to flip the baby depending on baby's position. ?

And, I work with a guy whose wife did home births, one of which was breech until that morning. ?

goodhartedmommy

I think there is plenty of time for the baby to turn, and I'm sure she will try an external version or acupuncture to turn the baby. Most midwives will not actually deliver a breach baby, but will give the baby time to turn before refusing to do the birth.

Heidisean

I would opt for the hospital in that situation.  Having a baby can be detrimental to the mother if something happens.  I have 2 OT's that I work with that both needed blood transfusions due to hemmoraging and got very sick after they delivered. Neither of them had complicated pregnancies so you never know what will happen. 

kevschickee2

it is very irresponsible and selfish.  IMO if the baby doesnt make it she should be charged with murder

jorie

I should clarify that I don't think all home births are irresponsible and selfish.  But if the baby is indeed breech and she stays at home to fulfill her desire for a home birth, then I do think it's irresponsible.

Expecting0207

I wouldn't risk my child's life in pursuit of a 'birth experience'.

LOL at 'taken special classes and there is nothing to worry about'... my DH took 4 years of classes in med school  and has completed 3.5 years of hands on surgery training, and for some reason I don't think he would ever be able to say there is 'nothing to worry about' in any given procedure.  No two bodies and no two situations are the same.  The 'special classes' may not account for her situation or a cord accident.

KoriBrett

forgot to add, there's no way in hell I'd do a home birth w/a breech baby. ?DD was breech, no thank you.

penguingrrl

I think that's crazy.  But, I'm pretty anti-homebirth.  I had an undetected birth defect and would have died within minutes had I been outside a hospital.  Because of that, I would never consider homebirth.  That said, I live in NYC and one of the hospitals here has an in-hospital birthing center and if I hadn't had a C last time I would look at delivering there (they won't do VBAC in the center).  I do think that there needs to be medical care available just in case there's something wrong with the baby that has not been detected.

Amanda&Chris

No, I wouldn't.

BubblyToes

Nope

JellymanKelly

I am surprised that her MW is going to allow her to still have the homebirth. Classes or no classes, that's a risky situation for her and the baby. I bet she'll end up with an emergency hospital transfer.

JOEBunny

1900, when home births were common, 1 in 130 women died in childbirth. 

Today, 1 in 13,000.  I consider home births a form of natural selection.  When I hear people say things about how interventions are so common in hospitals and that is why they don't want to give birth there, I think, thank god they are common because they don't just save lives of babies and mothers, but also prevent birth defects like CP, strokes, ect.  I know one lady who had a heart attack giving birth and she was a very fit person, probably best to be in a hospital!  12% of home births end in a hospital transfer.  I am sure that is relaxing. 

goodhartedmommy

Yet maternal and fetal death is more common in hospital births than homebirths, JoeBunny.

Natural selection. Nice. 

 

hikerbeth

Well, there's still a lot of time for the baby to turn, so staying optomistic with the original birth plan is not a bad thing.

Transverse is impossible to deliver, though, so if the baby stays that way, no way.  Not footling either. . . I just don't think that feet dialate the cervix as well as a head.

A frank breech presentation, though is very possible to deliver vaginally (assuming the person is trained) especially with a second child.  My little sister was frank breech and delivered vaginally.

I'm not ever planning a homebirth, but that's my take.

kevschickee2

goodhartedmommy:

Yet maternal and fetal death is more common in hospital births than homebirths, JoeBunny.

Natural selection. Nice. 

 

 

wouldnt it be more common in hospital births than home births because most people deliver at a hospital?  How can anyone think its ok to take this risk when you know the baby isnt in a good position?

BrainySmurfette

I wouldn't.  It really doesn't seem to be a wise choice.  Of course, after having life-threatening complications myself, I will not give birth anywhere except a hospital without regard to the baby's position.

jorie

goodhartedmommy:

Yet maternal and fetal death is more common in hospital births than homebirths, JoeBunny.

Natural selection. Nice. 

 

jorie

goodhartedmommy:

Yet maternal and fetal death is more common in hospital births than homebirths, JoeBunny.

Natural selection. Nice. 

 

JOEBunny

Yes, goodheartedmommy, that is true, but it is not an apples to oranges, since the majority of home births have no complications, if they do have complications, they are transfered to a hospital and then become hospital births, so they are not counted as home births. 

We can agree to disagree on this topic.  I will never agree that it is a good idea and clearly, you do.   You are entitled to your opinion.

amanda&rob

Personally I would never have a baby at home.  I like hospitals and pain killers ;o) 

But, in all seriousness, IF it stays breech, I think she is being highly irrisponsible.

jorie

I don't know why I copied that twice.  I was going to ask where that info came from?  I'm assuming that could be a valid statement seeing as how so many more people deliver in a hospital.

jjr

my daughter was breech and I had a c-section.  pls let your friend know that it is very dangerous to give birth vaginally to a breech baby.  if your water breaks the baby can drop into the umbilical cord strangling the baby.  lots of complications.  pls let her know that a hospital with c-section option (if necessary) is probably best option.

goodhartedmommy

kevschickee2:

goodhartedmommy:

Yet maternal and fetal death is more common in hospital births than homebirths, JoeBunny.

Natural selection. Nice. 

 

 

wouldnt it be more common in hospital births than home births because most people deliver at a hospital?  How can anyone think its ok to take this risk when you know the baby isnt in a good position?

I agree that it's dumb to attempt to deliver a breach baby at home, but I think there is still time to decide that 2 months away.

And it's statistically more common in hospitals, meaning percentage wise. 

CleoKitty

There's got to be more to the story.?

I am quite sure that there isn't a midwife out there- even a totally wacky one- who would attempt a transverse breech homebirth. Vaginally birthing a transverse breech simply isn't possible, even in a hospital setting.

I can only imagine that with 2 months left she is not totally ruling out a homebirth because there is still plenty of time for the baby to change positions, but if the baby's still transverse when labor begins she will need to go to the hospital. That is my assumption, of course. ?

Otherwise, it just doesn't make sense. ?

Rebekah1021

They have asked for our church to pray for them. The doula is pretty much calling the shots. I pray that baby turns around.

W&J'sMommy

kevschickee2:

it is very irresponsible and selfish.  IMO if the baby doesnt make it she should be charged with murder

 I think this is really harsh.  Maybe she is planning on her baby turning.  And if her MW agrees to it, she must think it's possible. 

 

goodhartedmommy

jorie:

I don't know why I copied that twice.  I was going to ask where that info came from?  I'm assuming that could be a valid statement seeing as how so many more people deliver in a hospital.

From a World Health Organization (WHO) report - subsection on Place of Birth:
 

It has never been scientifically proven that the hospital is a safer place than home for a woman who has had an uncomplicated pregnancy to have her baby. Studies of planned home births in developed countries with women who have had uncomplicated pregnancies have shown sickness and death rates for mother and baby equal to or better than hospital birth statistics for women with uncomplicated pregnancies.

Summary of Results of Matched Population Study Comparing Hospital Birth with Home Birth
Summary of Results of Matched Population Study Comparing Hospital Birth with Home Birth
     Summary of epidemiologically controlled comparison of home and hospital birth. Original study, by Mehl LE et al. Outcomes of
     elective home births: a series of 1.146 cases. J Reprod Med 1977;19(5):281-90.[web page lost to web entropy - please e-mail me if you come across this page anywhere on the web.  Thanks.]
Mehl, L., Peterson, G., Shaw, N.S., Creavy, D. (1978) "Outcomes of 1146 elective home births: a series of 1146 cases." J Repro Med.
     19:281-90
Neonatal Outcomes:

• In the hospital, 3.7 times as many babies required resuscitation.
• Infection rates of newborns were 4 times higher in the hospital.
• There was 2.5 times as many cases of meconium aspiration pneumonia in the hospital group.
• There were 6 cases of neonatal lungwater syndrome in the hospital and none at home.
• There were 30 birth injuries (mostly due to forceps) in the hospital group, and none at home.
• The incidence of respiratory distress among newborns was 17 times greater in the hospital than in the home.
• While neonatal and perinatal death rates were statistically the same for both groups, Apgar scores (a measure of physical well being of the newborn) were significantly worse in the hospital

I delivered once with a midwife in a hospital, once with a high risk OB in a hospital, and once with a midwife at home, and I can assure you that the homebirth midwife knows 1000x more about birth than an OB and knew exactly how to handle emergencies, and would never keep a woman at home that  needed the hospital.

I think it's great that there are medical interventions available to us, and if anyone wants to birth in a hospital, that's perfectly fine with me, but I think that OBs know nothing about normal childbirth and I'm so thankful for my opportunity to have my baby at home. 

 

CleoKitty

BTW, my dd was footling breech until about 37 weeks. I knew that if she didn't flip that we'd have to consider our alternatives (trying an external version, scheduling a c-section, etc.) but she luckily turned around at the last moment. At no point did I call off my plans for a homebirth, but of course I knew that I was going to have to remain open to whatever was necessary when the time came.?

MrsSledge

I didn't know what transverse breech was, and found this website.  It looks like the accepted approach is to either wait and see if the baby turns, or try to make the baby turn before resigning yourself to a c-section.  Maybe she's just being optimistic.

https://www.birthingnaturally.net/birth/challenges/transverse.html

Oh, and is says less than 20% of babies that are transverse at 37 wks remain that way.

CleoKitty

MrsSledge:

I didn't know what transverse breech was, and found this website.? It looks like the accepted approach is to either wait and see if the baby turns, or try to make the baby turn before resigning yourself to a c-section.? Maybe she's just being optimistic.

https://www.birthingnaturally.net/birth/challenges/transverse.html

Oh, and is says less than 20% of babies that are transverse at 37 wks remain that way.

Exactly. My guess is that she knows the odds are in her favor that the baby will turn and therefore she's still planning her homebirth, but I'm quite sure that she and her midwife have a contingency plan just in case. You simply cannot convince me that there's a single birth professional out there who is willing to attempt a vaginal transverse breech delivery. ?

kevschickee2

W&J'sMommy:

kevschickee2:

it is very irresponsible and selfish.  IMO if the baby doesnt make it she should be charged with murder

 I think this is really harsh.  Maybe she is planning on her baby turning.  And if her MW agrees to it, she must think it's possible. 

 

 

sorry but when you are told your child in breech and you still decide to have a home birth and the baby doesnt make it IMO its your fault.  You as a parent are responsible to keep your child safe and doing this isnt keeping your child safe. 

AliBride2006

Thank goodness there are options for everyone.

However, an uncomplicated pregnancy does not mean an uncomplicated delivery. I can 100% state that if I had delivered my daughter at home she would be dead and I had an incredibly great pregnancy. Even my labor went fantastic and without medical intervention (well except the IV and monitor) until I pushed. If they had waited two more minutes to do that c-section, I wouldn't have my little girl upstairs. It was 1 in 100,000 but you don't know what side of that statistic you are on until you've delivered.