BREECH BIRTH IS NORMAL

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This article appeared in Pathways to Family Wellness magazine, Issue #61.

by Nona Djavid, D.C. Author Bio.

To purchase this issue, Order Here.


The transition from maiden to mother is the most transformative and sacred journey I have ever taken. It’s the ultimate form of shapeshifting. I was reborn after the birth of my son, Rayan. I remember telling my midwife, “If I can do this, I can do anything.” It was empowering, and the most authentic expression of the divine feminine I have ever experienced. 

The first 37 weeks of my pregnancy were extremely spiritual and enlightening. For months, I’d read Ina May Gaskin’s books on midwifery and natural childbirth. I ate healthy, exercised, practiced yoga, and meditated. I was under chiropractic care, went to acupuncture, and did everything in between. I chose to have no ultrasounds, no unnecessary tests, and no medical interventions. I had full trust in my body’s ability to do what my female ancestors had done for centuries. There was no fear and no doubt. I told my midwife I wanted a free birth—where only my hands and the hands of my husband would touch the baby. When people asked if I had a birth plan, I would often say that I wanted to squat down and give birth to my son.


I dreamed about it. I longed for it. I smiled when I envisioned it. And then, three weeks prior to my due date, everything suddenly changed. That’s when I was told my son was in a breech position, and that it was “abnormal” and that my midwife could not, by law, deliver my breech son. He would either have to turn, or I would end up with a C-section. My world was upside down. I felt an immense amount of pain in my heart. For the first time in my pregnancy, I experienced fear and doubt. You see, fear of birth is something my mother carried with her. She experienced a lot of trauma after multiple miscarriages, a stillborn child, and losing a ten-day old newborn baby. This fear was grand, and it had been carried by my ancestors, generation after generation. Stories of loss, trauma, and pain were flooding into me. I had mindfully put all of these stories away for what seemed like eons, but now the fear was deep and it was consuming me. 

Shortly after hearing this news, my husband and I went to get an ultrasound to confirm our baby’s position. And yes: Our son was, in fact, breech. After hours and hours of research and phone calls, we found three OBs in all of southern California who were known for delivering breech babies vaginally. One had retired. One worked out of a hospital. And then there was Dr. Stuart Fischbein, the only OB who did home births including VBACs, breech, and twins. 

We met with Dr. Stu. I remember him saying, “Breech is a variation of normal.” This was the most refreshing piece of information; my heart was dying to hear it. Something about breech being “normal” felt right, and I started to feel at peace again. He shared his research and his work with us, checked everything out, and let us know that we would qualify for a breech vaginal birth. 

He continued to explain how vaginal breech options were taken away from women in the 1980s. This was due to lack of training and a lack of skilled practitioners familiar with specific techniques to deliver breech babies vaginally. This unfortunate trend coincided with a 2000 Term Breech Trial Study that showed poor outcomes for vaginal breech births compared to C-sections. Multiple studies came out afterward that proved the study to be flawed or invalid, but it was too late to make a difference. The American College of Obstetrics and Gynecology had already stopped teaching and recommending a natural birth for these moms, and they have not updated their recommendations since. 

I now had found my sliver of hope to have my baby enter the world how I chose to—which I believe is every woman’s birthright— but I was saddened that the art of delivering breech babies vaginally was dying. As a result, fewer and fewer women would have it as an option. 

Of course, I still tried everything in my power to turn my baby. More chiropractic care, more acupuncture, hanging upside down, ice, music, lights. None of these techniques worked; my baby wouldn’t turn. As I was running around doing all of these things, something inside of me felt incongruent. I felt out of alignment. I stopped and listened to my newfound instinct, and I immediately knew that nothing about this pregnancy—nothing about him, nothing about his position, and nothing about me—felt urgent. 

I knew in my heart that Rayan had picked his way of coming into the world—peacefully and through the birth canal. I was there to surrender, and perhaps learn my first lesson in motherhood. I let go of the circumstances, maybe even for the first time, and began to heal. 

It was time. I was in what my midwife calls labor-land. Dr. Stu and my birth team were on the couch discussing the meteor shower that was taking place that night, and hoping to catch a glimpse of it at 4 a.m., while I was finding my strength and place of surrender with every contraction. At 4:08 a.m. that early morning, I witnessed the birth of my son, butt first, Earthside. As my midwife would say, I experienced the “rebirth of a mother born by the battle she has endured and just won.” 

To me, what Joseph Campbell describes as the “hero’s journey” meant giving birth my own way, on my own terms. I became a vehicle for life, and in the process was reborn. When you go through an experience that is so profound, it shakes you to the core. You begin to overcome all fears, challenges, and perceived conditions. Without the outstanding doctor who reminded me of what I already knew—that breech birth was normal—my journey would not have been the same. 


My Breech Birth Story

Mercy Reign was born Saturday, February 3 at 4:43am by way of C-section after 40 hours of intense, unmedicated labor at home. She was frank breech, 9 pounds, 9 ounces and 23 inches long! Mercy was extra-well done (haha) at 41weeks and 3days, extra-large, extra cozy, folded completely in half,  and slightly transverse, likely due to how long she was! This was not the birth story I wanted, it was the birth story God knew we needed. 

Zach and I did everything we could to prepare for a home (water) birth, something we both dreamed of having. We prayed. We took A Heavenly Welcome's Kingdom Childbirth Class and the 8 week Mama Natural Online Birth classWe hired an amazing Christian midwife with 29 years experience who thoroughly cared for, educated and encouraged us from 9 weeks pregnant through the "4th trimester". We both read Ina May Gaskin's Guide to Childbirth book, Hypnobirthing and Supernatural Childbirth. A word on Hypnobirthing for those whose "New Age radar" just went up: Chew on the meat & spit out the "New Age" bones - most of the info on what happens in the woman's body during pregnancy, labor and birth + the breathing techniques in this book were very accurate and helpful though I don't recommend the cd or some of the wierd visualizations.  We also watched endless videos of amazing home births, and once we found out she was breech, endless vaginal breech birth videos. I LOVED The Heavenly Welcome Podcast in my last trimester, listening to all the supernatural birth stories/testimonies!! 

The Lord specifically instructed me on how to prepare my body before getting pregnant, after He gave me  the dream about Mercy. He gave me the words TRUST and DISCIPLINE, and challenged me to get a 1-year chronological Bible to read for 2017 (as of March 2018 I've almost completed it...hahaha...better to finish with grace than become legalistic and ashamed, right?!). I also felt the Lord instruct me to start pilates reformer classes to prepare my structure, as I was just coming off of a serious back injury involving 2 bulged discs and severe muscle spasms. He advised me to lighten my load and work on my adrenal glands/hormones, as my periods had gotten painful and a bit irregular after prolonged high stress.  The Lord also nudged me to finally change over the last of my makeup/skincare regimen. I had been using Bare Esscentuals for years and justified that it was "natural enough." I finally took the time to see how EVERYTHING I was using on my face/body ranked on the EWG- Skin Deep App and did my research to find  the BEST, most pure and complete cosmetic line  once and for all. (I hate changing makeup/searching for new products!) There are hundreds of serious carcinogens, hormone disruptors & other toxins in most makeup/skin care products. I still make my own body butter and anti-aging skin serum, both of which I used (mixed together) for stretch mark prevention throughout the whole pregnancy (and I didn't get a single stretchmark with my 55 extra pounds of  Mercy love!!!). I had pages of birth declarations and scriptures (you're welcome to use them) typed up that I meditated on for weeks to keep my mind constantly renewed and excited versus afraid. Aside from those specifics, I was already eating super clean and healthy, teaching Indoor Cycling classes 2 times per week and working a balanced schedule. I took responsibility and trained accordingly, as I knew childbirth was not something to "just wing". 

Everything the Lord advised me to do paid off and served its purpose. I had a wonderful pregnancy despite the fact that it was "God's plan" and not our own in the end. Mercy was head down until the middle of third trimester when she flipped. My amazing Chiropractor, who specializes in pregnancy and pediatric care,  is who suspected she was breech and referred me out for emergency ultrasound for confirmation on Christmas Eve (35.5 weeks). Praise God for the wise words from a dear friend who reminded me: "Remember, home birth isn't the ultimate goal, a health mommy and baby is". That was Truth I needed to remember for such a time as this. This pregnancy and birth experience took me to another level of surrender and trust, once again reminding me that we are not in control. I so desperately wanted to have this baby naturally at home. I fully believed that God was going to honor "the desires of my heart". My recovery entailed much more than physical healing. 

We prayed fervently through the end of my pregnancy and had so many others praying (even fasting for us). We did everything to get her to turn (Webster technique, Chiropractic care, Acupuncture, Moxibustion, External Cephalic Version 3 times, inversion exercises from SpinningBabies.comessential oils, homeopathies to increase my amniotic fluid making more room for baby to move, etc).  We were still lead to try to have a home birth instead of cave to C-section immediately since there were zero complications, and I was healthy and low risk through my entire pregnancy. We had to hire Dr. Stuart Fischbein (with Dr. Milo Chavira on call, his backup which is who we ended up with because Dr. Stu was out of town when I went into labor... the plot thickens!) the only Obstetricians in the area who specialize in vaginal breech HOME (or birth center) birth. Sadly, California law will not allow a breech home birth with a midwife any longer (don't get me started on that!). It is pretty much exclusively hospital policy here to force women with breech babies to have a surgical birth and not even allow them to try to deliver naturally. God kept opening doors of hope and possibility. 

Something I learned from our amazing and very experienced birth team through this journey: If you are trying to deliver a breech baby vaginally, induction and intervention are major no-no's. (Of course, I'm not a fan of either unless they are truly MEDICALLY NECESSARY anyway. One intervention often quickly leads to a whole cascade of interventions, which can have adverse effects on mommy and baby). Because Mercy could not descend through the birth canal due to her position and size, my contractions never developed a regular pattern into active labor, and I never dilated past 4 cm. I had MANY 10-15 minute, excruciating, back-to-back surges as my uterus did its job to TRY to bring her down. I fought to have her naturally, but it eventually became medically necessary to transfer. My water had been broken for nearly 48 hours.

This was my Garden of Gethsemane. 

“...Father, if it is possible, let this cup pass from Me; nevertheless, not as I will, but as You will.” -Matthew 26:39 NKJV

There were some incredibly HOLY moments late in my labor where tears flowed from the depths of my soul. I was able to dance and worship, feeling almost zero pain for a couple hours!! I had a supernatural breakthrough and clearly heard the Lord speaking to me about restoring the family unit, the ancient ruins (Isaiah 61), and the places that have been long devastated through many generations. He spoke to us about making all things new through us, a fresh start, a new and healthy generation, and encouragement that I don't have to be afraid of me or Zach doing the things I witnessed growing up. These have been deep, tormenting and paralyzing fears throughout my life. The Lord "delivered" me as I was delivering my daughter into the world. I was fully surrendered at that point and HOLY is the only way to describe it.

Perhaps if my birth story had been "easy", I would have missed out on the healing that only comes through the kind of pain that brings you to your knees. I could quickly get caught up in grieving and re-living my birth story, wallowing in the emotions and making it an idol. Instead I CHOOSE to simply trust The Lord and thank Him for this baby girl that was worth it all!! After all, I don't "deserve" anything. Anything the Lord gives is a gift of grace in reality. 

Ultimately we had our home birth...with a cesarean delivery and a healthy mommy and baby. We did everything we could and therefore, will never have any regrets. In God's mercy and grace, Miss Mercy Reign never once showed any sign of fetal distress through the entire labor or birth or postpartum!! Thank you Jesus!!! 

We are in love!!! Mercy is so strong and healthy and BEAUTIFUL and FUN and squishy and delicious!!!! God's MERCY truly REIGNS and we can be grateful His plans are better than ours will ever be!!!

THANK YOU to ALL who have prayed, called, sent cards and gifts, celebrated and journeyed with us!!!

Psalm 136:1 "Oh, give thanks to the Lord, for He is good! For HIS MERCY ENDURES FOREVER."

FUN FACT: A breech presentation is a variation of normal (like us! haha), not a pregnancy complication. It occurs in 3-4% of pregnancies and no one really knows why. Vaginal delivery is ideal for a low-risk breech baby so long as you have a properly trained birth assistant (OB or Midwife). The real problem is that medical schools are no longer training Doctors how to deliver breech babies, so there is a LOT of fear-mongering around this topic. Just as many things can go wrong during C-section delivery of a breech baby if a Doctor isn't properly trained (brachial plexus injuries, etc). It is still wise to avoid a surgical birth whenever possible unless it is truly medically necessary like mine ultimately was. 

2017 Birthing Instincts Year in Review

 

Well, that went fast. Another year of births, advocating and teaching for the Birthing Instincts team. I want to specifically thank my staff and students, Kati and Catalina along with all the midwives who refer and trust me with their clients. As always, a special thanks to midwives Beth Cannon and Blyss Young who have been with me through it all. It is always interesting to look back so let’s see what adventures, both personal and professional we had in 2017.  As always, I was available to answer questions, emails and calls from midwives and clients pretty much every day, 24/7 365. It didn’t take long to see that the 2017 practice was going to be caring for more and more breech families. As choices diminished with the retirement of Dr. Ronald Wu and the banning of breech and most twin deliveries at multiple hospitals women were left with fewer options. We are happy to note that friend and colleague, Emiliano Chavira, MD helped picked up the baton and gave women the option of a hospital breech birth at St. Francis Hospital in Lynwood, CA. The first week of January saw the waterbirth of our first 2017 twins born 45 minutes apart. The very next day we dropped off my daughter, Madeleine, at LAX on her way for her semester abroad in Barcelona. A month later I traveled to Barcelona to visit and we had a great time. Seeing the sites, sampling the food, the Salvador Dali Museum and catching a match between Barcelona and Real Madrid were all special. Not much better than Father-Daughter camaraderie.

Sadly, in late January, we lost my dad to his battle with father time. He lived a wonderful 96 years and will be missed (Reminder: You can hear some of his wisdom and humor when I had the good fortune to interview him on his 96th birthday at DrStusPodcast.com #100). Later in February I once again traveled with the charitable Cure Cervical Cancer team, this time to Vietnam. We spent just over a week teaching and screening for cervical cancer in the villages around Ha Long Bay. My stepson Max moved back to LA from Brooklyn so now all my kids are in the SoCal area and family gatherings were made that much easier. April saw the arrival of the Annual ACOG Meeting, this year in San Diego. While there was much to see and learn there was an obvious huge gap between the medical birth world and the midwifery one. I was inspired by the lack of acceptance of breech and limitations on VBAC and twins in the lectures to go on and acquire a breech trainer, Sophie and her mum. With the help of so many of you and a GoFundMe account I was able to raise nearly all of the $11,000.00. Thank you all so much. Happy to say the Sophie and her mum now reside in my apartment in downtown Los Angeles and are looking forward towards many journeys in 2018.

 

The month of May saw a well-attended ICAN event in Santa Barbara in support of VBAC. Dr. Emiliano Chavira, Dr. Terry Cole and Jen Kamel of VBAC Facts joined me and some eloquent VBAC mothers for an informative evening. We also had an emergency episode of Dr. Stu’s Podcast in support of our friend and colleague, Dr. Brad Bootstaylor in Atlanta. His local institution was trying to restrict legitimate birthing options. Funny, with more and more literature coming out supporting the importance of the microbiome and the concerning high cesarean rate you would like to think hospitals would be climbing on board instead of going backwards. Big sigh!

 

June saw me travel to NYC for a special night with an old friend and a dinner party in Manhattan. My friend worked for the United Nations and she and I were treated to a warm hug from Swami Amritaswarupananda Puri, the spiritual leader better known as Amma. A very special moment. Another special moment came when a local ENT physician and his wife had a beautiful home waterbirth against the best advice from all his partners and medical colleagues. What do they know, anyway? In July, I was privileged to be invited to the swearing in ceremony to American citizenship of one of my clients along with several thousand new Americans. Another very special and moving moment. Only a month later she gave birth in her bed at home. Welcome Piper!

Congratulations to my long-time associate, Jason Rothbart, and his beautiful bride, Leigh on their August wedding in Spokane. Nature continued to show its wonder with the total eclipse that, for 3 minutes, mesmerized the country. All year long many visitors came to spend time with me, saw clients, attended a few births and pick my brain. I enjoy these interactions and they keep me on my toes. With the onset of Autumn, Nebraska Birth Keeper Angie Hock spent a week with the highlight being a Los Angeles, Kings hockey game, of course! September saw my colleague Rixa Freeze of Stand and Deliver blog fame and me submit a paper for peer reviewed journal publication comparing 60 home breech births with 109 home singleton cephalic births. We hope it will be out very soon. In October, Sophie and her mum held their first seminar with Dr. Stu attended by local midwives in Ventura. We are very excited with the expanding teaching schedule for 2018 and we are hopeful to get CME accreditation so we can attract doctors, residents and medical students to these events. (Check the calendar page on the web site)

November is often remembered as the month of Thanksgiving and this year there was much to be thankful for. Our student, Catalina, discovered some very exciting personal news. More to come on that in 9 months! Dr. Stu gave a talk on breech techniques at the 2017 MANA conference. And while not everyone seemed in the thankful mood this year it was nice to see so many old friends and colleagues. Congratulations to Dr. Stu’s niece and nephew on the unmedicated delivery of his great niece proving once again that good things can happen in the hospital setting. Dr. Stu’s daughter, Madeleine, turned 21 and she celebrated by going skydiving with her friends and drinking legally with her dad. The year ended on a sweet note with a Christmas HBAC in Santa Barbara proving once again that good things can happen in the home setting, too! As always, Dr. Stu and his staff want to express their gratitude to all the mothers and fathers and birth professionals who have supported the Birthing Instincts mission. Your trust and assistance provide the sustenance that keeps us going all hours of the night. Happy new year to you all.

 

2017 Birthing Instincts Statistics

 Total Clients in care: 45

Transfer of care prior to labor (TOC): 6

 

1)     Twins, 37 weeks, SPROM, A is footling breech

2)     VBAC, Macrosomia, Type 1 Diabetes

3)     Twins, VBAC SPROM at 34 weeks

4)     Twins, SPROM at 35 weeks

5)     VBAC, IUGR

6)     Twins, TTTS at 23 weeks treated with Laser therapy

 

 

Laboring Clients: 39

                  Primips: 21 (Includes 1st time mothers and VBAC mothers)

                  Multips: 18

 

Vaginal: 32 (82.1%) (Home Vaginal Delivery Rate is 72%)

                  NSVD:                      15

                  Vacuum:                4

                  Twins:                      2

                  Breech:                   9

                  VBAC:                       2

 

Transports: 11 (Rate 28%)

                  Cesarean:               7 (Rate 17.9%)

                  Vaginal:                                    4

 

Transports in Labor:

1)     Breech, VBAC, Hypertension (VD)

2)     VBA4C, Pain

3)     Breech, Arrest @ 6cm

4)     Br/Vtx Twins, Arrest @ 7cm

5)     Breech, Arrest @ 7cm

6)     Breech, Floating @ 5cm, Footling

7)     42 Weeks, Desired pain relief (VD)

8)     Breech, VBAC, 4+ Meconium at 8cm

9)     Twins, VBAC, Sharp suprapubic pain at 10cm

10)  VBA2C, Hypertension (VD)

11)  Primip, Vertex, Desired pain relief (VD)

 

Summary: 45 clients entered into care with Dr. Stu as the primary caregiver in 2017. Many entered into care late in their pregnancy because of newly discovered breech presentation and midwife care going beyond 42 weeks. Six of these women developed antenatal problems requiring a transfer of care to a hospital based physician. Of the 39 remaining, 32 delivered vaginally (82%). There were 11 transports with 4 of these delivering vaginally in the hospital and the remaining 7 transports having a cesarean section (18%). All 4 vacuums were at the request of midwives to assist with their laboring clients. As our practice has evolved we are seeing more clients with conditions considered high risk in the medical model as choices diminish resulting in higher cesarean section and transport rates than in previous years. Many local midwives are accepting VBAC clients with more confidence and Dr. Stu saw more than 20 of these women in consultation for VBAC “clearance”. While not required by California law, consultation gives reassurance to those midwives and clients who prefer a second opinion. Structural 20-week scans and dating ultrasounds as well as biophysical profiles continue to be offered to midwife clients in a reassuring environment. In addition, Dr. Stu continues to provide the option of repairing significant lacerations in the home setting when requested. We assisted births from San Luis Obispo to San Diego and even had one family relocate from Aspen, Colorado to have their twin birth plan honored.

All of us at Birthing Instincts, Inc are honored to be of assistance and provide these services to the families and practitioners who desire them, wherever they may be.