A version of normal (Australia)

Jesse Gutierrez

First time mum

29 years of age

Lennox Head, NSW

Birth photography is by Tahlia Williams (tahlia_lucy@hotmail.com) 

On June 23rd, 2021, I was 35 weeks pregnant. My partner and I went in for our birth plan meeting at the Byron birth centre. We had an informal bedside scan and found out that bubs was breech. I was devastated and disappointed. However, I had suspected that bubs had been like this for weeks, for I had felt like a large, round softball was always protruding under my right rib. That had been bubs head, constantly pushing upwards. I was mostly upset because the breech position threw a wrench in our whole plan. We had taken a hypnobirthing course, read up on countless natural births and had been planning and preparing to birth at the Byron birth centre with midwives. The birth centre of course did not support breech births or caesareans, which is what everyone began suggesting I have. As a first-time mum, having all my plans uprooted in the last 5 weeks of my pregnancy was beyond stressful. We were sent to have a formal well-being scan to confirm bubs position and to confirm that the baby was otherwise healthy and could be born without interventions, such as an early induction or scheduled caesarean.

Following the formal scan and confirmation it would be up to me to either transfer to Tweed or Lismore Hospital publicly for a caesarean, as most doctors do not have the experience to support a vaginal breech birth. I didn't like the odds that either of these choices left me, so I began to look for option 3. I started to research and inquire into ways to naturally turn the baby. I found that many people had success with several practices and so I began. We tried spinning babies' positions, hypnobirthing tracks, meditation, moxibustion, acupuncture, acupressure, prenatal massage, and water massage. We tried these, some of them twice a day for 2 weeks. I hadn't felt any big movements from the baby, so I began to work on our next option. The fourth option would be to go into hospital to allow the doctors to manually turn the baby from the outside through a procedure called an ECV (External Cephalic Version). I was informed that there were risks, including that I could go into early labour, or that bubs would become distressed during the procedure, and I would have to go for an emergency c-section. At this point I felt like this was my only chance to possibly avoid a caesarean.

On Monday July 12th I went for the ECV and it was terrible. I was administered a drug called Terbutaline to relax my uterus. Two doctors again then confirmed through a bed side scan that bubs was still in breech position, frank breech to be exact, and that the umbilical chord was not wrapped around their neck. One of the doctors then began to press her fingers from one hand into the centre of my lower stomach where bubs bottom was engaged, and the fingers of the other just below my ribs where the baby's head was. (Reliving this moment through writing this makes me want to vomit) I had previously watched Youtube videos of successful ECV's and had done my research so I knew that this procedure would be more than uncomfortable. On the contrary it was extremely painful. (Looking back at it now the pain was comparable to birth with no build-up of contractions. It was like going from zero to active labour is one second.) My body writhed in the pain. I was given gas to breathe and was told to do my best to relax my body and mind. They attempted three times to turn the baby and at that point I was physically pushing the doctor's hands away from me to stop her from further touching my baby. I felt like I was in shock. 

After the ECV, they wanted to monitor the baby's heart rate as well as my own to make sure that we would both be okay to return home. Both heart rates remained high and distressed for the next four hours. By the time I was able to go home we had been at the hospital for over seven hours. I had to return to hospital the next day to again monitor the baby's heart rate and for the next three days I rested, my body feeling like I had been in a car crash.

I felt so defeated, and so broken. What was wrong with me? What had I done wrong and why couldn't my pregnancy be normal? Why would doctors refuse to deliver breech babies? These thoughts constantly plagued my mind. Thank goodness I had stopped working because I was an absolute wreck. I needed more information and I needed support. I reached out to birth workers and friends to find out more information on vaginal breech births. I was determined to still have some kind of natural, no intervention, non-induced, hypnobirth that I had been envisioning for both the safety and well-being of my baby and me. We decided that we would birth in Lismore with one of the only two providers in the region who support breech births. The difficulty was that with a private doctor, Dr. Steele, was that we would have to pay for most of the care out of pocket. I met with Dr. Steele on Friday July 16th and he ordered a pelvic scan for Monday July 19th to confirm that my pelvis would be capable of a vaginal breech birth. Dr. Steele said that he wanted to have full confidence in my ability to birth this way before moving forward. At this point I was just 38 weeks pregnant.

That Saturday my partner and I had a very busy day up in Queensland planned visiting friends and family in Springbrook and on the gold coast. In the early afternoon at about 2:30pm I started feeling cramp like pains in my abdomen and pelvic region. At first I thought that it may be constipation, but when it continued to repeat and trips to the bathroom were unsuccessful, I figured they must be Braxton hicks contractions. I started to time them, and they were about 10 minutes apart, lasting about 30 seconds. I told my partner that I thought they were just false labour pains and so we continued on to visit some friends near Harbour town, Queensland.

Over the next four hours I continued to time these contractions. They were coming every 10 minutes, sometimes even 15 or 20 minutes apart. Though they began to increase in frequency and intensity after a few hours. It became hard for me to speak during contractions as I needed to focus to breathe through them. I called my friend Tahlia, a midwife and part of my birthing team and updated her on my condition. She advised me to ring the closest New South Whales hospital, as they could see me and determine if it was true labour, and they would also be able to gather my records from Lismore hospital. I rang Tweed heads hospital and told them about my contractions. They advised me to come in and said that they would check me and either send me home or onto Lismore if I could make it. At this point I still thought that it was likely false labour pains since I was early. (Although I have always felt that I would deliver early, but everyone told me that I would go over and deliver late with my first baby)

When we got to Tweed Heads Hospital, they quickly admitted us. They were very surprised that I didn't have anything with me, not my prenatal card, medicare card or hospital bag. I told them that we were not expecting this and that we had been up in Queensland spending what we thought was our last weekend away with friends. Earlier I had messaged my student midwife, Jemma, letting her know that we were on our way to Tweed hospital if she would like to join us and to my great relief she promptly arrived. Jemma had been a great advocate for me through this entire pregnancy. She had accompanied us to countless appointments and always had my best interest in mind. This time I appreciated her arrival now more than ever. 

Once in the birthing suite, Jemma worked with the other midwives on staff to begin monitoring my heartbeat as well as bubs, and soon the doctor came in to do a cervical exam to see if I was dilating. To everyone's surprise I was already 4cm dilated. It was around 8pm Saturday night and at this point I was still able to breathe through my contractions quite calmly. The doctor let me know that there was a supervising Doctor, Geeta Sales, on call that was experienced in breech birth. They then began to talk to us about the pros and cons, and associated risks of choosing to go for a vaginal breech birth over an elected caesarean. They explained that the risk factors double, though only from 1 to 2 percent, for a vaginal breech birth. However, the recovery time from a caesarean would be much longer for me than if I birthed naturally. Jessy and I took some time to discuss what we wanted to do in this moment. We both felt that we had always wanted to try to do this naturally and that we should continue with our plan for us and for our baby. We explained this to the doctor, in between contractions, and she was happy to support us in our decision.

From this point on the contractions intensified, though to my surprise I wasn't feeling them in my front abdomen but in my lower back and bottom. The pain would creep up, hold in intensity for about a minute and then fade off. I was able to breathe through them, focusing on keeping my body calm, knowing that with every surge I was coming closer to meeting my baby. My partner, Jessy was right by my side, whispering in my ear that I was doing great and telling me how proud he was of me. Jessy was my guardian, my rock, my pillar though the entire birth. He offered me water, took me to the toilet and held my hand or got toilet paper for me, held my hair when I threw up, rubbed my back, and offered to put on music or mediation tracks. Surprisingly I didn't want any music on. I remember sensing that there were a lot of busy people in the room, but I was focused inwards. I barely recall hearing anyone else, except when they whispered in my ear or called on my direct attention. I focused on my breathing, on getting through the next surge, and on having the confidence in my body that I knew how to birth my baby. I fluctuated between positions. I would kneel on the bed, leaning over the back of it (as it was elevated to have an upright back more like a chair), then I would stand at the end of the bed and put my hands down on the bed while I bent my knees and swayed back and forth, then I would labour on the toilet. I didn't want to lie down as the pain in my lower back was too intense. I would speculate this could be from the baby's spine being up against my own or because my placenta was anterior, but truthfully, I'm not sure.

I was dilating at the expected rate, about 1cm per hour and I think it was when I was maybe 6cm dilated my waters broke after I was being examined on the bed. There was a lot of meconium in the waters, but that was fine since we were dealing with a bottom down baby. I think that it was sometime after my waters broke that Tahlia arrived at the hospital. She had also been on a weekend away with her family up on the gold coast, but when she heard that I was truly in labour she headed back home to New South Whales with her family, got her camera and came to the hospital to support me and to do some amazing birth photography. Tahlia is a rockstar and a bloody legend. She knew exactly what to do. She was there to support me as well as to support my partner Jessy. She rubbed my lower back and pressed into my hip bones through contractions. She got cold compresses for my head. She tied my hair up out of my face, and she encouraged me to breathe through the pain. Tahlia had read over my birth plan weeks ago and was aware of the natural birth that we had wanted. Jessy was able to pull up my birth plan on my phone to show to the midwives there so that we could all be on the same page.

With a breech birth they continue to monitor my heartbeat as well as bubs through the entire labour. With me moving around so much the probes that were strapped against my stomach kept losing contact. They asked if they could attach a small probe to the baby's bottom instead so that they could have a clear and consistent reading. It would bruise the baby's bottom but otherwise do no damage to them. I agreed as I understood that they wanted to keep a close eye out for any signs of distress. The doctors also put me on an IV drip with fluids as they thought that I was dehydrated.

When I was nearly 10cm dilated, Doctor Geeta arrived. I believe that this would have been around three or four in the morning. Looking back at our discharge papers I can see that stage one labour lasted 5 hours and 15 minutes, stage 2 labour was 1 hour and 28 minutes, and second stage active pushing labour was just 39 minutes. Total duration of labour and birth was 6 hours and 52 minutes. When Geeta arrived she examined me and let me know that I was nearly there, she had me on the bed, feet in stirrups pushing but I needed more time and I told her that. She gave me more time to stand up and labour. At this point my back was in so much pain that it was preventing me from focusing on pushing. I began to ask for something for the pain. I tried some gas and that helped a little. I was starting to feel defeated, feeling like I was so close but couldn't quite get there. 

Tahlia mentioned to me about getting sterile water injections into my back. I remembered learning about these during our hypnobirthing course. I consented to receive the injections and was warned about how they would feel like bee stings going into my back and last for about a minute in that pain. Then the result of them would differ, as they relieve back pain for some women for 30 seconds, others 30 minutes or longer. I felt like this was my only chance to push the pain out of my focus and to be able to concentrate on birthing my baby. I chose to believe that they would work, and they did.

After the injections I was ready to return to the bed, feet up in stirrups and ready to push. Geeta used hot compresses to massage my perineum. I pushed through each contraction but there wasn't quite enough room for baby to come out. The doctor told me that we were getting close to the time that the baby would need to come out. I knew that this meant if I was not able to push bubs out soon, they would be sending me for an emergency c-section. I continued to push but nothing was emerging. Geeta proposed we do a medio lateral episiotomy to get this baby out now. I consented and with the next contraction they applied a local anaesthetic and cut me. I only felt the needle and the process was quickly completed. 

Geeta suggested I hold onto my legs while I push and that when I push, I breathe out for as long as I possibly can until I need to take a deep breath in and then push again. I did just that and at this point my contractions had slowed down to maybe 5 minutes apart. With my next giant push and moaning out roar I pushed out the baby's bum, legs in an upright V shape and torso. 

The contraction was over, and I continued to breathe calmness knowing that my baby was nearly here. I could feel the baby's body wriggling outside of me with their head still inside. Geeta told me that with my next contraction I would need to continue to push and not stop until the baby was out. I braced myself, grabbing my legs and pushed their head out with Geeta turning and pulling them out. At 5:13 Sunday morning our baby was born. The baby was immediately put onto my chest and the doctors instructed Jessy on how to cut the cord.

The doctors and midwives then took the baby to the corner of the room to be seen by the paediatrician. This happens for every breech birth as they want to immediately identify any complications. The only things they noted were their legs being upright with their feet near their face and their head being a bit flat from being up under my rib cage. I asked Jessy what they baby was, and he told me that it was a girl. He had tears in his eyes as he told me how great I did and how proud of me he was. I will never forget his words as they meant the world to me. Our baby girl was returned to me, and it was time to bond. I had Tahlia cut my t shirt off as it would be too difficult to try and remove. Tahlia helped me to breastfeed our little one. I called my mother and told her the good news and then Jessy proceeded to call and message the rest of our friends and family who were all so excited to hear the news. Our baby had been born 9 days early so this was a surprise for everyone.

We decided to spend the next 3 days in hospital. I had lost a lot of blood and hadn't slept. I was feeling a bit dizzy, too weak to walk, and needed more assistance with breastfeeding. Those three days were difficult, especially since Jessy could only be there during the day. However, I was fortunate to have round the clock midwife assistance in caring for our baby girl.

Looking back at my pregnancy and birthing journey, I only wish that I had been taught that breech was not a complication to correct, but that breech was in fact a version of normal.