10/12/2026
Breech babies are a variation of normal. Thankfully, our midwife Heather Hays Lemanski is well trained and very experienced in breech birth
Breech birth story, baby born this evening:
Home birth mom at 41 weeks and 5 days called me with decreased fetal movement. I asked them to come to the clinic for a non-stress test. Quickly realized baby had flipped breech, most likely in the last 24 hours. Informed family that I am trained in breech and offered a home delivery. I went over the a very thorough informed consent document. They were shocked and overwhelmed with the choice as well as all of the scary information we must talk about when we do informed consent.
Meanwhile the non-stress test did not go well. Results were inconclusive and recommended getting more monitoring in the hospital. The family asked if they could wait a few hours to repeat the test and give them time to think about the breech options. They came back to the clinic at 5pm, she was starting to have good contractions but the strip looked VERY bad. Like, almost bad enough to call an ambulance bad. Sent the family directly to the hospital 15 minutes away. Upon arrival baby looked great on the monitor and whatever had been troubling baby had resolved.
The receiving doctor at the hospital informed family they “are not comfortable” with breech unless it’s a second twin. They gave us the options of stopping labor, giving relaxants and attempting an ECV, a c-section or that leave and go do the breech at home. The mom was starting to really labor hard and was unable to make a decision. Meanwhile I am wondering how and if we would make it to their house, and how I would get my gear set up and all the team in place. Honestly I was flattered she gave them the offer to do a home birth as planned as a viable option. Except it wasn’t really a viable option.
The doctor repeatedly suggested we leave or consent to a c-section and started using the “dead baby” card. She repeatedly talked about the big baby and how dangerous a big breech baby could be… I asked if I could share some information. I shared that it’s actually safer to do big breech baby than a tiny breech baby. She admitted she had no breech training other than assisting a 2nd twin. I also shared that this baby is most likely smaller than her others due to a good diet and modest weight gain in this pregnancy.
They left the room again. Dad turns to me and asks if I could deliver the baby in the hospital. I said if the water breaks and we have 2 minutes alone that’s what might happen.
Doctor comes back in and leans hard on the warnings about how a C-section is better than a dead baby and how much she would regret it if their baby dies….ad nauseum….all while she is laboring hard on the toilet. Suddenly SPLOoosH… the water breaks and we see two legs hanging into the toilet.
I get down on my knees on the bathroom floor ask for gloves and tell her she can go ahead and push. The doctor hands me a pair of sterile gloves. I ask mom stand up and lean on dad. Baby slides down with every push as I call out the breech milestones. “Hips out. Cord thick and pulsing. Good tone., tummy crunch….”. The doctor has her hands all over the baby and I tell her to let it hang. She says, I’m just supporting. (Ok, whatever). Arms deliver with a thick, juicy cord wrapped all around. Chin appears. Then the doc starts to try to turn the baby’s head on the perineum by turning the body and starts torquing its little neck. I say “DONT TWIST!”. She stops. Baby drops out and doctor catches baby and hands crying baby up to mom’s arms.
Baby slipped out in 40 seconds after water breaking. He indeed weighed a full pound less than her previous baby. Everyone was really quiet after that and the doc avoided my eye contact. I casually said at one point, “That sure was a lot easier than a c-section” They did not appreciate that comment, even though it was just an honest observation. 😬 The difference was especially striking to me as I had supported someone in a very complicated c-section a few days prior.
When asked her birth she said “that was delightful”. Her last birth was technically “low risk” …. an exhausting 22 hours with a terrifying 5 minute shoulder dystocia, with resuscitation and a broken clavicle on baby, then significant blood loss. Today’s birth in contrast, was a theoretical “high risk” birth - 2 hours of active labor, 3 pushes and no complications.
I appreciate so much about this birth. The opportunity to show people a better way of birthing breeches. I appreciate that the doc she trusted me to take this mom out of the hospital to get the job done. I also appreciate that she handed me a pair of sterile gloves.
But it would appreciate even more if they would just give women the option to give birth breech vaginally in the hospital where we have better support “just in case” and where most families are more comfortable. Until then we will keep fighting the good fight and catching breech babies at home or wherever the water breaks and they decide to be born.
