Content
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What is a Breech Position?
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Is it dangerous to have a vaginal breech birth?
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What are the main reasons labor is induced?
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Knowing your options
Guest: Dr Stuart J. Fischbein
Stuart J. Fischbein MD is a community-based practicing obstetrician and an associate of the American College of Obstetrics & Gynecology, published author of the book “Fearless Pregnancy, Wisdom & Reassurance from a Doctor, A Midwife and A Mom” and peer-reviewed papers Homebirth with an Obstetrician, A Series of 135 Out of Hospital Births & Breech birth at home: outcomes of 60 breech and 109 cephalic planned home and birth center births.
Dr. Stu spent 24 years assisting women with hospital birthing and, for the last 12 years, has been a homebirth obstetrician who works directly with midwives.
Dr. Stu travels around the world as a lecturer and advocate for reteaching breech & twin birth, respect for the normalcy of birth and honoring informed consent.
Resources
Instagram @birthinginstincts
The Birthing Instincts Podcast with midwife Blyss Young
Mother's Circle. Birth story from Mckenzie
Sponsors & Gifts
Energy Healing Course (10% discount code: Motherhood22)
50% Discount Prenatal Programme
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What is a Breech Position?
A breech presentation occurs when the baby's buttocks, feet, or both are positioned to come out first during birth. Breech is common in early pregnancy, and by 36–37 weeks of pregnancy most babies will turn into the head-first position. Around 4% of full term birth will experience a breech birth.
Is a breech birth dangerous?
"Delivering a breech birth is not being taught to doctors, not because it's dangerous, that's a misconception.
It's not being taught because it's misunderstood, or it's just expedient or economically not feasible to teach it anymore and so they're not doing it. It's taking away a really viable choice and actually putting women and babies at greater risk, because it's not an option out there. And, when physicians don't know how to do these procedures, we again, put mothers at risk." Dr stu
Part 2. Induction
What are the main reasons labor is induced?
Labor induction is the use of medications or other methods to bring on (induce) labor. Mothers may experience complications in pregnancy which require the conversation to induce labor (eg. pre-eclampsia, growth restricted baby, diabetes, etc.)
Here are some reasons you may have come across:
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Growth concerns in the baby
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Age of the mother
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Too little amniotic fluid around the baby.
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Gestational diabetes.
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High blood pressure.
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Preeclampsia.
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A uterine infection.
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Placental separation from the uterus.
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Rh incompatibility.
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Over the due date
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Doctor is going on holiday
Knowing your options
It may feel that you are being told what to do instead of being made aware of your options. This is all too common. Asking the right questions will help you to understand your situation and discover your options.
BENEFITS - What are the benefits of this intervention
RISKS - What are the risks with this intervention short and long term
ALTERNATIVES - What are my option?
INTUITION - What is my intuition telling me?
NOTHING - What if I did nothing?
Remember you have time, you do not have to decide straight away. Discuss your options, concerns and insights with a trusted member of your birthing tribe.
I love the book 'Why induction matters' written by Rachel Reed, which offers a comprehensive an evidence-based guide to this common intervention.
What are the different types of induction?
Medical Induction: ripening of the cervix and breaking the waters.
Here are a few medication you may hear mentioned.
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Synthetic (artificial) prostaglandins to ripen your cervix.
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Dinoprostone.
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Mifepristone.
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Misoprostol.
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Oxytocin.
Medical procedures to ripen your cervix:
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Amniotomy. A small hook is used to rupture the membranes around the amniotic sac. Breaking the sac can help release prostaglandins to enable cervical ripening.
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Stripping the membranes: A hand is used to rub or separate the membranes connecting your uterus and amniotic sac. This technique releases prostaglandins and helps ripen the cervix.
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The inflated balloon or foley bulb stays in place for 24 hours and puts gentle pressure on your cervix.
Medical Induction: inducing contractions, such as Pitocin, which is a synthetic version of oxytocin, and doctors use this IV medication for labor induction.
As with any intervention you are inferring with nature and in some cases it is necessary. When you feel stuck between your intuition telling you NO and your medical team telling you that you may bring harm to yourself or your baby by refusing an intervention, the decision becomes much harder to make.
To make an informed decision, either informed consent or informed refusal, women need to know the benefits, risks and a basic understanding of the physiology of birth.
'Natural' Induction.
Is there such thing as a natural induction?
I thought yes, I had heard about Castor oil and other methods and never really questioned the term 'Natural' Induction, then I found the Indie Births podcast episode dedicated to topic.
Natural Induction, is still an induction and a rushing of the baby to come out. “Hey, I am ready, let’s go!” (As I mentioned before, in some cases necessary consideration)
Interventions like Castor oil work by aggravating your digestive system and in turn may induce labor, the risks here are that you become dehydrated, you put stress on your baby and yourself. Dr Stu had seen little success with this method.
Other methods you may consider for non medicalised cervix ripening:
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Sex.
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Nipple stimulation.
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Acupuncture.
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Acupressure.
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Transcutaneous electrical nerve stimulation (TENS).
I would love to hear your experiences and insights.
Send me a message at depthsofmotherhood@protonmail.com.
Blessings to you,
