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Entries in Vaginal Breech Birth (1)

Wednesday
Jun202012

Dead Breech Babies

Recently, I read an article about Ina May Gaskin entitled “Mommy Wars: The Prequel - Ina May Gaskin’s and the Battle for Home Births.” In the very long piece, Ina May speaks about breech babies, saying in part:

 “’Footling breeches, which are thought to be the most difficult, in our experience, they often just slid right out.’

Now, I have a huge issue with her saying this in print at all because footling breech babies are the highest of high risk breech babies and out of the hands of someone as skilled as Ina May, the birth can also be a death. Granted, she wasn’t saying it to the reporter, but to a breech class at The Farm, but it’s out there, nevertheless. And she’s teaching this to women in a weekend seminar? C’mon.

Ina May continues:

“‘The main danger with breech babies is that the head, the largest part of baby, is last to come out, so it may get stuck,’ she told the students. ‘If the baby has been delivered to the umbilicus, you have five or six minutes before hypoxia sets in, but you don’t want to pull on the head if you can’t see the neck for fear of injuring the baby,’ Gaskin said.

 Sounds a little more than the baby “sliding right out,” doesn’t it? sigh

There is the belief (true, from what I’ve seen) that midwifery care creates a level of connection so intimate that if things go wrong in birth, the midwife is rarely blamed by the parents. In fact, even when the District Attorney or Medical Examiner takes up prosecuting the midwife, it’s extremely rare to have the parents speak out against her. Instead, parents often become the most vocal of supporters. To this end, the article says:

“Farm midwives give intimate intensive prenatal care and have a high degree of trust with their patients. That’s why, Gaskin said, in 2006 when a breech baby she delivered became temporarily stuck and suffered permanent neurological problems, the parents did not sue. ‘We thoroughly discussed the issues, and they didn’t see a reason to be punishing,’ Gaskin told me.

That’s one damaged breech baby born.

The newspaper piece continues:

“When I visited the Farm, Gaskin was planning to travel to testify at the trial of a C.P.M., Karen Carr, who delivered a breech baby in a home in Virginia who died.”

That’s one dead breech baby.

Karen Carr, a midwife “pleaded guilty to two felony charges in an infant death that she attended during a home delivery in Virginia last September. The state of Virginia argued that Carr was negligent during the home birth after the baby's head became entrapped for more than 20 minutes during the delivery. The baby died two days later.”

Lisa Barrett is another midwife who has lost a breech baby. (I’m struggling to use the word “lost” because I feel she was more actively responsible, not a passive bystander.) Jahli Jean Hobbs died in April 2009.

Two dead breech babies

In April 2004, the first twin of Elizabeth Hammill (in the UK) delivered breech and got stuck, the parents refusing to allow the three midwives required to attend to do anything, believing only an unassisted birth was a true natural birth. (“Home birth baby died after mother told midwives not to interfere”) Even when the mother was counseled two weeks before the birth about the risks of delivering a vaginal breech birth, the family said they wanted the unassisted (but observed) birth anyway. Then, after the death, the mother had the gall to say no one told her of the “gravity” of the situation. Makes me cringe, her backpedaling on her initial beliefs. (I do believe some women aren’t told the risks clearly enough, but it sounds like this mom was so freakin’ married to natural birth that nothing less than unassisted was going to do for them. Who knows if the baby might have lived if the midwives were able to assist at the birth. Possibly, that’s for sure.) The woman’s twin was delivered via (emergency) cesarean at the hospital. Alive.

Three dead breech babies.

Two babies died at home after the mother tried to be birth them breech. (“The tragic dangers of home birth – ‘A senior coroner has urged a change in the guidelines for midwives on home births after two breech babies died.’”)

Phoebe was born at home in January 2002, her midwife “suspecting” the baby was breech; the mother saying she accepted the risk of delivering at home. While the birth had a challenge with the head, the baby delivered and was resuscitated. She seemed fine, but two days later, died from an adrenal hemorrhage caused by lack of oxygen at birth.

Four and five dead breech babies.

Christopher was born in July 2002 and seems to have been a surprise breech whose head got stuck and the baby died an hour after the birth.

Six dead breech babies.

In March 2012, Sara Snyder’s baby Magnus died 13 days after birth, attempted breech birth at Greenhouse Birth Center in Okemos, Michigan.

Seven dead breech babies.

And this is just searching “dead breech babies” on Google. How many more stories are out there we don’t even know about.

I’m writing about this because it isn’t a subject spoken about very often. Instead, breeches are considered “a variation on the norm” of pregnancies and labors. On the contrary, 3 to 5 percent of babies present breech at birth. That is hardly a variation of normal. That would almost be considered “not very common.” I think that until the very real risks of breech births are talked about, women who choose to birth one out of the hospital isn’t receiving true informed consent. Romanticizing and simplifying these types of births… as Ina May seems to do in her breech workshops (just reading what was in that original article at the beginning)… does an enormous disservice to women needing the most information before making their decisions.

I initially began this post after reading the article about Ina May because in that piece, she mentioned one damaged breech baby and one dead breech baby all while touting their ease of delivery. I can’t recall an article that talked about birth while including a mention of a stillbirth because they are so incredibly rare. It seems, from reading the press alone, that breech deaths are not that uncommon at all.

Think, oh women with a breech baby, before coming to the conclusion that it’s fine to deliver your baby at home or in the birth center. I’m aware the options aren’t fabulous for a vaginal birth in the hospital, but is the life of your baby worth the risk just not to have a cesarean? Please be sure of your decisions. I once thought I would want to deliver my breech baby at home. Now that I know better, I would have a cesarean without hesitation. You have to make your own choice, but you also have to live with it. And I don’t think anyone can say “I didn’t know any better!” anymore. Now you know.