Mary-Anne Healey has had four babies. All were in the breech position, and all were born vaginally.
The Victorian mum is concerned by news that the state’s only specialist breech clinic, at the Royal Women’s Hospital, is being closed.
According to a report in The Age yesterday, women who have visited the hospital recently with a baby in the breech position have been told that the hospital no longer does planned vaginal breech births
“I’m not against caesars,” Healey tells Mamamia. “If it has to happen, it has to happen. It’s just that sometimes you have to deliver the baby, and the staff need to be prepared.”
Healey has been diagnosed as having a double uterus. Her obstetrician told her that there was no way for her to carry her babies other than breech.
“They actually stood up. They had no other choice. They didn’t have any room to turn.”
Healey’s first baby was born 35 years ago. The little girl was stillborn. An autopsy found she had died long before the birth. “Her being stillborn had nothing to do with the way she was born,” Healey points out.
She then had two babies born prematurely. Her son was very premature.
“He was eight weeks early. I went to the hospital and he was born in under 15 minutes. They wouldn’t have had time to do a caesar. If they hadn’t known what they were doing, I would have had a second death.
“I was lucky I had a doctor that knew what he was doing.”
Healey says her breech births weren’t a bad experience. “By the time I had the fourth one, it just felt natural. I’ve never done it any other way.”
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Between three and four per cent of single foetuses are in the breech position – bottom or feet down, rather than head down – beyond 37 weeks.
The attitude to women giving birth vaginally when their babies were breech changed following the release of a study in 2000. That study, the Term Breech Trial, reported that 1.3 per cent of breech babies born via planned vaginal birth died, but only 0.3 per cent of breech babies born via planned caesarean birth died. The study also reported that the babies born vaginally had a higher rate of disability and significant damage.
The number of breech babies born vaginally dropped dramatically after the study was released.
But Brisbane obstetrician Dr Will Milford says the study was “flawed”.
“There are some fairly extensive critiques of that study available online,” he tells Mamamia.
Dr Milford still delivers some breech babies vaginally. He informs mothers-to-be about the risks and benefits of each type of delivery, then lets them make the choice.
“I’m a big advocate for not making decisions for my patients,” he says.
After talking to Dr Milford, most women choose a caesarean delivery. There’s also the option of trying to turn the baby before the birth, known as external cephalic version. This has a success rate of around 50 or 60 per cent.
But a small number of Dr Milford’s patients – one or two a year – still choose to deliver vaginally when their baby is in the breech position.
“One of the ones I did most recently was a lady that was having her sixth baby, and it was breech,” he remembers. “She’d had all vaginal deliveries of head-down babies before. She had a vaginal delivery and it all went fine. She was a good candidate to have that.”
Dr Milford understands the current situation with breech births in Victoria. But he points out that if hospital staff don’t do breech vaginal births, they will lose their expertise.
“There are situations where a breech vaginal birth is unavoidable,” he adds.
Have you had a vaginal breech birth? How would you have felt knowing your only option might have been a caesarean?