Vaginal breech birth in a birth centre

Does your hospital support vaginal breech births in the birth centre? If not, why not make 2024 to year to make this happen?

Becky Talbot  generously shares her wonderful story of this happening at The Rosie birth centre. What an incredible experience for everyone this must have been.

“I was determined to turn my baby, but he was more determined to stay breech. With the help of our Doula, Becky Talbot, I tried everything: bouncing on my ball, hunching over it while I watched TV, inversions, handstands in the pool, osteopathy, an ECV – but no luck. After the ECV, the Consultant briefly discussed our options: a planned cesarean section or vaginal breech delivery in the Delivery Unit. We scheduled a follow-up discussion with the Consultant Midwife, in ten day’s time, to finalise a plan.

I was hugely disappointed and frustrated to be in this position. Why hadn’t he turned?! I had had a straightforward vaginal delivery with my daughter, so my gut decision was for the vaginal breech delivery, but I wanted to be in the Birth Centre. I wanted a less clinical environment, with midwife led care where I could feel the most relaxed and least interrupted.

My partner and I discussed the options with Becky in preparation for our meeting. I was absolutely confident in birthing my breech baby in the Birth Centre with skilled midwives, but feared pushback because the guidelines were to be in the Delivery Unit with Consultant led care and constant monitoring.

My waters broke Friday morning, three days before our meeting with the Consultant Midwife. Becky rang The Rosie to inquire about a Birth Centre delivery while I started labouring at home. After discussions on my behalf with the Lead Midwife and Consultants to consider my history and baby’s well being – I was cleared to use the Birth Centre! They would be expecting us, under the care of one of the most experienced breech delivery midwives. I was extremely relieved and appreciative to get this news and be supported in my choices.

I laboured at home for a few hours before arriving at the Birth Centre, where everything was ready and waiting for us. A mat and birthing ball were set up in the corner, where I could labour and deliver my baby in a comfortable position for me and as recommended by the midwife. With the support of my partner, Becky and the midwife, my baby made his entrance into the world Friday afternoon – bum first! We enjoyed the golden hour and stayed the night in the Birth Centre before heading home the next morning.

My Birth Centre birthing experience was all I could have hoped for. I felt cared for, supported and safe. My birthing team approached the situation with confidence, but most importantly calmness and compassion, which helped my baby arrive without any complications or interventions. We are extremely thankful and appreciative of The Rosie team who supported our wishes to use the Birth Centre for our breech birth and hope this can be an option for other women who want to do the same.”

 

Do Breastfeeding Doctors Bedshare?

A group of researchers in the USA were interested in how many doctors bedshared with their babies, and whether this affected their breastfeeding journey. Unlike the advice of professional organisations in many countries, which tend towards positivity or neutrality thanks to up to date research showing its benefits, bedsharing is still contrary to the recommendation of the American Academy of Pediatrics (AAP).

 

77% of their group of respondees were in roles where they were responsible for the care of pregnant women and people, and/or infants. This is perhaps relevant as doctors in these roles may be more aware of the AAP’s guidance than other doctors.

 

Despite this, the doctors in the survey were still likely to bedshare, with 68% reporting “some bedsharing”. Bedsharing led to an average of 4 months longer breastfeeding duration.

 

Interestingly, 52% of the doctors did not tell their own healthcare providers that they were sharing a bed with their baby. The researchers note that this could perpetuate the stigma of bedsharing, and reduce the chance of positive discussions being had, as well as the sharing of safety information about sharing a bed with a baby.

You can read the full report here…

BASIS is a great source of evidence based bed-sharing information for parents and professionals. (Click here to go to their website)

NMC – Independent Culture Review “An institutional bully of the professions it regulates”

July 2024 saw the publication of the Independent Culture Review of the NMC by Nazir Afzal OBE. The Review is a mix of quantitive data, such as employee retention, and, crucially qualititive data – the voices of the employees of the NMC and the culture within.

 

While the Review reflected some positive aspects of working for the NMC, there were many horrific reports which included bullying, racism, sexism and people considering that supporting vulnerable people is a “weakness”.

 

Over 18% of employees said that they had witnessed “discrimination, victimisation or harassment” from panel members or NMC staff. Nearly 10% of staff reported being victims themselves of the same.

 

Fitness to Practice panel staff raised issues around ethnicity. One panel member reported being told that her Indian name was “very difficult” and did they have a shorter version. Others noted that the panels were not diverse, and raised concerns about how this may affect the outcomes of NMC registrants who were facing a FTP hearing. One damning quote says, “It now makes me laugh when I hear the value of Kind being mentioned in communications – it doesn’t feel like that it is a value that is adopted – it’s just a word bandied about that makes it sound like that kindness is an embedded value – I don’t believe it is.”

 

The Association of Radical Midwives, ARM, responded to the Report with an open letter to Wes Streeting MP, Secretary of State for Health and Social Care. You can read the letter here. In it, they say:

 

“The NMC’s lawyer-driven, adversarial, punitive, destructive, and ridiculously drawn out approach to professional discipline and regulation is not in the public interest.”

 

“The charges made against [independent midwives] often result from the NMC’s complete lack of understanding of women’s reproductive rights and autonomy.”

 

“…the NMC is a contributor to the implosion of the maternity services over recent years and the unsafe environments in which women in the UK are giving birth to their children.”

 

“An institutional bully of the profession it regulates”

 

Will the NMC take note this time and make changes from within? Will the new Government recognise its failings and intervene?

 

Some midwives are fighting back. YOU can make a difference.

 

1) Contact Wes Streeting (link here) and tell him your experiences with the NMC.

2) Join the Association of Radical Midwives (ARM) Midwives’ Haven group for support and campaign ideas. You can choose what aspects of the group you would like to join in with (contact ARM here).

 

This is a great movement for change – why not be a part of it!

Supporting Stillbirth: A Guide for Doulas

Supporting a family through stillbirth is one of the most feared roles as a birth worker, and yet almost always it happens without the opportunity for us to really have had the time to consider how we can provide the best support possible. This article aims to give you some thoughts and ideas to help you to plan for this tragic possibility. If you are in need of this article right now, I am so very sorry for what you are experiencing and for your clients’ loss.

 

The doula’s role after stillbirth

As doulas, we talk a lot about holding space, and this is never more important than after the death of a baby. In the shock of the tragedy, parents will not know what to do or what is expected of them, and a doula can make a huge difference by supporting them to take their time, and reminding them that they don’t need to rush any decisions. If hospital staff are pushing for decisions to be made, you can ask what the reason for a fast answer might be, to help to work out whether it’s medically necessary, or whether it’s something that can wait for a while. Nowadays, there is usually a trained bereavement midwife, or bereavement team, so it can be helpful to ensure that they are involved with the family’s care, if that’s what they want.

 

Practical aspects of doula care

Some ways that doulas can help are with ensuring that parents are aware of things that they are unlikely to have heard of. For instance, you can find out if the parents can access a cold cot, sometimes called a cuddle cot. These are little bassinets with an integrated cooler. In between holding their baby, parents can lay him or her in the cuddle cot, which helps to preserve their baby’s body for longer, giving them more time with their baby. Sometimes, cuddle cots can be taken home so parents can still bring their baby home for up to a few days.

 

Some mothers or birthing parents will want to stop their milk supply, if they don’t already have a child that they are breastfeeding. Others may wish to donate milk to a milk bank, but few people will know that this may be an option. It isn’t an option for everyone, so it’s worth finding out where your local milk bank is, and seeing what their donor requirements are.

 

Have a list of charities that you know can be helpful for parents. For instance, SANDS offer an excellent bereavement service. Now I Lay Me Down To Sleep is a volunteer photography service, who will come to take professional photos of stillborn babies. While there are not many in their database, they have useful information for photographers which could still be helpful for parents. Little Angel Gowns make beautiful funeral gowns and outfits for newborn babies, made from donated wedding dresses which allow babies to go to rest dressed beautifully, made by volunteers who have also sometimes experienced loss.

 

Support Yourself

Supporting families through loss will be one of the hardest things you’ll ever do. Remember that you can speak to your mentor, or contact your preferred doula group to discuss your feelings and experiences. It’s ok to share what you are going through, provided you respect the family’s privacy and any details of their birth and baby, unless you have permission. Remember the circle of grief theory (if you don’t know it, read it here) and comfort in, dump out. But make sure that you do dump out. Do seek support for yourself, and take time for yourself. It’s ok for you to grieve as well.

Local Birth Support – Yorkshire and Manchester

UK Homebirth Support Group: Visit them on Facebook

Bradford Choices is the 2nd Tuesday of the month, beginning at 7.30pm.  Join the Facebook group for more information and the venue: https://www.facebook.com/bradfordbirthchoices

Wharfedale Birth Choices Group meets in Burley in Wharfdale, on the 3rd Saturday of the month at 10:30am. Would love to see you there, and please do help us get the word out by inviting friends and colleagues to join the group. Find them on Facebook HERE

Huddersfield and Calderdale Home Birth Support Group meet every six weeks. Find them on Facebook HERE

Ilkley Positive Birth Movement Group meets on the last Sunday of the month at Midwife Amanda’s house in Ilkley.  Please contact Amanda on 07828 315622 or visit them on Facebook.

Leeds and Bradford Caesarean and VBAC Support Group. A ‘peer’ support group for women and their partners who are considering caesarean, who have had a caesarean and want to discuss their emotions relating to their experience, for women planning another baby or already pregnant and wondering about their options and choices to birth normally next time around. Click HERE to go to their Facebook Page.

Harrogate Homebirth Support Group. The Harrogate and District  Home Birth Support Group meetings are held on the third Sunday of every month 10.30am – 12 noon at the Oatlands Community Centre, Gladstone Street, Harrogate. For further details contact: harrogate@nct.org.uk .

Leeds Choices – St. Andrews Church, Horsforth. Their Facebook page is HERE.

Manchester Homebirth Group. Visit their facebook page.

Wakefield Birth Choices is now only on Facebook.

York Home Birth Support Group meets on the first Sunday of the month from 3-5pm. See Facebook HERE

Sheffield Homebirth Group – https://www.facebook.com/sheffieldhomebirth/

Hull & East Yorkshire Home Birth group – meets third Monday of the month.
https://www.facebook.com/HEYHomeBirthGroup
http://www.hulleastyorkshomebirth.org.uk/

La Leche League Groups in Yorkshire:

Having a homebirth in Leeds – information and support from your midwives. Contact the Lotus Team on  0113 392219
There are home birth and water birth information evenings, speak to staff at the LGI for information.