Where I Offer Breech Support

Massachusetts: Homebirth breech with me directly
New Hampshire: Homebirth breech available when attended with my CNM colleague
Maine: I offer breech consultation; Mercy Hospital may support vaginal breech

Have questions about your specific situation? Contact me to discuss your options.

The Basics of Vaginal Breech Birth

Q: Can I have a vaginal breech birth at home?
A: Yes, vaginal breech birth can happen safely at home under the right conditions. Many women still do! In fact, 50% of vaginally born twins will have one or more twin born breech.

With careful planning and appropriate screening, many families successfully choose homebirth for breech. It is essential to work with an experienced provider. Not all breech babies are in an ideal position to be born vaginally. There are risks that differ from other vaginal births. However, the evidence encourages supporting women who choose to birth vaginally, even when their baby is breech.

Q: How is a vaginal breech birth at home different from a hospital birth?
A: It is very much the same as any other homebirth. Oftentimes there will be an additional provider present. Breech babes tend to take a bit longer to come around immediately after birth. This is normal and common.

At home, there is less medical intervention available. Each family must assess if this is the right choice for them. A transport plan does not guarantee any particular outcome. However, the evidence shows that the vast majority of breech births go nearly as well as others.

Safety and Evidence

Q: Is there evidence that vaginal breech birth can be safe at home?
A: Yes, there is favorable evidence supporting safety when done with skilled attendants. Research by experts such as Breech Without Borders has shown positive outcomes. Planned vaginal breech births, when attended by trained professionals, can result in good outcomes for both parent and baby. While breech births can be more complex, most complications can be easily resolved at home.

Q: How does the midwife ensure the safety of a breech birth at home?
A: There are no guarantees, as with anything we do in this lifetime. However, breech-trained providers receive special education on breech maneuvers. These help bring down the baby’s arms if needed. They also help flex the baby’s head for the safest delivery possible.

The vast majority of the time these maneuvers are not necessary. Birth can proceed unhindered. Providers trained in breech watch for signs of possible necessary intervention. Signs may include a baby not performing tummy crunches, a very limp or pale cord, or arms that are up over the head.

As with any delivery, the provider watches for signs that the baby may need help breathing. This is more common with breech deliveries. Most babies do great with gentle stimulation and a moment to catch their breath.

Am I a Good Candidate?

Q: How do I know if I’m a good candidate for a vaginal breech birth?
A: Vaginal breech birth can be safe and reasonable for many women. This decision should be made based on individual factors and after an informed consultation. The ideal candidate meets certain criteria and feels confident in their decision. Be sure to take the BREECH PARENT COURSE on BWB.

Q: What factors make someone a good candidate?
A: Research suggests vaginal breech birth can be safe under specific conditions:

1. Frank breech or complete breech position
2. Estimated fetal weight between roughly 5.5 lbs and 8.8 lbs
3. A flexed head position
4. No fetal anomalies or major health issues
5. Normal maternal pelvis (potentially determined from prior vaginal delivery)
6. Gestation age between 37 and 42 weeks
7. Spontaneous start of labor with a reassuring heartrate
8. Mom and her support team feel confident and trust the process

When these criteria are met, the likelihood of a successful delivery is high. However, each pregnancy is unique. Consult with an experienced provider to weigh the risks and benefits.

Finding Support and Making Decisions

Q: Why are there so few practitioners who offer vaginal breech birth?
A: Many doctors and midwives no longer have training in vaginal breech deliveries. Some prefer cesarean sections, believing them to be safer despite research suggesting otherwise. The current healthcare environment often prioritizes efficiency over individualized care. This lack of experience has made vaginal breech delivery less common.

Q: How should I approach this decision?
A: Base your decision on careful consultation with an informed practitioner. Start by gathering information. Seek a provider who supports your choice. Discuss all options openly.

Assess your personal feelings about birth too. Some women feel strongly about experiencing labor and vaginal birth. Others may prefer a cesarean. This is a deeply personal decision with no one “right” choice. The key is having time to reflect and feel supported.

Turning Techniques and Other Options

Q: What non-invasive techniques can help with a breech baby?
A: Several techniques can encourage a breech baby to turn head-down. These include acupuncture with moxibustion, chiropractic adjustments, and certain exercises or postures. If these don’t work, you may consider an external version around 37 weeks. If unsuccessful, you can then explore vaginal breech birth.

Q: What if my baby doesn’t meet all the criteria?
A: If key criteria aren’t met, a cesarean section may be the safest option. Follow the guidance of your care provider. Make decisions based on safety for both mother and baby. In situations where criteria are met, you may still wait and see how labor progresses.

Q: Can I still have a vaginal breech birth with a willing practitioner?
A: Finding a skilled practitioner can be challenging. The number of trained professionals is decreasing. If you meet the criteria and feel informed, vaginal breech birth can be a safe option. If your practitioner is uncomfortable, seek a more experienced provider.

The key is a supportive environment where you feel confident and well-informed. Each woman’s experience is unique. Your feelings should be respected as part of the decision-making process.

What About Hospital Transfer?

Q: What if I need to transfer to the hospital during a breech birth at home?
A: While the goal is always a safe, peaceful birth at home, some situations may require transfer. Your midwife will develop a transfer plan with you well before labor begins. Everyone involved will know the steps to take should the need arise.

Breech birth requires experience and quick decision-making skills. Knowing when to seek hospital care is an important part of the process. Most planned breech births at home will not involve a hospital transport.

RESOURCES ON BREECH BIRTH

Breech Without Borders
A nonprofit dedicated to improving breech birth outcomes worldwide. They provide training, research, and resources on safe breech management. Visit their Facebook page. Providers should enroll in their classes and get their book Guide to Physiological Breech Birth.

Birthing Instincts
A wonderful podcast discussing many birth topics, including breech. They also offer the Reteach Breech Initiative. Providers can learn hands-on with Dr. Stu in a two-day workshop.

Breechbirth.net
Great breech resources from providers on the other side of the world. Check out the Infosheet on Deciding whether to Birth Breech.

The Breech Birth Handbook by Laurie A. Boucke
A comprehensive resource written by an experienced midwife. Evidence-based information and practical advice for families considering breech birth.

Spinning Babies
Focuses on optimizing fetal positioning for birth. Offers techniques for safer vaginal breech birth and turning breech babies. Order the digital Breech Birth Quick Guide.

Evidence-Based Birth
Research-based information on various birth topics, including breech. Covers the latest studies on breech delivery safety.

Midwifery Today
Articles, workshops, and online resources on breech birth safety and management. Designed for both families and midwives.

Coalition for Breech Birth – Facebook Group
Grassroots organization advocating for vaginal breech as a normal option. An interdisciplinary group welcoming parents, doctors, midwives, doulas, and all interested individuals.