WTHeck??...

I was very happy to get a call from this awesome family. They were expecting their first baby. We met at the center and she did seem to be in a great labor pattern. She spent a little time getting settled in, going to the bathroom, being in the room. Her vital signs were stable and the babe sounded good. Then came time for a cervical exam. I gently eased my fingers into her vagina and easily found her cervix, which was lovely and soft, opened to 6cm. Then, it became confusing...what is this presenting part? It feels so soft...are these the sutures?..What am I feeling...then something floated into my fingers....are these fingers?....no!...this is a foot!!

I have often heard providers describe finding a breech presentation by internal exam, and they have all talked about a certain level of confusion. How you try to somehow make sense of what you are finding, and try to make it fit into being a head. That is exactly what I did in this situation. Additionally, for some reason, I had not as I usually do, done Leopold's yet on this beautiful belly. When I did do Leopold's after the exam, it was not a clear case...had I not felt that little foot, I would not have suspected.

Then came the most difficult part...telling this family that their sweet little one was breech, that she was in active labor and that her only option at this point was a cesarean section at the hospital. We all cried a bit, but then this great family was able to switch gears and quickly just focus on the fact that their babe was soon to arrive. I was in awe of their strength and grateful for their grace.

I work in a large urban setting and providers willing to do vaginal breech births are rare. We are blessed to work with one such great physician. However, he will only do "scheduled" vaginal breech births....breeches that are found during prenatal care. In these cases, we can send a family to him, he will do an evaluation and discuss all the pros and cons about vaginal breech and cesarean section, give truly informed consent and follow the family's decision. He will also offer to preform an external version, if he feels it is a safe option. We have had a couple babes born with us after he completed a successful version. Unfortunately, for this Mama, we did not discover her breech baby early enough....