On my travels, I often meet mothers (and some fathers!) who open up to me about their birth experiences. I am, of course, curious to hear about birthing practices around the world and I feel very privileged to have these intimate and personal stories shared with me. Meeting my beautiful friend Laxmi in Goa, India, was no exception…
Laxmi is mother to a 5 year old son and 3 year old daughter. She told me how grateful she feels for the hospital care she received during her pregnancies (monthly ante-natal checks) and the safe delivery of her two healthy babies by caesarean section.
Sadly, two years earlier Laxmi’s first baby died at birth. She was home alone when her labour began, after several hours her neighbours called for help… the baby was breech, by the time the doctor arrived she could not be saved. The doctor asked why she “did not call for help earlier”?
Understandably, the opportunity for hospital care and caesarean birth when Laxmi became pregnant with her next baby was the most reassuring option. The same care followed for baby number three, neither baby was presenting as breech and the option of a VBAC (Vaginal Birth After Caesarean) was not discussed.
On another continent, on the edge of one of the largest slums (informal dwellings) in Nairobi, Kenya, the FreMo Birth Centre has an almost 100% natural vaginal birth rate, including the safe delivery of breech and twin babies.
FreMo’s dedicated team of midwives and doctors offer the most caring and professional ante-natal and post-natal support, including breastfeeding education. Most of the mothers build a relationship of trust with the FreMo team during pregnancy; occasionally a labouring woman will just show up in the middle of the night and be welcomed warmly into this safe haven.
In many areas of Australia today, it would be unlikely for a mother like Laxmi, with her breech baby, to be accepted into a Homebirth Programme or even be given the option of a vaginal birth in a hospital.
Although there are successful Breech Birth Programmes in some hospitals, most obstetricians will err on the side of caution and recommend a caesarean delivery. Dr Andrew Bisitis (known as the Baby Whisperer) has been a pioneer in re-introducing natural breech birth into both the John Hunter Hospital, Newcastle and the Royal Women’s Hospital in Sydney. Here he writes about Upright Positioning in Breech Birth.
Between 3% and 4% of all babies are in breech presentation at full term. With the overall rate of caesarean in Australia now at over 32%, breech presetation is the 4th most commonly reported indication for caesarean section. For more information the Breech Birth Australia and New Zealand website is a helpful resource.
Moving forward… encouragingly, the NSW Health has accepted the surgical birth rate is too high and has pledged to reduce it to 20 per cent over five years. The State target for for successful VBAC birth is 50%, which is currently only achieved by 13% of those women hoping for a vaginal birth after caesarean.
Finding the balance in birthing, where ‘natural’ and ‘medical’ can successfully co-habit is an elusive and often difficult to grasp concept. The prescence of a Doula (Birth Support) during labour can significantly improve birth outcomes – reducing casarian rates by up to 51%, shortening the length of labour and reducing the use of forceps/vacuum deliveries (down 57%).
The longer term benefits of doula care, include improved success with breastfeeding, increased time with baby for easier bonding and reduced postpartum depression. For the new mother – increased satisfaction with her birth experience is a key element of embracing motherhood with an open and aware outlook.
As I sit here writing, the full moon in the sign of Libra (sign of Balance and Harmony) rises over the ocean, this feels like the perfect time to say a prayer for more ‘Balance in Birthing’ for women and babies all over the world!
Anna Watts is a Sacred Birth Educator, Counsellor & Healer, supporting birthing women and their families since 1990.