"Explicit" Photo of Face Presentation Violated Facebook Terms of Use

Face presentation is rare, and most people won't ever see one in their lives. A mama I know recently pushed her baby out face first when she had her VBAC in the hospital. This is an amazing photo that her photographer took of the baby's face emerging. I'm in awe of mamas, babies, and birth itself. Babies can come out in all sorts of ways. The mother gave birth with an intact perineum (no stitches needed) and the baby was healthy without any problems.

If this photo offends you, I'm sorry. I don't post it to be shocking or offensive. I feel it's tastefully done and shows something simply amazing. I find it beautiful and interesting. I posted this on the Mamas and Babies facebook page and I was reported for posting an explicit or obscene photo and had to remove it or face losing my account.

Notice the baby's tongue between the lips. What an amazing shot.

From the photographer: " This picture may be shared under these conditions: no editing or cropping of any kind, please. You may repost exactly as you see it."
MamaMatters.com

Video: Frank Breech Water Birth

Warning: Full nudity!

I like this video for how it shows a frank breech vaginal birth. See how the bottom comes out first, quickly followed by the legs and feet? Notice how the time between the bottom being birthed and the head is less than eight minutes. My understanding is that it's important for the head to be birthed within about 10 minutes after the body, as head entrapment is one of the biggest concerns with breech birth.

The only thing I don't like about this video is how much the midwife touches the baby. Everything I've read about breech birth, including Michel Odent's work, has said it's best for the mother and baby to be untouched. Mom should be upright and let the baby come out. Coached pushing is not advised, as it's best to let the mother's body push the baby out naturally. I was so grateful to my midwives who simply observed my breech baby's birth, and resisted the urge to reach in and try to manipulate his body. It was a truly amazing experience for everyone there.

Photos and Description of Vaginal Breech Birth

Footling breech and the pelvic bone.

Breech is a variation of normal

Click here to see photos and descriptions of a vaginal footling breech birth.

Prevent Cesarean Surgery

Information about the risks of c-sections to both mother and baby.

Including quotes from women who have had both cesarean and vaginal birth.

Lovely Twin Home Birth Video

Twins can be born vaginally, and even at home.

Notice the second baby was born in the caul.

Twins and Triplets Born Vaginally

Twins have to be born by c-section, right?

Thank again.

Pay close attention to the sizes of the babies.  Many of the multiples shown were full term and bigger babies.

Vaginal Exams: Useful Tool or Unnecessary Intervention?

Vaginal exams are something that women have come to accept as an uncomfortable part of being pregnant and having a baby. Before the onset of labor, a care provider may put their gloved fingers into the vagina of the expectant mother to check her cervix and see if it has opened up, and how much. During labor vaginal exams are routinely used to determine how much progress a woman has made in labor.

Effacement is the thinning of the cervix, and is expressed generally as a percentage. 80% percent effaced, for example, indicates that the cervix has thinned out 80% and still has another 20% to thin out completely. Effacement can precede or accompany dilation.

Dilation or dilatation (depending on your preference of terminology) is the opening of the cervix. Generally 1 fingertip-breadth (of the provider who is checking you) equates to 1 cm of dilation, 2 fingertips equals 2 cm, and so on, all the way up to 10 centimeters (or "complete"). The provider actually sticks their fingertips into the cervical opening to check this measurement.

Many times the vaginal exam is used to guess how much longer a woman may have left before the baby will be born. Unfortunately, this is a poor indication because every woman dilates and progresses at her own pace. There are many factors that affect labor progress, and it's unrealistic to rely on cervical checks to predict the future. I believe vaginal exams are a small part of our modern world's effort to control labor, combined with the use of medications to start and speed up labor to try and fit it into our schedules and what we think labor should look like.

Vaginal exams are uncomfortable in the least, and sometimes downright painful. At times during labor the provider may want to do a vaginal exam at the height of a contraction, which makes it even more uncomfortable. From my experience, it can also interfere with the laboring woman's focus and coping techniques and make it harder for her to work through the contraction.

Vaginal exams can be harmful. Yes, you read that right. Downright dangerous. When anything is inserted into the vagina (gloved or not) it brings bacteria from the outside of the body into the birth canal. Our bodies have different types of bacteria in different places, and they're not meant to be mixed up and put in places where they aren't normally found. This can cause maternal infection and fever, particularly if the bag of waters has already ruptured.

If your has water broken (before or during labor) and you want to avoid the risk of infection, AVOID VAGINAL EXAMS.

The reason hospitals have time limits on labor (baby must be born within 12, 24, or X number of hours after rupture of membranes) is because of this risk of infection. If you avoid vaginal exams (or anything that could contaminate the birth canal) you may virtually eliminate this risk, and you can safely wait for labor to start and progress on its own.

I've covered the risk. Now let's talk about the alternatives.

How Dilated Am I? Assessing Dilation in Labor WITHOUT an Internal Exam.: This is a really good blog post outlining multiple ways of checking labor progress without an intrusive vaginal exam. These methods include closely observing outward signs from the mother including the sound of her voice, smells, irrational thinking, feeling the top of the uterus, and more. I've found it to be extremely helpful.

Checking dilation without a vaginal exam: I love this post, as it outlines very specifically how to use touch to measure the space between the top of the fundus (uterus) to the breastbone:

"During a contraction and with mom on her back, determine how many fingerbreadths of space are between the fundus [top of the uterus] and xiphoid process [the triangular tip of the breastbone] at the height of a contraction.

5 fb = no dilation

4 fb = 2 cm

3 fb = 4 cm

2 fb = 6 cm

1 fb = 8 cm

0 fb = complete"

My understanding is that it's best to use the fingerbreadths of the mother herself, but someone else can check the measurement as well.

Isn't that great?! These posts give great information that can help empower women to stay comfortable and safe in labor, and also arm them with tools to help them in the process.

Here is another article outlining The Dangers of Vaginal Exams if you want to learn more.

Breech Resources: Turning a Breech Baby

I love sharing information with the amazing mamas on my Mamas and Babies facebook page. I recently asked for some resources about breech babies, and I want to share those with you.

For information about the risks and options with breech babies, please see some of my past posts on the subject:

• Breech Presentation: Risks and Options
• Breech Baby (Breech Position or Presentation)
• C-Section Not Best for Breech Birth

Here are some other resources:

• Spinning Babies is the first resource I think of when someone asks about turning a breech baby. It's full of information and tips, and I'm honored that they have a link to my own breech birth story.
• Stand and Deliver has some really great posts about breech: The Dance of the Breech (which has amazing illustrations and descriptions of how to catch a breech baby), and International Breech Conference, Day 1 and Day 2.
• The Times Colonist has a great article about Canadian doctors no longer doing automatic c-sections for breech babies. They are, in fact, trying to teach physicians how to attend vaginal breech birth.
• Traditions in Prenatal Care has a transcript of a radio show on which they discussed breech babies and a technique called "sifting" that can be used to help turn a breech baby into a head-down presentation.
• Here's a website that has 17 ways to turn a breech baby.
• The ICPA has some information about the Webster Technique, which is a method that chiropractors can use to attempt to turn a breech baby.
• And last, if you're on facebook and want support and interaction with other moms of breech babies, you can look up Breech Birth.

Only 3-4% of babies will not turn head-down before birth. Most babies will be vertex and in the optimal position for birth. But for the small percentage who don't, we need to know how to help them, whether by turning before labor begins or in assisting with a vaginal breech birth.

If you have any additional information or resources about breech babies, please share them! I have a special place in my heart for breech babies.

The Dangers of C-section and Benefits of VBAC

I've recently come across quite a few articles and blog posts about c-sections and VBAC's, and I want to share them with you.

Dangerous delivery shows peril of multiple C-sections - This article may be a bit shocking, but I appreciate the candor about the risks of multiple c-sections. The old adage that "once a c-section, always a c-section" is not necessarily true, although many doctors and women still act like it is. The truth is that the more c-sections a woman has the more dangerous it is for her, and vaginal birth after a cesarean can be a viable option.

"The case points out a fundamental truth about surgical delivery: a first cesarean for most women leads to a cesarean with every pregnancy. And while a first section is quick, easy to perform, and rarely complicated, each repeat surgery carries greater risk."

Does Electronic Fetal Monitoring Increase the Rate of Unnecessary Cesareans? - This blog post on The Unnecesarean outlines something that I've read about in other books and articles: Electronic Fetal Monitoring is unreliable and leads to unnecessary c-sections. You know those belts and monitors that are strapped on a laboring woman in the hospital? One of those is the EFM monitor, and that's the culprit we're talking about. If you haven't heard about this risk before please, PLEASE read this post.

"There are numerous reasons that one of three U.S. births now is by cesarean, but Dr. Alex Friedman blames some on an imprecise monitor strapped to laboring women. Too often, he has sliced open a mother’s abdomen fearing the worst, only to pull out a pink, screaming bundle."

"'Everyone knows it’s a bad test,' said Friedman of the Hospital of the University of Pennsylvania. 'You haven’t done the patient a big service by doing an unnecessary surgery.'”

A Doula’s Journey to Vaginal Birth after Three C-Sections - This is a really cool post written by a doula who had a successful VBAC (Vaginal Birth After Cesarean) after 3 prior c-sections. She tells her story, her journey, and how she came to experience what she has supported other women in experiencing in her years as a doula. It's a really beautiful story

Dr. Poppy Daniels Surprise VBAC - Dr. Poppy Daniels had scheduled her third c-section and ended up with a surprise VBAC on the same day her surgery was scheduled to happen! I love her perspective as a doctor who is supportive and trusting of women's bodies to birth babies without intervention. She also explains her journey and how she came to have a beautiful surprise vaginal birth.

International Cesarean Awareness Network - For more than just anecdotal evidence, go here for VBAC information and support. ICAN has local support groups everywhere to help women meet and support each other.

Vaginal Breech Birth: A Lost Art

Here's a photo of me and my sweet breech baby.

Liam

His bottom came out first,

Then one leg came out followed by the other leg,

He kicked his legs in the water,

And the midwife said "Look, he's doing just fine!"

An arm came out next and then the other arm,

And then "he put the hands and the feet on the bum cheeks,

And pushed his head out!"*

The Dance of Breech

*as told to me by my sweet 6 year-old who, along with his 9 year-old brother watched his baby brother's birth.

VBAC Articles

Enjoy Birth blog shared these great articles about VBAC, and I thought I'd pass them along.

Rebirth of the Midwife

A Change of Delivery

Enjoy!

Thinking Out Loud Re: Breech Babies

This topic has become very important to me since giving birth to a breech baby last year, and I'd like to share some of my thoughts on the subject with anyone who cares to read.

Laws in many states require that mothers whose babies are in a breech or transverse position be under the care of a physician and give birth in the hospital. In cases in which the mother is planning a vaginal birth, this usually means a change in plans and a scheduled c-section. If the mother is planning a home birth with a midwife, this means changing her care to an OB and planning a hospital birth (again, most likely a cesarean section).

Why?

This blog post explains in detail about breech babies: Breech Presentation: Risks and Options.

There are ways to try to turn a breech baby into a favorable position before birth. My blog post above describes some of these, and there is also an excellent online resource called Spinning Babies that gives great information about breech babies and how to attempt to encourage a fetus to turn into a vertex (head-down) position. Sometimes the baby moves on its own or with help and the mother is able to plan a normal vaginal birth. Sometimes however, the baby stays breech, and the mother must seriously consider her birthing options at that point.

A recent study was done which found that the risks of c-section outweigh the risks of vaginal breech delivery: C-Section Not Best For Breech Birth. The study states that vaginal breech delivery is the preferable option of birthing breech babies, and that doctors should be trained to support women in this option.

The sad truth is that doctors are no longer trained in vaginal breech delivery. With cesarean section becoming more widely used, it has become the common method of delivering a breech baby. Unless you have an older doctor who has had experience with vaginal breech births, your doctor is likely unqualified to support you in birthing your breech baby if you want a vaginal birth. With many midwives, however, the skill of vaginal breech birth is still being taught and passed down.

The laws however, do not support the evidence. Automatic transfer of care of breech babies, in my opinion, should NOT be required. I feel the laws should allow for the care provider and the expectant parents to make an informed choice in how to birth their baby.

As explained in my blog post above, there are different types of breech presentation and some are more risky than others. For example, a full-term baby in frank breech position is the best candidate for a vaginal breech birth, and a woman with a baby in this position should be given the option of vaginal birth with a provider who is skilled to support her. This could be a midwife or a doctor, as long as he or she has the proper training, and depending on the woman's preferences and choice of birth place. If the baby is a stargazer (looking upward) there is a great risk to the spinal cord if a vaginal delivery is attempted, and experts agree that a c-section is warranted. These are just two examples of breech presentations.

Transfer of care should be a case-by-case decision based on the precise presentation of the baby. A woman should be informed of her options of attempting to turn the baby, as well as the risks and options associated with her infant's presentation and all proposed methods of birth.

This may not be a realistic expectation with current trends, but I hope that in time changes can be made. If doctors are not trained in their regular curriculum about breech birth, then perhaps additional training should be made available to those who are interested in learning and offering the service to their patients. This training should be evidence-based and consistent, and available to midwives as well. Perhaps a certificate could be given, such as with CPR and NRP (neonatal resuscitation) training. Ideally, it would be a requirement for all birth care providers, as basic as any other training they receive.

Does Elective Cesarean Surgery Improve Newborn Outcomes in Ultra-Low-Risk First-Time Moms?

"Henci Goer is an award winning medical writer and speaker. She has published two books: The Thinking Woman’s Guide to a Better Birth and Obstetric Myths Versus Research Realities (a new edition of which is in press)"

Guest Blog – Henci Goer: Does Elective Cesarean Surgery Improve Newborn Outcomes in Ultra-Low-Risk First-Time Moms?

In her guest blog post on the International Cesarean Awareness Network blog, Henci Goer scrutinizes a medical study that supports elective cesarean section.

I've read her book "The Thinking Woman's Guide to a Better Birth", and I've been very impressed with her intelligent evaluation of the modern medical maternity system. She provides sound perspective amid the confusing debates surrounding pregnancy and birth.

Position Change, McRobert Maneuver, Corrects Shoulder Dystocia

The McRober Maneuver is a position change technique which is used when a baby's shoulders are stuck behind the pubic bone. The maneuver helps free the shoulders and allow the baby to be born.