By Cassidy Piney
This is the story of Cassidy Piney who had a vaginal breech birth with her second daughter in February 2021. She was lucky enough to be under the care of the only midwife in Canada who has hospital breech rights. Cassidy experienced a hands-off, upright breech birth. She hopes by sharing her story she can help others make educated decisions regarding their births.
Bailey’s birth story is far from typical, as my sweet girl was a planned vaginal breech birth. Bailey was in a frank breech position; she was folded in half with her bum down and her feet by her head. Leading up to her birth each ultrasound left me filled with panic and crying at the thought of a caesarean and knowing that my home birth plans were gone too. I spoke to my midwives about pursuing a vaginal breech birth and due to restrictions put on them by the hospitals they were unable to be my providers for that. I had a breech consultation with a local obstetrician, but he had a very medicalized view on breech and I did not foresee a successful birth with him. I did not want a medical breech extraction and I knew that there were more physiological ways to birth breech babies. I reached out to the ONLY midwife in Canada with hospital breech rights, who was working at a hospital only an hour away from me. She was teaching midwives and OBs the benefits of an upright breech birth and needed clients to show these providers an example. I switched care on a Friday when I was 38+3 weeks. I had an external cephalic version planned for the next Monday and was to meet the breech midwife and the other midwives that would be attending my birth on that day. My baby and body had other plans and I went into labour Saturday night, just over 24 hours after confirming my new birth plan with my new midwife. I truly believe that my baby and body knew it was safe to birth due to the immense sense of relief I felt at finally having a plan for a breech birth.
Saturday night I was in bed trying to sleep when I felt very light tightening on my stomach. The tightening decreased after a bit so I went back to bed and fell asleep. I woke up around 7 a.m. and the tightening was back and much stronger. At this time, they were coming closer together so we called our new midwife and she said to go to the hospital as it was over an hour drive and wintertime. My first birth progressed quickly, it was only five hours from spontaneous water breaking to meeting my baby, an only two hours in active labour, so we wanted to make sure I arrived at the hospital with time to spare.
Once I got to the hospital, I met with my new birth team for the very first time and confirmed that baby was still in a frank breech position. Surges were still very manageable and I was able to easily talk and joke through them. I didn't want to be in a hospital longer than necessary, or at all, but I was happy to be able to get to know my birth team before things got more intense. Meeting my team in labour was a very different experience to my first home birth. I had a very good relationship with my original team of midwives, they were my providers for my first baby, so I was disappointed they wouldn’t be with me for my second birth. My new team of midwives made me feel so comfortable though and went through my birth plan with me so I could express my desires before things got too intense.
Over the next couple of hours my surges slowly picked up and I was focused during them but still pretty aware between them. I spent the next couple hours labouring in many different positions off of the bed. I was moving and walking around as a way to manage the contractions. I was unable to stay still during contractions, I would walk fast during the surges and rest on a ball or my husband between them. The intensity of the surges picked up so I went in the birth tub and felt such relief. After a while I felt the desire to move again so I got out and laboured leaning on the bed and rocking through the surges instead of walking. I felt very focused and was able to use my breathing to ease the surges. My husband was providing counterpressure on my hips as I felt most of the surges in my hips.
During the transition phase I lost the focus I had and began to feel very out of control. Now I was labouring in the shower leaning over the side of the tub and onto my husbands’ arms. I got too hot and went back to the bed as I knew it was getting close to birth time. I laboured on my hands and knees with a stack of pillows under my shoulders so I could lean into them, this would be the position I birthed in. I was in full transition mode and overwhelmed with all the emotions I was feeling. Every time I would feel a surge coming, I would start crying and panicking thinking about the intensity that was about to happen. I asked my midwife to help me with my breathing and “say nice things to me” to help me regain some of the focus and control I had lost. I knew this was transition, something I never experienced with my first birth, and that things were moving along and I would meet my sweet girl soon. At no point during my birth was I afraid because of the breech component. My midwife had immense confidence that came with being one of the most experience breech providers in North America. My team was so calm and made this hospital birth feel as soothing and relaxing as they could. They completely respected my every wish and I felt comfortable at every single moment.
While on the bed, on my hands and knees, I got the urge to push and followed my body’s lead. With each surge, I roared and pushed the surge down. My water broke in a big gush and the relief was instant and for the first time in over an hour I was able to relax. I leaned forward and rested my head on the stack of pillows. I continued to get powerful surges and deeply roared through them in my own version of “breathe your baby out”. My midwives were so respectful and quiet at this time, they helped my husband get cool cloths to wipe across my back and kept their hands off me while I did my thing. My breech midwife encouraged me to feel my baby. I put my hand in my vagina and could feel her little bum, I kept my hand there for my next surge and felt her move lower until she was “Rumping” which is the frank breech version of crowning. I cupped her bum as she came lower and roared with the intense pressure and stretching I was feeling. I was rocking side to side and back and forth during and between surges. One more really strong surge brought baby down so that her folded body, from her knees to her butt was visible, her belly button and umbilical cord were also visible behind her legs. I was saying affirmations out loud and my husband was echoing them which helped me stay focused. On the rest of the surges, I gave low moans instead of roaring as I felt more in control now. On my next surge I breathed her down and while doing so baby flexed her legs away from her body trying to help stretch her way out. I was so surprised by her sudden movement I yelled out, then used all my strength and pushed as hard as I could to meet my baby. Baby kept moving but I was not having surges anymore. We waited for one to come as Baby had been born up to her umbilical cord for sometime now. My midwives were encouraging me to listen to my body and trust that my baby and body knew what to do. With verbal consent the breech midwife applied fundal pressure, where she wrapped her arms around the top of my stomach and applied downward pressure. This triggered a small surge and I put as much strength as I could into a push, groaning as I did. Baby moved down a lot and I kept pushing until her legs came out. Her head and arms were still inside me but her legs and torso up to her ribcage was hanging out of me. My baby had very low tone and poor colouring and was not doing any tummy crunches while her legs were out. The midwife tried fundal pressure again and I was able to push hard to bring baby lower. My midwives were still very calm and not treating this like an emergency like some providers would have done. They let my baby descend on her own and did not try to manually remove her, which could have caused more problems. Another round of fundal pressure was applied and that triggered a surge that brough baby low enough that her elbows were visible and they were able to sweep her arms out. My midwife then pressed baby’s shoulders back towards me which brought her head down and out. After what felt like hours of pushing, but in reality, only ten minutes had elapsed. My Bailey was here! She was passed through my legs and placed on the pillows in front of me. I rubbed her and gave her kisses but due to her tone, the cord was immediately cut and she was taken to the pediatric table in the room. The placenta was delivered minutes after baby and I had no tearing.
A pediatric team was on standby in the room as per hospital protocol. They used a mask and a bag to help her breath, and shortly after she took her first breath. A couple minutes later she was consistently breathing on her own but she was still transferred to a CPAP machine because her breathing was a little laboured. Her heart rate throughout was strong, and her colour and tone improved.
She was transferred to the NICU mostly as a precaution as she was breathing well and her APGAR was within normal now. Bailey was wrapped in a blanket and given to me to hold for a very short period of time before leaving to go to the NICU. Her daddy went with her and I got to meet her an hour and a half later. I couldn’t believe so much time had passed between her birth and me meeting her as it felt like minutes. She was taken off CPAP quickly and I was able to establish breastfeeding and finally do skin to skin. After only a couple hours she was discharged from NICU and went back to the hospital room with us.
This story may seem scary to some but I was confident in my midwives and knew that my baby would be safe. Breech babies, whether born via C-Section or vaginal birth tend to have a harder time adjusting to the outside world. I was well educated on this fact so I was prepared for this outcome and I trusted my care providers. I am still very happy with my decision to have a vaginal breech birth. Breech doesn’t have to mean surgery, it also doesn’t have to be a highly medicalized delivery. Breech is a variation of normal and you can have a calm safe breech birth.
Cassidy Piney lives in Port Hope, Ontario with her husband, her two-year-old daughter, her nine-month-old daughter and her dog, Whiskey. She holds ar Child and Youth Worker Diploma and works as an Educational Assistant. Cassidy enjoys reading and competing and training in dog sports. Cassidy is an advocate for normalizing breech birth and hopes to start her doula training soon.
More moving birth stories
Did you miss the Birth Sharing Circle? Listen to some of the 2021 finalists telling or reading their own birth stories. Also, don't miss the introduction by Karen Lawford who talks about maternity care and Indigenous communities, and the musical performance by Kim June-Johnson. A truly beautiful and moving event, all about birth!