Monday, February 09, 2009

Breech, Breech Baby

There is so much great stuff going on to write about – I mean, I don’t know whether it’s that great to read about – but this has been a week of implementation of a lot of interesting tactics because we found out on Monday (I started this post on Jan 9th) that the baby is breech.

Lots of people don’t know that much about their own births. Because my mom has always told me the story of my birth on my birthday – with great warmth and fondness, no less, bless her, I have always known a few key things about mine.

1. I was huge -- 2 oz shy of 10 lbs. This, owing to the fact that
2. I was three weeks late, which they would never let happen today, especially if
3. A baby is breech, or with its head up rather than down, which I was.

So. I’ve always viewed my mother as sort of a superhero for various reasons, but when I think about these facts, especially. And I’ve always been sort of proud of the breech detail – in the same sort of way that I like that I am left-handed.

However.

The obstetrician confirmed the other day that the large round place which, depending on the moment, is either nesting comfortably near or chipping painfully up against the ribs on my right hand side – the spot that if I scratch it, lightly, produces a referred flutter of movement low, low in my pelvis – was a head. My sister had been speculating that it was a bottom up there, and that when I scratched it, I got punches in my lower abdomen. But it’s a head rather than a bottom, which is the other big round hard sticky outy part that babies have got.

That means that the head is up, which means that the baby is not head down. These days, being head down is a pre-requisite for being born through the most obvious exit.

(Obstetricians used to be trained to deliver breech babies, but that is no longer standard practice – these days, if a baby is head down at the time when a mom-to-be goes into a labor or need to be induced, the solution is a c-section.)

I was told that one way to deal is to see an expert in turning at the hospital. Apparently, just as they sent us to St. Luke’s Roosevelt Hospital to see a specialist in doing amniocenteses, they have a special who does something called a “versioning,” which basically means that this person is specially trained to manipulate the position of a baby inside of a person from outside of the person’s stomach. By pushing. It's generally done at 37 weeks, and may or may not include its own epidural: it doesn't feel good. It can result in placental tears, and emergency Caesarian section, and bruising to the mother, and I would think, discomfort for the baby.

I asked whether there was anything I could do to try to change the position of the baby.

There are three obstetricians in our practice and the 3 docs within have very different modes of operating. Counter to the way I often fee, I like and trust all of them but the one I was with that day is clearly the least amenable to say, woowoo practices, like the hiring of a doula. He told me: “WELL. If I were a midwife – which I am clearly not – I might tell you to get your hips up off of the ground several times a day to let the baby turn. Other people recommend acupuncture. I’ve never seen any of these things work. But these are the things that people try.”

The versioning sounded frankly terrible, so I decided to pull out all of the stops to avoid it. Below, I will detail the hocus pocus we tried to move the baby. And tune in at the bottom to see whether or not it worked!!

THE HOCUS POCUS

MUSIC DOWN THE PANTS

This is the most obvious and easy-to-try-at-home trick: put headphones low, low, low on your belly and wait for the baby to dance down to listen. They definitely do react to music even while still inside – for months this one been expressing opinions about swingtime music, the song Back in the USSR, anything with a blastpunch of happy horns. The problem is that you never know whether the kicking and punching means “more!” or if it means “the outside must be scary. why would you put me through this?” I always prefer to think, “more!,” but the things I listed are all things that I love.

ACUPUNCTURE

I contacted Laurel, an acupuncturist I’ve seen before for help with nausea (and out and out vomiting) in the first trimester. She told me to come on in. She did some points in my feet and elsewhere to help with reflux, but also, burned "moxibustion" sticks near points on my toes to try to encourage turning. Lots and lots of people had recommended this Chinese medicine therapy. I’d heard about Chinese medicine you can put on your toes to make a baby turn and this is the stuff.

Moxibustion sticks are like incense sticks but not as stinky. She burned a few in her office, then she gave me a bunch to take home. At night, M would have me sit in my glider and put my feet on the ottoman and he’d burn it near the "spleen points" on my smallest toes and try get them hot but not burned. And inside I could feel Baby start to flounce and scrabble. And outside I could watch M’s eyes water, not from emotion: from smoke.

The doctors had told us that the baby was really pretty big – possibly too big to turn again, so we didn’t know if it was in vain, but we tried this for several evenings, in conjunction with . . .


YOGA

Laying on your back when pregnant isn’t pleasant –unless you have a thing for being smothered by your own outsize organs. (I would like to say something about my uterus: at one point, I swallowed my pride and asked one of the obstetricians whether it was possible that it had actually expanded to the degree that a portion have climbed to the outside of my ribs. He said, "uh, no." But the head was RIGHT THERE, so that is to give you an idea of the size.) And laying on the back is bad for circulation, so it’s bad for baby, but like many things about pregnancy – like nutrition – the mother’s health gets compromised first. Ie, a pregnant person would puke or pass out before anything happened to the baby. But my yoga friend / teacher Marisa came over with a bunch of information and some hilarious props and we did a supported bridge – an arching pose we’ve avoided during pregnancy except for in this situation. But she’d checked it out and it was the solution, plus she was monitoring me and the OB had basically mentioned it. And it's not dissimilar from the old “propping the ironing board up on the couch and laying with your head down and feet up” that people recommend for turning breech babies.

Anyhow we tried this after some chanting of things to activate certain chakras and also, playing a little gong she brought over. It was great. There we were, pulling out all of the stops! The supported bridge made me immediately clammy and nauseous, though, and I had to roll off and we put me into the supported chauvasana that makes me nap and snore and smile. In contrast to the supported bridge, it is pretty much the most comfortable I pretty much ever get during pregnancy. This is not a picture of me but it shows you the position. If you are pregnant and can’t get comfortable, I recommend a yoga session ending with this!

HEADSTANDS IN THE POOL

This is another thing that was highly recommended by many people as helping out with flipping a baby, with no real logic provided, but it’s hard not to try to think about the logic, and this is all I can come up with: “well, if I am a baby who likes my head up, and my nest gets upended, I will not know, being a baby and stuck in a cocoon of goo, but will be conscious enough to claw my way around to have my head up, which is actually down.”

Huh.

We went over to the Chinatown YMCA. I wasn’t big enough to need a maternity suit last summer, and just never got one, and couldn’t find one to borrow, so putting together the swimming outfit was going to be a challenge.

I ended up with a bikini top I have that ties rather than clasps, some boy shorts which are my normal bottoms but worn a little lower, and a t-shirt over it. We don’t, though, have a full length mirror in our house, so seeing my, uh, splendorous body in the mirror at the Y was really something! I think that I gasped. Everyone at the pool was very tolerant and tried not to stare.

Anyhow, I did a few laps then some headstands, but water does not negate heartburn in the way that it negates weight, and so as the acid started to sizzle my eyes, it was pretty quickly time to get out of there.

If the towels at the Y wrap around you, consider yourself lucky! Well, normal, but I certainly missed that feeling.

CHIROPRACTOR (The Webster Technique)

Rather than in needles, the acupuncturist seemed to put most of her baby-flipping faith in moxibustion and in something called the Webster Technique, which is a thing that chiropractors do with ligaments connected to your hips to ensure that a breech baby has enough space to get head down. The acupuncturist actually shares space with a chiropractor but suggested I go to a specialist in Park Slope.

For some reason, I have always been suspicious of chiropractic endeavors though I am, if not the first, definitely not last in line to sign up for other hocus pocus. But I’ve had the experience with some acupuncturists and it has been my impression of chiropractors that what they REALLY want to do is get you to commit to going twice a week for the rest of your life. So you can pay them a lot? And to do this, they ask just a few targeted questions before telling you that your life is going to hell in a handbasket.

But I trust the acupuncturist I see now and wanted to give this a try, so I called and set up an appointment with the chiropractor. I was told it would take alternating sessions – regular adjustment, then Webster Technique, regular, then, etc. I made an appointment for the next day.

My jury remains on whether chiropractic stuff is brilliant or bullshit. I met the woman, she looked at my posture, I got on her table belly down on a maternity-style pillow with a stomach cut out, I felt horrible in that position but she told me it wouldn’t take long.

First, she touched my back for a second. Like you’d expect a chiropractor too, right? Right before they started crunching you and twisting you around? But then she quickly moved her hands down and got to business in my, uh, butt crack. Or gluteal cleavage, as they say in the bodywork business. This part of me was wholly clothed in corduroy pants, but I can’t describe what she did to me in any better terms than . . . slowly stroking up and down my butt crack. Sorry – ahem. Gluteal cleavage. She did, to her credit, briefly acknowledge that it was an unusual place to pet me. Then she would do a rapid hand movement that felt like nothing more or nothing less than she was picking up and flicking away a piece of lint.

From my butt crack.

In order to turn my baby.

There was no crunching, twisting, aligning. It was just energy work. When I left I called my husband, who expressed concern that I was getting all sorts of things done that he figured might harm an otherwise healthy baby. A valid concern, but I tried to explain to him that she just lightly stroked my buttcrack and then picked lint off of me. I cannot remember whether or not I mentioned the fact that it cost $175. But he asked me to PLEASE call the obstetrician to get this okayed. This time, I got a different of the 3 docs on the phone, who said that as long as she didn’t manipulate my belly, it was ok with them.

I saw the chiropractor again the next day when she did the actual Webster Technique. This time I had to lay on my back (also very uncomfortable) but she stuck her finger into my -- sort of in between my abdomen and my hip crease. On my right side. For a matter of seconds. Then she released it and sent me home.

I was ready to never go back. And I didn’t.

WHAT NOW?

The baby still had a hard round spot crammed up under my right ribs and I thought we had failed. It was time to go back to the obstetrician, but I wasn't that interested in the versioning. I wholly expected the obstetricians to try to talk me into it, but it was just the opposite. The one I saw for my next appointment said he’d schedule if it I like, but he also told me that in my situation he’d never opt for it.

I was glad to hear this – because one thing I’d learned through all of the breech madness is that my MOTHER had experienced a versioning on the day I was born.

She went into labor at 43 weeks and when the dr. poked around and determined that I was still breech, he called in a very large nurse.

Now, my father had asked to be present at the birth – unusual for that time period. And he hadn’t seen my sister be born 5 years previous, so when he saw a gigantic, Brunhilda-ish nurse climb on top of the table where my mother lay, and straddle her, begin to push on the bump, he figured that this was a part of all births. (No one had mentioned to him that I was breech.) Because of my mom's experience, I should at least be willing to try it if it was recommended. I apparently was squooshed into a better launch position and born vertex -- ie, head down. I thought that both she and the OBs would figure I should try it.

As it turns out, my mom's scenario with me went as good as it could have. Versionings are now done at 37 weeks, which is an acceptable time to be born, but not an ideal one.

If the baby wanted to or could turn, I thought, it would. I wasn't sure about forcing it. I talked with my mom, who absolutely agreed. And then, the obstetrician I saw that day decided to put a c-section on the calendar for 39 weeks. C-sections are things that typically make women feel bad. Bad in a way because someone slices through their tummy muscles -- but more than that -- emotionally put through the ringer. People feel like failures because of something that I actually feel we should be happy was invented -- it's a procedure that keeps death from childbirth at a FAR lower rate that used to be. It is not what I had pictured, but I had talked myself into the fact that if I needed a c-section, then that would be okay. I sort of refuse to be a woman who feels bad about something that I can't help.

But then he did a sonogram, and alas, baby was head down!

Not to switch gears so fast, but it wouldn’t stay that way, of course. Big baby, schmig baby. It swam around and about for the next several weeks. Now I am at 39 weeks and as of last appointment, was head down, so I did not go through with the scheduled c-section, which would have been on Friday.

There have been other excitements in the pregnancy, which will come in the next post. But as for breech, I will check in again at the OB in a few hours and we will see!