Dear Friends:
    I met a mother yesterday in a hospital, newly  delivered of her 6th baby. 
All the staff were buzzing about her birth story; she  and her husband were 
proud and angry.
    A few weeks before the due date, her baby was found  to be in a frank 
breech position. They were told that while there were two  options, a vaginal 
delivery and a cesarean section, that the recommendation was  for the surgery.
    This family went home and combed the Internet and  learned that their 
baby was in an excellent position for a vaginal birth, and as  she had a 
wonderfully proven pelvis, that was the choice they wanted. 
    They are poor in money; of African descent, and  Muslim.
    When she got to the hospital in labor, both she and  her husband were 
appalled at the way they were being treated. They felt  manipulated, coerced into 
something they didn't want, and patronized. The  husband told me that the 
hospital staff reacted to their desires and education  by turning 
confrontational, and telling them that they could be killing their  baby.This couple believes 
that membranes were ruptured deliberately to trap  them into a situation 
where they would have to have the surgery.
    So they left.
    They went to the parking lot of another hospital,  and sat there for 3 
hours, until the baby was coming out. Then they walked into  the ER, where the 
baby was delivered. Everybody is fine: mother, baby, and  dad.
    The father was angry that no one in the other  hospital attempted to meet 
them where they were, or put out an attitude of  cooperation. He was 
disturbed that his expressions of what he had learned and  what he and his wife wanted 
was met with threats, and stirring up fear. He felt  lied to; the staff at 
the other hospital told him that his baby had a 20% chance  of dying if she 
delivered vaginally. He knew that breech is 3-4% of  presentations, he knew that 
frank breech was an excellent position for a vaginal  delivery, and he knew 
that 1% of all breech deliveries have complications.
    I think they are very lucky (the baby was born with  one foot first, 
which is the riskiest type of breech, as the cord can sneak  through where  the 
butt would fill if it was a frank breech). I am  also impressed with their 
advocacy. They were strong with each other, and polite  and articulate with me.
    Breastfeeding is going perfectly; because of their  culture, she's nursed 
all her babies for over 2 years.
    After Rachel's lovely post about the breech study  in Norway, I wish they 
could have gone there.
    This fits into our thread about power and  control.
     I believe how this family was treated; I've  been witness to many such 
things in my hospital nursing work. I've seen  physicians use a vacuum during a 
precipitous delivery, and then tell the mother  that "that baby really tore 
you up." ( I was amazed that the doc had time to get  the vacuum cup on!) I've 
refused to give pitocin to a woman contracting every 2  minutes for 1 minute, 
and then had to face disciplinary action from my head  nurse for disobeying a 
physician. (I told him at the time that he could give the  pitocin himself if 
he believed she needed it. I also asked him if he wanted her  uterus to fall 
out?) I've seen physicians lie about a  monitor strip  because they wanted to 
be done with their clinical day.
    A trouble in this case is that folks don't know how  to deliver a breech 
any more. It is only the older physicians and midwives that  have had any 
experience, and there aren't enough of them around. Plus there is  this incredible 
fear of liability. Never mind that the mother is a wreck  after  a cesarean; 
the baby has been got out alive and that is all that is  important.
    I am glad that I met this couple. I will be calling  them to see how 
breastfeeding is going. As her mother is coming to stay with her  for at least a 
month, and she is very experienced, I expect it will be just  fine.
    warmly,
 
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
Maternal-Child Adjunct  Faculty Union Institute and University
Film Reviews Editor, Journal of Human  Lactation
www.breastfeedingalwaysbest.com

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