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Born Breech: The Birth of Benedict Raphael

Time for another of my own birth stories because this baby somehow turns seven tomorrow! Benedict is my fifth son on earth and the one with the craziest birth. I want to give a warning of sorts that this is not a typical birth or situation, although it likely could have been. It ended up being a transfer from home to hospital so if that type of story isn't helpful for you right now, no need to read! While the overall outcome was good, looking back with what I have since learned about breech babies, I would have made different decisions.

The Lead Up

My Benedict Raphael was the most different of my five full term pregnancies, the most different of my births. The whole pregnancy something felt just…different. I couldn’t put my finger on exactly what it was but I certainly battled a lot of fear of the birth and the pregnancy itself was harder than my others. More sickness, more fatigue, more swelling, more weight gain, way more emotions. While I felt the similar readiness at the end to be done being pregnant, it was coupled with a fear of what adding another baby to the family would mean as well as the knowledge that there was no way out of the pregnancy than through birth. And some part deep down inside of me knew that this birth would be different. I didn’t know what that meant so I just planned as best I could for a normal home birth.

All four older babies were born in the 39th week and while I was so ready to end pregnancy, the weekend I reached 39 weeks, I went to bed praying that labor wouldn’t start. It had been an absolutely crazy weekend filled with a family party, baseball games, and notice that we had to go pick up our two new hives of bees. I knew there was no way I’d be able to give birth in the exhausted state that I was in, weary to the core and not getting to bed until almost midnight. Thankfully, labor didn’t begin that weekend nor in the few days after. But his head was definitely down low and engaged. We were both physically ready and it would be soon.

A few days later around dinner time I felt him shift a bit and I could tell he had moved but it simply felt like he was just a little crooked. It didn't feel good but I wasn’t worried since after a few babies, it becomes more likely that baby doesn’t engage until right at labor. It now felt like his head was in my lower left side of my pelvis and his bottom was diagonal to the top right underneath my ribs. I figured he would settle back into place soon and smoothly. It became extremely uncomfortable and forced me on the couch for most of that evening.

The next day I had a late afternoon appointment with my midwife and mentioned how uncomfortable I was and how he had shifted. I hadn't been sleeping well anyway, the night before even more so, and I was beyond exhausted. As she checked his position, it became increasingly clear from his heartbeat, her palpating, and from where I was now feeling movement that he had flipped breech. I don’t think it hit me when she first said it. I didn't have the emotional or mental energy to grasp it and it felt much like a dream. This would somehow figure itself out…and besides, maybe we were just making a mistake and he was totally fine. I left with an appointment first thing next morning with a Webster chiropractor, some discussion of getting an ultrasound to verify his position, a plan to work that night with exercises to help flip him back, and the brief mention of a cesarean section.

My friend Lori (also a doula and my midwife’s assistant) came over that evening and we did a round of exercises and positions to try to help turn him back head down. Hanging upside down from the couch, laying on the dining room table, all sorts of floor exercises. I didn’t feel much. Brian mentioned as I laid on the dining room table and was questioning everything and especially wondering why a previously engaged and head down baby would turn so last minute that maybe there was a good reason he had turned. Just maybe he had to unwrap himself from a funny cord or for some unknown reason he had to be in this position to get out. I wasn’t as positive but it did help a bit to think of things this way and trust in the process.

I felt a lot of pain that night and barely slept. I was having prodromal contractions but it wasn’t normal labor, more like my body trying to move him into correct position. I tried doing more positioning and I listened to the Hypnobabies “Turn Your Breech Baby” soundtrack. I finally slept for a few hours around dawn and woke up feeling more normal. In fact, it almost felt like he was in a better position! I was slightly hopeful that even though I hadn’t felt a big turn, that maybe by the grace of God, he had turned on his own. I waddled on downstairs around 6:30 feeling a growing sense of hope that things were fine and he’d be born that day. I went to the bathroom and had some bloody show. My hopes surged that the baby was now back in place, that it had all just been a small bump in the road, and I would be birthing him soon.

I called my midwife to let her know what was going on and wondering if I should still go to the chiropractor appointment that was scheduled in an hour. She said she would stop by to check what was going on. She arrived to our house soon after and to my disappointment my hopes were unfounded. He was still breech. She performed a vaginal check and didn’t feel any dilation. That was really hard to hear but at this point, things all just felt so surreal and I almost felt like I was on auto pilot.

Brian decided that he would take off from work because of the uncertainty of what was going on and we headed out to the appointment. On the way there we prayed a Rosary. The appointment was with a Webster chiropractor but I was surprised and a bit disappointed that she didn’t do anything different than she did at normal appointments. Not sure what I was expecting but was hoping she’d have some fancy moves to help baby flip. Fifteen minutes or so and it was over and we left to go back home to a sort of limbo mode.

I can’t say even now what my state of mind was during all this and for the majority of this day. It was part surreal, part exhaustion, part robot-mode. Brian took care of the boys while I spent hours alternately resting and trying to get the baby to turn. As the boys played and laid mulch with Brian, I did more of the positioning exercises, took a bath (while contorting myself into all sorts of strange positions), listened again to the Hypnobabies audio, prayed, rocked on the birth ball, put ice and peppermint high on my belly to try to motivate him to turn, and even manually tried moving him myself (he would only move the tiniest bit but then wouldn’t budge past a certain spot). I made an appointment for the next morning at an acupuncturist. I emailed a couple friends asking for prayers. My appetite was nonexistent and I barely ate. In the early afternoon I realized that no matter what happened, I probably wouldn’t have the chance to do some of the birth things that I had planned. If baby did turn, I felt it was going to be fast and furious. If he didn’t, I knew she would recommend the hospital. It was just a matter of when. So I decided to take out a puzzle I had made and did it while sitting on the birth ball or doing my different positions. I listened to Marian Grace, the music I wanted to have with me during birth. I began to pray for all the intentions on my list. The day was so emotional and utterly draining. I left a message that afternoon for my midwife that nothing had changed.

The Birth

A short while later, at 6:13 p.m. to be exact, my midwife called and said she wanted to come over to talk about options. My stomach sank and I could tell from the sound of her voice that she was going to recommend we go to the hospital. A vaginal delivery is certainly possible for a frank (bottom first) or footling (feet first) breech. In fact, in Canada, they now recommend a vaginal birth over cesarean and are requiring that obstetricians be once again trained in safe and healthy breech birth as preferred to an automatic surgery. Unfortunately here in the United States, most providers are not trained at all to handle a breech vaginal birth and the skill has been mostly lost, making cesarean birth the default option. How I wish I had known more about breech. How I wish I had more confidence that my body and baby knew what to do. It's hard to think about now, honestly. I really wish I could go back and make different decisions than I did.

Several minutes after getting off the phone with her, I suddenly began to shake and felt extremely cold, a trembling shake that you can’t stop. At first I thought it was my nerves knowing that it was almost inevitable that we’d be going to the hospital soon. That sometimes happens to me when I get nervous. But then a contraction hit…a crazy hard stuff-is-getting-real one, the kind that drop you to the floor. And I knew instantly that it wasn’t nerves at all but transition. This baby was coming and very soon.

I had two or three more of those crazy contractions before she got there and when she did I was having another on the toilet. You know things are getting real when you no longer care and invite someone right in to the bathroom as you’re sitting there! One look at me and she could tell what was happening. As she sat on the bathroom floor, she checked his heartbeat (it was perfect) and asked which hospital I preferred. I don't remember if she gave the option of just staying home. I wish she had, even if it wasn't what she would have recommended. I wish I had had the knowledge and confidence to just stay home.

I told her which hospital I would rather go to and asked if Lori could come. She called Lori who then called our friend who is an obstetrician. While she wasn’t available to come in, she did say she would phone Dr. P., the head of obstetrics at the hospital, part of the same practice, and a family acquaintance and ask if he would come in. He agreed. She told Lori that they could try an external version (the manual turning of the baby) and if it worked, that I could then go home to have the baby. I don’t think she realized how close I was…if baby did turn, there was NO way I was going to be able to go anywhere and he'd be coming quickly but I still appreciated that consideration.

Lori headed over to meet us and Brian called my mom to come over to watch the boys. In the meantime, I somewhat randomly wandered around the house trying to figure out just what the heck I was supposed to bring to the hospital, still in that surreal state I'd been in all day. Brian grabbed some extra clothes while I made sure we had phones, my crucifix, a few of my prayer cards, the camera, and I had brushed my teeth. I can’t even remember what other random things I threw in that bag. I said goodbye to the boys and that was one of the hardest parts of the whole day. I knew how much they wanted to be at the birth and now it wasn’t going to happen while I also made sure they weren’t scared (they weren’t). They said they would pray. Lori and my mom got there around the same time a few minutes later. I don’t remember much from those few minutes except Lori saying, “right now, every step you make has to be towards the car.” I remember as we walked outside getting the reminder that if my water did break, I needed to get on my hands and knees with my head down and bottom as high in the air as possible to avoid a possible cord prolapse, a risk with a truly footling breech baby.

I want to stop here and say that at this point it was never confirmed exactly how baby was lying at the time of birth. Because he ended up coming out feet first, I was told he was footling breech but I've since learned that a true full term footling is almost unheard of with a full term baby (think of a baby standing up with feet at your cervix, there just isn't room). What is much more common is a frank breech baby with a foot presenting. This means bottom low near the cervix but baby's knees are bent so feet are coming first. A footling breech leaves room for a possible cord coming out first which can be dangerous, a frank breech does not.

Regardless, at the time I was told and we were acting like this was a footling breech situation. I think that’s when the potential seriousness of the situation hit me. This birth was happening and it was happening very differently than it ever had before. We decided to take Brian’s truck since I could have the whole backseat and the van is filled with car seats. He threw a blanket down, Lori got in the backseat with me, my midwife followed us in her car, and we headed out. I think I had a contraction on the way and then about half way there another one hit, and then I felt the pop. My water broke.

At that moment, the amount of peace that flooded me was palpable. At what could have been a scary moment, I just felt peace that no matter how things played out, it was as it was supposed to be. I wasn’t afraid and I felt completely present to the moment, differently and with more clarity than I had felt in the last few days. I told Lori and right away I got on my hands and knees on the back seat of the truck, head laying on the seat, as she helped me out of shoes and pants and checked for a cord. None. She called my midwife who was right behind us and gave the status and who then called ahead to the hospital so they could have a stretcher ready at the entrance. Through all of this, Brian drove fast but didn’t at all panic.

We pulled up to the hospital doors a few minutes later and there was a stretcher and a few people waiting. Khristeena came to the truck and checked me to again make sure there was no cord (still none) and said she could feel a foot. She checked his heartbeat and again, it was perfect. He was healthy and constant during the whole birth. I was told I needed to back out of the truck on hands and knees and climb onto the stretcher which was quite…amusing? Fluid leaking, people watching…I climbed onto the stretcher and looked up at all the faces (while still on my knees with head low) and said hello to everyone. They thankfully covered me completely with a sheet while wheeling me down the halls. I remember tracing and following the path to labor and delivery, a path I had walked myself many times before for doula clients, while I kept my head down and peeked at the rolling wheels of the stretcher. I heard my midwife giving all the stats and information that they needed. When we got near the operating room, I looked up to see them holding Brian back which panicked me for a moment and I asked if he was coming in. The nurse reassured me that he was, he just needed to get the surgical gear on. My midwife also was able to come right into the room with me as well which was such a huge blessing. I wish Lori could have come in, too.

A lot of things began to happen at this point in the space of a few minutes. I remember an I.V. going in and asking what was in it. I remember the resident in the room checking me (I wish he hadn’t.) I remember asking if I had to get antibiotics. I think people thought I was in denial about what was going on or was even being stubborn or idealistic or something with some of my comments and questions, but I was completely aware and at peace with what was happening, enough to be able to not be freaking out and to ask what was happening and why they had to do certain things. I remember someone telling me my scapular was beautiful and asking me where I got it. I remember them saying they were giving me terbutaline to stop the contractions. I remember Brian pressing a rosary into my hand. I remember my very first ever catheter going in (OUCH). I remember thinking about all the intentions I had been given for this birth. I remember them telling me I had to flip over and get on the operating table and me laughing. (I still can’t get over how they call that thing a table! It’s like two inches wide.) Somehow I managed to flip over and do it despite me thinking they were obviously joking. I remember the anesthesiologist asking me questions about when I had eaten. I remember saying I did not want to have my arms strapped down (that freaks me out). I remember my midwife walking me through what they were going to do. I remember how ridiculously cold the room was. I remember looking up while on my back and seeing a whole slew of people staring at me. (Weird.) I remember the obstetrician on call getting in. Dr. S...I didn’t recognize her.

My midwife told me later that when Dr. S. came in she asked if I knew I was getting a cesarean and she replied that I did. The doctor said she was going to do another check to see how dilated I was. She did and then, I think to everyone’s shock, she pulled out a foot. Then she reached in and pulled out another. Suddenly, I was being told to push.

I don’t think I’ve ever pushed as hard in my life. No contractions, no urge, flat on my back. Exactly how you aren’t supposed to push a baby out and pretty much the hardest way to do it. Nurses were pushing my knees back by my face and I pushed. I felt a bottom come out and with the next push the shoulders and arms. With my other babies, once the head was out, the rest sort of slipped out…this time I was going easiest to hardest. But I pushed with everything in me and I did it, his head was born! He (another he!) was born! I remember my midwife saying his apgars were 9, 9 (perfect) and her telling them to hand him right to me. And they did, thank God. He was brought right up to me and I took him while doing the post-labor uncontrollable shaking and overhearing the neonatologist someone had called in berating her for not giving him the baby. She was totally respectful and professional but completely assertive. The baby was fine and there was no need for him to intervene in any way so he stayed with me. There was a feeling of awe in the room. Most all the doctors and nurses in that room had never seen a breech vaginal birth.

We arrived to the hospital at 7:56. He was born at 8:08. All of this happened within a crazy whirlwind of twelve minutes. I don't really know how to count actual labor. I feel like it only makes sense to count when those hard contractions hit so that would be about an hour and forty minutes or so? (I wonder how fast it would have been had he been head down...)

One of the only pictures in the O.R. So many wires!

Dr. P. came in shortly after he was born and was surprised at the outcome. Dr. S. left and I didn’t get to see her again, though I did later write her a letter thanking her for the decision she made to spare me surgery. We waited a little bit for the placenta to come out and the whole time the cord was left intact to finish giving our little boy his blood. I was still shaking and could barely push out that placenta but I did and they thankfully saved it. They finally cut the cord leaving it ridiculously long since he was still on me and the cord and blankets and sheets were all tangled up all over me and rather than disturb us, they cut it down low.

Dr. P. checked and not surprisingly, I had a second degree tear. Before he could fix that, he said he wanted to check my cervix for tearing since I wasn’t completely dilated when he came out. Out of all the parts of the birth, this was the part that still leaves me feeling a bit of trauma. It was horrifically painful and I couldn’t help but scream. I just remember locking eyes with Brian and trying to “blow” like they said and literally feeling like the pain could kill me. I've actually had moments in the middle of the night panicking thinking about that exam. I so wish I had had it in me or been encouraged to say no and decline. The stitching up of the exterior tear was also rough. I wish in the hospital they didn't rush the repairs like they do. I'm grateful that at least I got to hold my little one through all of it.

Dr. P. thought I was bleeding too much and recommended a Pitocin drip to which I agreed. Again, looking back wish I had felt more present and in control to decline or at least look for myself. It wasn’t worrisome, but he said if I had that for a few hours and the bleeding was controlled then I’d be able to leave the next morning as soon as the pediatrician gave clearance. I didn’t have much energy or desire to argue and felt somewhat obligated since he had made the trip in to help (that is not okay and I shouldn't have felt that way but I did).

Who needs fancy photographers when you can get swollen faced gems like this all on your own?

We were brought to a normal birth room and finally it was just us again – Brian, my midwife, Lori, me, and our new little one. I think my midwife's first words were a stunned, “Mary! You just had a footling breech vaginal birth!” It was all still sinking in and it felt amazing to finally be in a quiet room and to have him here, to know what that "different" feeling had been all about, and to be at peace. He wasn’t wanting to nurse until then and I got him latched on and he nursed off and on for most of the night. The nursery nurse came in and weighed him and measured him. Seven pounds one ounce, though I'm absolutely certain that with the crazy long cord and the bracelets and monitors and stuff already on him, that his true weight was six pounds 15 ounces just like three of his older brothers. Twenty inches long. He got the vitamin K shot (required in NY and this ridiculous hospital literally gets a court order if you try to decline). The nurse was very kind and “missed” his eyes with the also mandated eye ointment and I rubbed the tiny little bit off his skin right away anyway.

Caught in the midst of a postpartum contraction but check out the crazy long cord.

My midwife and Lori made me eat a very underwhelming sandwich from the hospital Tim Horton's and we chatted a little bit about how everything happened. We made a few phone calls and let family in on the news of the newest little man. They left soon after and we were brought up to the maternity floor for the night. While the hospital is not my ideal place after having a baby and there is SO much I would change about how they do things, I have to say that everyone at this point was incredibly respectful and helpful. There were lots of the routine interruptions but the nurses I had were friendly and kind and the overnight nurse was even a woman I knew from birthy circles who had had two home births herself!

In the morning, we waited two hours on the phone to order breakfast and still didn’t get any (seriously. NOT OKAY.) but the pediatrician did come in by ten or so and did a quick check of the baby. Once I told him that my midwife would be doing the PKU and heart check in the next few days he gave us clearance to leave.

Dr. P. came in a few hours later for the final check and we chatted for a little bit. He let us know that had he been there when we arrived, he wouldn’t have done what Dr. S. did. Apparently, she is the only doctor old enough on their entire staff to have been trained in breech birth and with the experience to feel more confident in it. I have no doubt that God’s hand was in that. From what I've been able to gather, when she went to check me she was assessing dilation and determining whether or not she thought I could get the baby out. My midwife had also told her in the room that I had four previous full term vaginal births so that also played into her quick decision to go for the vaginal birth. I’m so thankful that she happened to be there at exactly the moment that I needed because that split second assessment and decision was the difference between a surgical birth (with the risks and recovery of such) and not.

There's a lot of complicated feelings still around this birth. Gratitude that she was there and how it ended up happening but also a lot of regret, trauma, and frustration that I didn't know more, that I wasn't confident enough to just stay home, and wondering what it could have been like had I done that.

His Name We left the hospital about 2 p.m. after finally making the agonizing decision of his name. We were literally filling in the birth certificate paperwork with the final decision as the man was waiting with the wheelchair to bring me down. Benedict was never even remotely on the radar for a boy name this time. When I was holding him in recovery, though, the name Ben popped into my head and seemed just…right. Raphael has been a patron of our marriage and family for some years now and it’s been a name that was always in the back of my mind. Together they mean Blessed Healing of God, which seems appropriate in so many ways for our family this past year. I know there are people who thought it a bit weird (they got over it) but I feel so much peace that this is his name. The boy name I had been rooting for all pregnancy was Augustine, though Francis (Frankie) also had some discussion. A girl would have been Brigid or Therese, with Mary or Marie/Maria as a possible middle name. After he was finally named, we headed home to my relief and to the welcome of four very thrilled and excited older brothers. This boy is pretty blessed to have so much love.

The Agnus Dei

I can’t end this birth story without mentioning a gift someone had given me that week which I feel strongly played a part in Ben’s birth. A few months before I was due, I was chatting with a fellow homeschooling, home birthing friend at our learning center. I was telling her about all the inexplicable fear that I had surrounding this birth. She is one of the most sincere, generous, kindest women in the world and she stated that I had to have an Agnus Dei and that she would get one for me. I had no idea what that was but she explained that it’s a long forgotten sacramental of the Church. It’s a piece of wax from the Easter Candle in the Vatican and is blessed by the pope and imprinted with a stamp of the Lamb of God symbol. (You can read more about it here.) One of the uses is for protection and blessing during childbirth and our local cloistered Carmelite nuns had a supply. As my due date approached, I thought maybe I wouldn’t get it in time or that it had been forgotten. I saw her two weeks before and she remembered and said that it had been ordered and “don’t worry, you’re not going to have the baby before we get it to you.” The next Tuesday evening (just a few short hours after I think he flipped but didn’t know it yet) her husband made a special trip out to drop it off to my house. And that’s when everything sort of started. I wore that Agnus Dei around my neck from that evening until a few weeks after the birth. I can’t explain it but I truly feel like the grace given through that little object (through God's power, of course) made a difference in the outcome of this birth.

I’m so so grateful for the gift of our Benedict Raphael. He is beautiful, looks just like his brothers did as newborns, and is so loved by everyone in our home. Out of all my babies he had the sweetest and most sensitive temperament. We sometimes joke that it made sense he wanted to come out feet first, tiptoeing into the world at his own pace, rather than diving in head first, such is his style. His life and even his crazy birth are a gift to our family and we feel so very very blessed to have been given this precious boy.


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