The Illusion of Informed Choice: A Breech Birth Story

Two years ago I made a choice. It was informed, heartfelt, safe, family centered and also very difficult.

At 37 weeks and 1 day, with the support of my husband and our midwife, I chose to give birth to our frank breech baby at home. This was the right choice, the safe choice and the best choice at the time.

Looking back on that day and the decision that we made, I have come to realize that my “choice” was really an illusion. Due to the state I lived in, the money my husband and I make, the access to an experienced midwife, the knowledge as a trained birth & postpartum doula, the family support and the experience of giving birth to my previous child at home, allowed me to believe I had a choice. In reality, the majority of woman carrying a breech baby have no choice. The only option available to them is major abdominal surgery via Cesarean which they have been led to believe is 100% safe.

Women as a collective have lost trust in our own bodies. We have lost skilled practitioners who know and trust physiological birth with the training and experience to support breech birth. Most women have lost the choice to birth where, how and when they choose regardless of baby size, positioning, previous Cesarean, and the list goes on.

When people learn of my breech home birth (in water mind you), the first question I get is, do I advocate this for all women who are carrying breech babies. My answer is always the same and always No. The way in which my baby was born was right for me, for us. We considered many factors, such as my previous birth experience, the breech experience of my midwife, my ability to control my own body during the birth, the family and community support we had, and the list goes on. Each birthing person must evaluate their own situation with their family and care provider to determine what is right for them, their birth and their baby. This means informed consent about the risks and potential outcomes.

The biggest concern with having our breech baby at home was community support. I was 100% confident in my body’s abilities and my midwife’s skills. The discussion was around the support or lack thereof that would occur should something go wrong. If you choose to give birth in the hospital and something happens to you or your baby, there are a lot of people to take blame, be angry at, bring legal proceedings against. Everyone typically stands by your side and tells you that you did everything right, they are there to support you regardless because it’s not your fault. If you choose to birth at home, especially with a breech baby or any other atypical presentation or risk factor, you may be left with a lack of support should something go wrong.  Even if a homebirth would provide you with the best chance for the least interventions and the healthiest outcome for both birthing person and child, the support you may be expecting could disappear. This was your choice when other wrongly perceived safer choices were available to you. It’s your fault. This weighed heavily on our hearts and minds.

My husband and I felt that we would be vilified by the community, shunned by our family and potentially prosecuted by the state. This is what we were dealing with, yet even through those circumstances by husband looked me in the eye and said, “I don’t want you to be cut for no reason.” This was when we decided to stay home, the safest place possible for us.

My hope is that the mystery, fear and concern around breech birth will begin to dissipate as we educate birthing people, care providers and the medical system on the real risk factors and arm them with the knowledge of how to handle a breech birth. This will eventually provide choices that are not commonplace today. This could decrease the number of Cesareans. This will empower birthing people to educate themselves about their choices and increase the support they experience when they make a choice that’s best for them and their baby.