25/10/2021
A Breech Vaginal Delivery After Cesarean
First and foremost, I’d like to thank the Delivery Team in Dr. Soliman Fakeeh Hospital. Special thanks to Dr Taghrid Badri, Dr Amira Saleh and Nurse Hana Raeed. Like every births, the honor for me as a Doula is being able to witness the birth of a life happening before my eyes over and over again, and I take no credit for this beautiful event. To the wonderful family that had me as their Doula, thank you for having me in that special moment where we once again witnessed Allah miracle and plan unveiling with perfection. To my dear client (G), you are such a strong believer and I truly believe your faith in believing what your body is sets you to do, made it all possible.
All I have to say is everything that happened was unexpected. No one had known before than that the baby was breech. In fact the birth happened before 37 weeks. My client was due for her weekly check and ultrasound, but the birth happened before her appointment.
I was done with all my October clients birth, and went to Makkah Friday afternoon. As I was packing early Friday, I just had a strong feeling of hesitation for the trip. However, knowing how busy my November would be I just continued with the plan to go on meeting all my clients as per schedule. Upon reaching the Hotel, one of my client who was expecting her 3rd baby and 37 weeks along was messaging me saying she is feeling contractions. This would be her second baby with me as her Doula, and knowing how her previous birth had been I was certain it is just a prodromal labor. Evening came and there wasn’t more updates from her, and I went on with my appointments.
Saturday morning, at 7am I got a message from my client G saying that her water had broke. I asked questions and confirmation regarding her gestational age, and advised her to go to the hospital for assessment. I mentioned to her that I was in Makkah and will head to Jeddah immediately. We arrange to meet at the hospital. I reached Jeddah a little after 9am, and met G at the hospital ER. She got her vital read, and her assessment done.
We were told that it was positive amniotic fluid and she is 4cm dilated. G was delighted when she heard that she was 4cm, as her previous caesarean was done at 2cm due to SROM at 40 weeks. The doctor were told that she is planning for a VBAC. However after the assessment, we were sadly informed that she will only be given a trial of 4 hours for her labor after caesarean. Hearing this news, G felt devastated and was stressed out. We weigh on the possibility and limitations, and since G has an option for another doctor’s opinion she thought of visiting her doctor for another assessment.
However, out of caution due to her previous caesarean G was advised against discharge and to be admitted. G, her husband and myself we spent the next couple of hours in the ER taking time to make a decision. After sometime G just kept telling me she has lots of pressure building up downwards. And we finally made a decision for admission, and per her birth plan she wanted a minimal VE. So, she was sent to the delivery room to labor in without any more VE in the ER.
We got to the ER and I was delighted to know that nurse Hana was assigned to our room. G changed, had the cannula inserted and asked to be excused to use the washroom. I followed and stay with her in the washroom and then, we made way to the delivery room. While waiting for the nurse to be back to have the CTG and BP hooked up, G was walking and leaning forward on the bed with every contractions. Her contractions came very closely together, and then she said to me that she felt like pushing. I called for the nurse, and she got a doctor to the room. The doctor did a VE and said she is 10cm dilated with baby in station 0 however, the baby was breech. As the got her hand away, she showed the tiny lil’ poo the baby had made as G was pushing with each contractions.
A consultant was then called, an ultrasound unit was brought into the room and a quick test was done. The consultant confirmed it was breech and declared that she should be sent to a caesarean. At this point G was just smiling, I saw a big smile on her face as she said to me, ‘’Nour, I did it. I got to 10cm.’’ I witnessed her contentment and satisfaction but my head was a mess digesting all this information was thrown around. I then explained to G the situation and what were to happen. And then, I talked to Hana and asked her if Dr Taghrid would do a breech delivery. Hana confirmed and said she is capable. And we got her husband’s approval to call Dr Taghrid for assessment, as they had initially requested for a different doctor for their birth. At this point, we had a quick talked and the couple just wanted a confirmation that breech delivery was impossible before agreeing to cesarean.
We had the room silent and to ourselves for a split second, before 2, 3, 4 and in total 12 people being in the room. It quickly turned to a familiar scene of any medical drama and movies. Our focus was only on the 2 doctors, they made a quick assessment and spoke to my client. No words of caesarean was mentioned, rather they worded it beautiful that a just trial will be given. The head of OBGYN lay out the risk and concern calmly. While everything and everyone was setting up the room for a birth. The doctors agreed for the birth to continue. With each contractions, Dr Taghrid would instruct and coach the mother through the pushing. As the bum emerged, I heard Dr Amira describing the baby’s ball were seen (The baby got balls indeed, to be born in this position). I was very close to the lower part of my client’s body and could see every single thing happening. All this while, my hand was holding hers, and I could see her pushing the baby with all her might and listening to every direction by the doctor. I looked around the room, and it was so intense as though no one was breathing, until the last push and the baby was born. A sigh of relieved by all that were in the room, followed by cheer and smile broke the previous moment of hard and cold atmosphere.
You did it, G. Congratulations. Even though you did not have a printed copy of a birth plan for your birth, your plan still went in your favour. All decisions were respected and supported. And I was glad that you too just a couple of months ago had a first hand experienced of witnessing the miracle of life when your horse gave birth. I am glad you share this story, and it became a reminder for you through your own birth.
What a birth.
A previous cesarean
A breech vaginal delivery
23 October 2021
2.1kg
12.45pm
Jeddah
Doula Nour Hafifi https://www.facebook.com/123017301376390/posts/1552133348464771/
