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Judah's Birth Story: A Natural, Footling Breech Delivery

Tabs' Blog

Judah's Birth Story: A Natural, Footling Breech Delivery

Tabitha Helms

Today is Judah's due date. Our Wellness Center always calls it a "guess date" because it really is a guess since baby can come two weeks before or after. Our little man made his appearance one week early, and I'm so glad he did!

Superhero Baby Photo Shoot

The week before, the Braxton Hicks contractions were feeling a little stronger and more uncomfortable than they had been. I didn't think Judah would make it to his due date. I had had a check up with the midwife at my doctor's office on Friday and Judah was in head down position, facing my back. It was a weight off my mind knowing he was ready to go whenever the need would arise. Sure enough, I had cramps all day on Saturday and surges began at 10pm. The trouble with a firstborn child is you don't really know what to expect or what you're supposed to be feeling. My surges seemed to progress really quickly and were averaging at 3 minutes apart at 1 minute intervals by midnight. It felt too early to me, but we went in to the hospital anyway. 

The first check-in was not fun. They made me lie on my back and wrapped two, tight elastic bands around my belly to monitor Judah and they checked my cervix, which is painful to say the least. Experiencing surges on your back with elastic squeezing your belly while being asked medical questions is not very helpful for trying to relax and breathe through surges. Unfortunately, the nurse checking me hadn't looked over my birth plan like the first nurse and had just been given a brief overview by the first nurse. So she wasn't given the memo about not telling me how far I was dilated. She told me flat out I was only 2 cm. Immediately I felt discouraged. I wanted to labor at home, not at the hospital. And here I was, hardly progressed at all. I knew I hadn't wanted to go in yet. I didn't understand why my surges had been so close together if I was hardly dilated.

My doula had come to the hospital with us and stayed with us for four hours while we waited to see if I progressed any further. It was not the best situation. Our doula, Ashley, had a cold and had lost her voice. We were supposed to meet with her on Friday night, but she had canceled because of her cold. Our doula that was on call in place of her if she was still sick when we went into labor, also happened to be on call at another hospital she works at on Saturday. So poor Ashley had to come be the stand-in when she should've been at home sleeping! 

Superhero Baby Photo Shoot

After 4 hours, I had made zero progress, so they sent us home to get some sleep and told us to come back later. Reagan was able to get some sleep, which was good. I slept fitfully--waking for each surge. I felt in and out of consciousness through the night. I continued to labor through the day--wanting to rest in bed where I was comfortable, but mostly laboring in the tub which was helping my labor stick to regular intervals. I was tired and uncomfortable, but Reagan talked me through my surges, timed them, and kept in touch with our on-call doula, Debbe, who was now off duty and going to be there for us. We walked, we danced, we swayed, I groaned for what seemed like forever.

Finally, Reagan coaxed me to do some curb walking, which we had learned about in hypnobirthing class. You walk one way with one foot up on the curb and the other down below it on the ground, then you walk back the opposite direction so your feet are switched. Apparently it helps the baby ease down. I tried it once and had a stronger, surge than I'd had before and declared I didn't like it and went back inside. Our doula was on her way over at this point and just before she arrived, I manned up and tried the curb walk again with the same, painful result. Our doula took one look at me and told Reagan to pack up the car. She helped me through my surges while Reagan got everything ready. 

Riding to the hospital on my hands and knees in the back seat while trying to breathe through surges, keep my balance, and grit my teeth over bumps in the road was not my favorite part of the long labor. We arrived and I had to stop three times on our way from the car to the entrance to breathe through my surges. It was nice to know the drive hadn't stalled my labor at all. 

Superhero Baby Photo Shoot

At 3:30pm we were taken to the same room as before, but with different nurses. I had two nurses this time--Desiree and Katherine. Katherine was in training at Scripps, but had been a nurse at Sharp for 20 years. They made sure to explain that to me because I had requested no students on my birth plan. These two ladies were amazing. God couldn't have picked better people for me. They hooked me up to the lovely elastic bands again and checked my dilation. They told Reagan (not me!) that I was 7 cm and Reagan and Debbe told me happily I was doing great. In my mind I told myself that meant I was 8 cm and baby would be coming soon. I continued to labor at the hospital for a while. The surges were much more intense and painful than they had been, and I focused my way through them with the help of my birth team.

I went to the bathroom (which always brought on a surge for some reason even though it was the most uncomfortable place to get through them) and noticed the shower there. I knew I was close to delivery so I wasn't sure if I was allowed to be in there, but it sounded like a good idea that would bring me some relief through these last painful contractions. I asked and they said yes so they set me up on a birth ball in the shower. Reagan sprayed water over me as I tried to keep my arm out of the water since hep locks aren't supposed to get wet. We didn't notice that the ball was over the drain and soon we flooded the bathroom on accident. The nurses cleaned it up fast and after not much time I felt the baby coming. 

Superhero Baby Photo Shoot

That's when I panicked. My doctor was on his way, but he wasn't there yet. I didn't want to give birth without him there. Through my surge I started saying "oh no!" over and over. Reagan asked what was wrong, and I told him Dr. Cap wasn't there. He calmly told me Dr. Cap was on his way. I yelped "The baby's coming!" The nurses sprang into action as I felt my body take over on the next surge and start to bear down. They got me into the bed and checked my cervix. I was unaware of much going on at this point, but from Reagan's side of the story, this is when they discovered little Judah was no longer in optimal position, but that he was breech and there was a foot ready to come out. I think I had two more bear-down surges before Dr. Cap arrived. The nurses just told me not to push and everyone was telling me to keep breathing. I tried my best, but there were moments that my body took over and my breathing paused and turned into a shout. 

When Dr. Cap arrived I immediately felt relieved. He checked things and came up next to me and calmly told me we needed to make a decision. (Already, this man is incredible. There was no, "We have a problem," or "There's a situation.") He told me baby was breech and said we could either skip the possible complications and do a belly birth or we could try to deliver him breech. There was a pause as he waited for me to answer. In my head I was thinking "How can I possibly make that decision? I've done all this work the past 20 hours and then I was going to have to have surgery and a longer recovery. But breech isn't normal, how can I manage that?" When I didn't respond, Dr. Cap told me, "I think you can do it." Relief flooded me, and I said okay.

Superhero Baby Photo Shoot

Immediately the room went into motion. They packed up my bed and wheeled me into the OR--explaining that we needed to be in there just in case baby became distressed at some point, and we needed to do a belly birth. Dr. Cap told me the anesthesiologist was there just in case, but wasn't going to be involved if baby was okay. I had a couple more surges through this transition and I remember Dr. Cap telling me to breathe and kept saying "We need to get Dad in here, can someone make sure Dad's coming?" Finally, everyone was in position. Reagan was on my right, by my head. The anesthesiologist was off to the left. A nurse was on either side of me holding my legs in position, and I was flat on my back. I hadn't wanted to give birth on my back after all my knowledge I had picked up about wanting gravity on your side with your position and your back is the worst position for that. But I didn't dwell on it, I just did what I was told--trusting my doctor knew what was best. As we prepared to push, Dr. Cap told me there was a foot protruding and asked if I wanted to feel it. Haha, no way! 

I have little awareness of how much time passed during those pushes. I only recall Reagan encouraging me, Katherine cheering me on and counting REALLY slowly to 10 three times in a row as I took 3 breaths and pushed with all my might, and Dr. Cap stretching my perineum and feeling for a second foot to fish out. I also felt aware that the pushes were completely exhausting, that I had to hold my breath and not shout like my body wanted to, and that I could feel nothing moving down and out for a long time. After a lack of movement, Dr. Cap told me he needed to make a small incision to help baby have more room to come out. He let me know that I was already numbed there just in case that had been needed. I said okay and felt nothing different. I remember gasping for air at the end of the sets of breaths and Dr. Cap telling me to slow down my breathing as he requested someone to tell him what my heart rate was. I was aware of Judah's heart rate on the monitor--nice and strong throughout and one of the few reasons that we could even consider breech delivery. At one point his heart rate paused, and Dr. Cap apparently shoved him back in, which made his heart rate get going again. It was a tense moment, but he was okay. 

Superhero Baby Photo Shoot

After what seemed like forever, at 8:22pm I felt him slide out--my body flooding with relief that it was almost over, and I had actually done it. Dr. Cap announced that Judah was peeing, and I suddenly felt a splash of wetness all over my thighs. They put him up on my chest and I put my hand on his back and couldn't stop smiling as they rubbed in the vernix. He wasn't crying, so they clamped his cord and Reagan cut it as they whisked him away to be checked. As soon as they lifted him up, he gave a hearty cry, and I breathed a sigh of relief. I watched over Dr. Cap's shoulder as they examined him. Reagan was there with him and I just tried to focus on how relieved I was and that my boy was born as I tried not to look at Dr. Cap stitching me up and tried not to feel the pulls of the thread going in and out of me. Yuck! 

Finally they brought Judah back and put him on my chest, and tears welled up in my eyes as I held our dear boy close. My stomach was massaged as Dr. Cap tried to help the placenta along. He exclaimed "Wow! Look how thin that cord is!" and all the nurses chimed in with amazement as well. He said he didn't want to pull it out for fear that it might break. I delivered the placenta and Dr. Cap said, "Look at that velamentous cord insertion!" We had known he had a cord that inserted to the uterus wall before going to the placenta from the ultrasounds, but it was amazing how thinly the umbilical cord was attached. The anesthesiologist said, "I know this is the last thing you want to be thinking about right now, but would you mind if we took pictures and had you sign off to have it published in a medical journal? It's just really amazing and it would be awesome to have other doctors learn from it." I laughed and said sure. 

At last, they brought my son back to me and laid him on my chest and I held him as he snuggled close to me, skin-to-skin. It was so beautiful, and I cried like I knew I would. That moment was the one that had kept me going through a lot of discomforts of pregnancy. Soon, I'll have my little Judah on my chest after just being born. It was as wonderful as I thought it would be. 

Judah's Birth Story: A Natural, Footling Breech Delivery

I was brought back to my room, and the nurse helped me get him to breastfeed. My parents came in--they had been in the waiting room once they found out Judah was breech and wanted to be there just in case there was an emergency. It filled me with unbelievable joy to present my son to their grandparents and the next day to their other grandparents and uncles and aunts. 

To sum up the craziness of Judah's birth is in his name. Judah means praise, and we can only pause and praise God for the miracle of his birth. God already has His hand on our little boy. There were so many things that could have caused problems or gone wrong, but they didn't: 

  • Velamentous cord insertion can cause problems with a baby's growth. Plus the fact that it was barely connected to the placenta at birth makes it even more amazing that Judah was born healthily at 7lbs and 19.5 inches. 
  • Stress at birth can cause lactic acid build up in the baby. Dr. Cap tested Judah's umbilical cord after birth and there was no lactic acid.
  • At birth we discovered I had two placentas. The extra one had no purpose; it didn't communicate with the one Judah was using. 
  • Most breech babies are born with both feet coming out first or their butt coming out first. Judah came out with a foot and his butt first. His other foot was up by his chest. That was the reason I hadn't made much progress pushing at first and why I needed an episiotomy. He was still able to be born naturally, vaginally, and without medication.
  • Dr. Cap is an amazing doctor. When I found out we were changing health insurance before I got pregnant, I looked for a holistic OB/GYN. I found him online and was impressed with his website and what he stood for. We picked an insurance that would cover him, and a month later we found out I was pregnant. Dr. Cap is not like other doctors. He is one of the best, believes strongly that women should be educated about pregnancy and birth, and provides many resources to help them do that. Beyond all that, he is comfortable delivering breech babies--a rarity in our current medicine/surgery happy culture. Judah was his 10th breech delivery, and his first footling breech.
  • Judah's heart rate was strong the entire 22 hours of labor. 
  • If I had had an epidural, I wouldn't have been able to deliver Judah vaginally because I would be too numb to push. 
  • God gave us so many people to pray for our birth. Besides family and friends, our nurse Katherine and both our doulas were praying unbeknownst to us. 
  • Our on-call doula happened to be one we had already spent a lot of time with in Hypnobirthing and Breastfeeding classes so we had a close relationship with her. She told us later that the whole time we took her classes and said our doula was Ashely, she had this feeling of "No, I'M their doula." 
Judah's Birth Story: A Natural, Footling Breech Delivery

We were able to go home on Tuesday and have been loving life with our precious little boy. I couldn't have asked for a better husband and partner in life and am overwhelmed with the love and support of our family and friends. I am completely captivated by Judah Reagan Helms.