Breech: Empowered Stories of Babies Born Feet First!: Empowered Birth Stories Books, #1

By Haley Pearse

You're on an extraordinary journey of bringing a breech baby into the world

Learn about your options and be encouraged through empowering stories of breech births, including twins and first-time mothers!

 

Finding comprehensive coverage of birth variations in books is challenging.
Here, essential information and empowering stories are brought together to provide you with a complete guide to planning an empowered breech birth. Discover breech affirmations, turning techniques, a chapter for dads, evidence-based information about breech presentations, and tips on finding supportive care providers who respect your choices. This book not only explains your options and childbirth rights but also equips you with practical advice and valuable resources. Gain the knowledge and confidence to make informed decisions and be prepared for whatever type of breech birth your body and baby need! Immerse yourself in a collection of encouraging stories that will reassure and inspire you as women share their pregnancy, labor, and breech birth experiences.

 

Although written for women with a breech baby, this book will become an invaluable resource for anyone curious about breech childbirth.

 

 

 

 

• Language: English
• Publisher: Liminality Publishing
• Release date: Aug 1, 2023
• ISBN: 9780645373028

Haley Pearse

Haley has birthed both her children at home and is currently pregnant with her third. She learned a lot about herself from those experiences. She continues to be passionate about homebirth first and foremost, though it has morphed slowly into a general burning desire to see all women having empowered births wherever they are. She is fascinated by the theology and theory of birth, and how that intertwines with the practical. While she can't often support other women in person due to location, she connects and encourages them via different online mediums. She can usually be found talking someone’s ear off about birth, trying to write or read books,  lost in discussion in Facebook groups (some of which she is the admin of), eating chocolate, or spending time with her family.

Book preview

BREECH

Empowered Stories of Babies Born Feet First!

Copyright © 2023 Haley Pearse

All rights reserved.

ebook ISBN - 978-0-6453730-2-8

Paperback ISBN - 978-0-6453730-1-1

License

No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the copyright owner, except in the case of brief quotations embodied in critical reviews and certain other non-commercial uses permitted by copyright law.

This ebook is licensed for your personal enjoyment only. This ebook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each person you share it with. Thank you for respecting the hard work of this author.

For permission or to send feedback, email: [e-mail]

The information provided in this book is for educational and informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

The author and publisher of this book have made every effort to ensure that the information presented is accurate and up to date. However, they make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, suitability, or availability of the information contained within the book. The author and publisher shall not be liable for any loss or damage, including but not limited to, indirect or consequential loss or damage, arising out of or in connection with the use of this book.

The techniques, suggestions, and recommendations presented in this book are based on the author's personal experiences and research. They may not be suitable for everyone and should be used at the reader's own discretion. The reader is solely responsible for any actions taken based on the information provided in this book.

Any reference to specific medical procedures, techniques, or products is for informational purposes only and does not constitute an endorsement or recommendation by the author or publisher. The reader should consult a qualified medical professional before undertaking any medical procedures or using any products mentioned in this book.

While the author and publisher have endeavoured to include accurate and up-to-date information, they do not guarantee or warrant that the information in this book is free from errors or omissions. Changes may be made to the content of this book at any time without notice.

This book contains links to external websites. While we strive to provide only

quality links to useful and ethical websites, we have no control over the content and nature of these sites. These links to other websites do not imply a recommendation for all the content found on these sites.

For privacy reasons, some names, locations, and dates may have been changed in the birth stories. Birth story image credits belong to the birther unless otherwise specified.

Cover Design by Haley Pearse

Cover images ©zhaowhat / @chekiwart / @Lucky Roy / @Lana Veter / via Canva.com

First Edition

Distributed by Smashwords

Published by Liminality Publishing

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Contents

Contents

Dedication

Epigraph

Introduction

Chapter 1: What is Breech Birth?

Chapter 2: How to Have an Empowered Breech Birth

Chapter 3: Breech Birth Options

Chapter 4: Ways to Turn a Breech Baby

Chapter 5: Tips for Breech Birth

Chapter 6: Surprise or Precipitous Breech Birth

Chapter 7: Feelings in Breech Birth

Chapter 8: Supportive Care Providers and Your Rights

Chapter 9: For the Dad

Chapter 10: Breech Birth Affirmations

Empowering Birth Stories

Chapter 11: How She Was Meant to Enter This World (First-Time Mother)

Chapter 12: I can see her toes!

Chapter 13: Beautiful Breech Birth

Chapter 14: Harmonious Breech Home Birth (First-Time Mother)

Chapter 15: Positive Caesarean: He Chose His Birth-Day (First-Time Mother)

Chapter 16: Supported and Empowered (First-Time Mother)

Chapter 17: Feet First in a Freightliner! (First-Time Mother)

Chapter 18: Determined to Birth (Twins)

Chapter 19: Faith and Freebirth

Chapter 20: From No Chance to Natural

Chapter 21: Halfway There, Breech and a Prayer

Chapter 22: Birth of Cedar Rose

Chapter 23: Breech Caesarean, Healing Breech VBAC

Chapter 24: Powerful and precipitous: Frank breech with no tearing!

Chapter 25: Wonderful and Positive VBB (First-Time Mother)

Chapter 26: Transverse to Triumphant (First-Time Mother)

Chapter 27: Making an Entrance (First-Time Mother)

Chapter 28: Blessed Reconciliation VBAC

Chapter 29: A Version of Normal (First-Time Mother)

Chapter 30: Ainhoa’s Birth (First-Time Mother)

Chapter 31: Battle For Breech

Chapter 32: I Wanted to Give It a Go (First-Time Mother)

Chapter 33: Hypnobirthing Hospital Breech Birth (First-Time Mother)

Chapter 34: Heads Don’t Do That! (First-Time Mother)

Chapter 35: My Twincredible Double Breech Birth (Twins)

Chapter 36: Chelsea-Lee’s Reclamation Footling Breech Birth

Chapter 37: Precipitous Breech Home Birth

Chapter 38: Waters to Waters

Chapter 39: Leaning Into My Power: Accidental Breech Birth in the Driveway

Chapter 40: Stretching Faith

Chapter 41: Double Breech Bathtub Birth! (Twins)

Chapter 42: Breech Resources for You

Postscript

Acknowledgments

About The Author

Contact Me

Glossary / Abbreviations

Notes

Dedication

To God, the Author of everything,

To my children, who made me a mother over, and over again,

To my husband who patiently bears with me as I birthed our babies and this book

And to the birthing women whose stories have inspired me and empowered others

Epigraph

The whole point of woman-centred birth is the knowledge that a woman is the birth power source. She may need, and deserve, help, but in essence, she always had, currently has, and will have the power.

– Heather McCue ¹

Introduction

Welcome to the Empowered Birth Stories books series!

After years of reading, writing, and supporting women through their birth choices, I have noticed that there is one question women frequently ask; I’m expecting to have this type of birth or pregnancy (VBAC, breech, first-time mother, twins, etc), has ANYONE else done it too? And what do I need to know?. They really want to know they’re not alone, that others have birthed the same way too.

Dear reader, you are not alone! Many, many women have birthed their babies safely just like you will. This book is just a small collection, but I assure you, there are thousands, if not hundreds of thousands of women around the world who have their own special and unique, (but similar) birth story to you.

Many books out there are aimed at an overview of labour, and perhaps you’ve read them or taken a birth class. They generally cover the stages of labour, how to breathe while pushing, and what you should eat during pregnancy. But they very rarely have more than a paragraph on variations like breech. This can leave you feeling underprepared for the birth scenario you are facing.

I want to honour the birth stories that are the variations - the normal births that we don’t see enough of!

In these pages, you will learn about your extraordinary body and the incredible variations of breech birth. You will also read the stories of women birthing in their power - I hope you will begin to feel prepared and encouraged. I believe we do not need to empower women. You are already powerful. We simply need to reacquaint you with your power.

Important Note:

Please remember that I am not a lawyer or healthcare provider and do not give legal or healthcare advice. Nothing in this book should be taken as advice about your personal situation, your healthcare, or the current state of the law and women’s birthing rights in your state or nation. If you need legal or healthcare advice or information, seek out a suitably qualified professional licensed to practice in the state or nation where you live.

Series Disclaimer:

This book is part of the Empowered Birth Books Series. All the birth stories are unique to each book, however, the information about your rights in labour and tips for labour are important for any type of birth. Should you read more than one book in the series, you may notice that some chapters like Chapter 2: How to Have an Empowered Birth, and excerpts in some other chapters are similar or duplicated. This is done so that no one misses out on important information. You will find all the specific tips, collated affirmations, information, resources, and statistics for breech birth in the chapters labelled as such.

Language Used:

The author is Australian (and writing predominately in British English). The birth stories are collected from around the world, mainly the USA, UK, and Australia. Thus, you will find a mix of writing styles, slang, and spellings such as color/colour, recognize/recognise, cesarean/ caesarean". None of these are spelling mistakes. It is simply the correct usage for different countries. You may also notice verbiage and vocabulary words that you haven’t seen before - just another example of how language and preferences of speech differ all over the world!

Throughout this book, I often use homebirth rather than home birth. I make this distinction because to me home birth makes home simply an adjective describing the location where one gave birth. Whereas homebirth as one word becomes a noun, an event, an idea, a name for a thing in and of itself. This is to show that a planned homebirth is something that women actively choose, and there is much more to birthing at home than just the location.

A hospital birth is also so much more than its location, as there are many types of birth possible there, as you will discover throughout the book.

Images Used:

Throughout the birth story section, you will find some pictures of mothers and babies during labour and shortly after birth. I have chosen to include very few images of babies during crowning, rumping, and caesarean emergence, instead focusing on the mother holding her baby afterwards. If you would like to see amazing images of physiological breech birth or surgical birth, there are a couple links included with the stories, and you can also go to the breech Facebook groups suggested, where many women have shared their pictorial birth story. Instagram is another site where you can see some fabulous birth images. And both Instagram and YouTube have birth videos available to watch.

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Back to Table of Contents

Chapter 1

What is Breech Birth?

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At a routine scan, we found out baby was breech...and that changed everything.

**Because this is an ebook, some ebook providers will automatically open the book here at Chapter 1. If you have not read the introduction, please scroll back and read it. It has some important information. Thanks!! - Haley**

What is Breech?

In roughly 96% of pregnancies, the baby’s head will be down (cephalic) by 37 weeks gestation. The remaining babies will be breech¹. Breech is the term to describe a baby who is not head first. Instead, they are positioned butt-first, feet-first, or sideways in the womb². If at the time of birth, either vaginally or by caesarean, the baby is still head up, it will be termed a breech birth.

The types of positions baby can be in are called:

Complete Breech: butt first with knees bent and feet down

Incomplete Breech: butt first with knee bent and one foot lower

Footling Breech: feet first

Frank Breech: butt first, with legs straight up and feet by baby’s head

Transverse: sideways in the uterus

Baby can also be anterior or posterior. Anterior means that their back is facing your belly. Posterior means that their back is against your back. ³

What Causes a Breech Baby?

No one really knows what causes breech, but there are some commonalities.

if a woman has had several pregnancies

in pregnancies with multiples, one or both can be breech

if a woman has had a premature birth in the past

if the uterus has too much or too little amniotic fluid, meaning the baby has extra room to move around in or not enough fluid to move around in

if the woman has an abnormally shaped uterus or has other complications, such as fibroids in the uterus

if a woman has placenta previa ⁴

Sometimes babies are breech for a reason and can’t be turned. A short cord or abnormally shaped uterus might keep baby breech, and the baby knows it is safest for them to be born breech. Not all reasons for breech can be discerned in pregnancy, and in some cases, you may never know for sure why your baby was breech.

Are there risks to a breech pregnancy and birth?

A breech pregnancy is as safe as any other pregnancy. You have the choice for routine blood tests and ultrasounds to check for any abnormalities, (like during the 20-week anatomy scan). You may face the usual pregnancy complications, inconveniences, and variations like nausea, heartburn, fluctuating hormones, symphysis pubis dysfunction, and weight gain.

There are some extra risks to the method of birth chosen (covered more in Chapter 3) but all births do have an element of risk.

Diagnosing Breech:

It is useless to diagnose a breech position prior to 35 weeks gestation. A baby usually flips around many times prior to labour. They can move daily - even hourly if you have a little acrobat in there! If you have been told that baby is breech at your 20-week ultrasound, there is no reason to worry at all that baby will still be breech at term. And even if baby does end up breech at term, you can make an informed decision about it then. Give yourself permission to relax and not stress about them constantly changing positions.

Breech position can be diagnosed by:

Ultrasound

A skilled provider palpitating the abdomen and assessing position based on where they can feel the baby’s head, back, and butt.

Hearing the foetal heart high on the abdomen

If breech is suspected by palpitation or heartbeat, your provider may ask to schedule an ultrasound to confirm.

Sometimes your provider may want to do a cervical check in addition to the external abdominal palpation. They can feel through the wall of your vagina and are able to tell if the head or butt is pressing against the cervix.

Belly mapping: This is done by yourself as per the Spinning Babies Guidelines on their website ⁵

Remember that all procedures, checks, ultrasounds, and touching of your body must be consensual. You do not need to consent to a procedure or cervical check if you don’t want to, even if your care provider wants you to. Ask your provider to explain risks/benefits, and your other options before any procedure, disrobing, or touching (more on your options in Chapter 2).

Some tips for feeling baby’s position

Feel for the two hardest lumps and press on them gently - one should be near ribs and one in pelvis, likely on a slight diagonal. Pressing on the butt lump jiggles the whole baby up and down.  Pressing on the head lump makes the head bobble on the neck, it doesn't move the body as much.

Next, follow the curve of the suspected butt lump and you should feel spine all the way down to the suspected head lump. If baby's back is against yours, you'll feel little tiny lumps (knees and hands) instead - perhaps try again later. If you start at the head lump, it has a dip at the neck before you follow the curve of the spine down to the butt.

Hiccups are generally felt lower with a head-down baby, higher with a breech baby.

Also sometimes a head-down baby will tickle your cervix with their fingers.

Diagnosed breech - now what?

First, don’t panic! It can be easy to stress and overthink. After all, breech is relatively rare, and you may not know many women who have birthed breech. You’re concerned about the safety implications for your precious little one. And you also have to wrap your head around a lot of things over the next few weeks. But don’t worry! You have this book. You have resources and support groups (see Chapter 40). You have some time (I assume you’re not in labour RIGHT NOW?!) And you have lots of options. I look forward to navigating you through them and helping you feel empowered as you birth your butt-first baby!

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Back to Table of Contents

Chapter 2

How to Have an Empowered Breech Birth

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Owning our story and loving ourselves through that process is the bravest thing that we will ever do.- Brené Brown ¹

Choose your own adventure

Have you ever read the Choose Your Own Adventure book series for children? Every few pages, the reader is presented with a choice. The decision they make determines what page they turn to next, and ultimately how the book ends. I admit I had often gotten curious, and I would try to read ahead to see if my character ran into trouble so that I could avoid that path.

In life though, we can’t peek ahead. The choices we make really do determine our adventure. It is partly for this reason, I believe you should plan an empowered birth rather than thinking of it in potentially limiting terms like home or hospital birth or unmedicated birth or caesarean birth.

I believe an empowered birth can be achieved in any scenario, from side-of-the-road car birth to an emergency caesarean. What is most important is not the location, but that you are clear on your rights, and you understand the physiology of birth. This will guide your actions, calm your mind, increase your confidence to advocate for yourself and baby and ensure you are supported in your decision-making.

No birth goal is guaranteed. If you plan a hospital birth, you could accidentally give birth at home, or in the car on the way there. You might make it to the hospital and birth alone in the room because the doctor isn't there yet. If you plan a home birth, even away from the interventions that usually cause complications, sometimes unavoidable things come up and you require transfer before or during labour. There’s one precipitous story I heard of where the mother attended a routine prenatal appointment, and while she was there, her waters broke, so she went into the bathroom to dry off. She had the baby two minutes later on the toilet! Birth really is an unpredictable adventure!

If you choose to plan an empowered birth, rather than specifically a home/hospital/birth centre birth, (even as you fully plan to birth there), if/when plans change, and you’re presented with a decision moment, you will be able to know what to do and confidently make a choice. Even though you can’t see ahead to know the outcome, you know that you did your best!

No matter what happens, you can have a plan in advance for how you can cope with changes, and how you can make decisions in the moment. Write a birth plan that includes reminders to use your BRAINS acronym (explained further down). So much is out of our control in life, and in birth. We could never plan ahead for all scenarios. Only you can make the choice in the moment for you based on your personal circumstances, current knowledge, and intuition. Believe in yourself to have the strength and wisdom to make the choices that align with your desires.

"However much we know about birth in general, we know nothing about a particular birth. We must let it unfold with its own uniqueness." – Elizabeth Noble ²

Empowered Birth

Some other words we could use for planning an empowered birth are a good birth or a positive birth. We aren’t aiming for natural vs medicated, or some other descriptor that focuses on merely how the baby entered the world in medical terms. But rather words that emphasise the mother’s role and her feelings about her birth.

We want a healthy baby AND a healthy mother. And that includes emotional health too. We want a birth for every woman that leaves that woman feeling positive about her journey, her own personal adventure; an adventure that isn’t compared to everyone else’s births.

When asked by friends and family what kind of birth you are planning (likely imagining you’ll say vaginal or C-section), you can say something like; I’ve made a birth plan that takes into account my personal and medical needs, while being flexible as to what baby and I need on the day, and I’m working with my care provider to get a positive birth at [insert location].

I know it’s a mouthful but have the conversation! Be confident in your choices and help empower other women. If you don’t want to disclose your birth plans to a negative person say, We’ll see what happens on the day! and change the topic.

A Good Birth

While Dr. Lyerly was a professor at Duke and performing research for A Good Birth," she and her team of researchers interviewed 101 women from racially and economically diverse backgrounds who gave birth in all types of situations — from scheduled C-sections to unassisted home births — and included women who had different birth experiences for each of their children.

Dr. Lyerly identified five qualities that led women to feel that they had good births, regardless of how their babies came into the world: agency (capacity to make their own choices, even if things didn’t go according to plan), personal security (a sense of safety during birth), connectedness (with medical providers, family members and with their babies), respect (an acknowledgment that birth is a transformative life event) and knowledge (understanding their bodies, and also understanding that birth was a process they couldn’t fully control)." ³

A Positive Birth

Here’s how the Positive Birth Movement defines a positive birth:

"A positive birth means a birth in which a woman feels she has freedom of choice, access to accurate information, and that she is in control, powerful and respected. A birth that she approaches, perhaps with some trepidation, but without fear or dread, and that she then goes on to enjoy, and later remember with warmth and pride.

A positive birth... simply has to be informed from a place of positivity as opposed to fear. The Positive Birth Movement is woman-centred and as such respects a woman’s human right to choose where and how she has her baby.

You can birth with positivity in hospital or at home, with or without medical intervention. You can have a positive caesarean, or a positive home water birth. Positive Birth is about approaching birth realistically, having genuine choice, and feeling empowered by your experience. A positive birth means: ⁴

Women are where they want to be

Choices are informed by reality not fear

Women are listened to and treated with respect and dignity

Mothers are empowered and enriched

Memories are warm and proud"

Rite Of Passage

I want to help you have a good birth, an empowered birth, a positive birth! When we know that birth is so much more than just popping out a baby, that it’s an adventure journey, we can start to lay out a foundation to help us view it as a formative rite of passage.

The childbirth journey is holistic; it is physical, emotional, psychological, cultural, social, and spiritual. Viewing it as a purely physical event disregards its power and potential. Considering childbirth as a rite of passage allows us to acknowledge that self-transformation occurs regardless of where it happens or how it unfolds.

Rachel Reed, pg. 49, Reclaiming Childbirth as a Rite of Passage ⁵

What do we need to travel through this rite of passage?

Well, I am going to mention a lot of things I think would help (the right support people, personal birth knowledge, and a skilled care provider) but at any minute any of those exterior factors can change. So it’s beneficial to do some prep work and have your own mindset ready for whatever may come. It’s you who will go through this birth. What do you want from it?

An Empowered Birth Plan

While a lot of care providers don’t put much stock in birth plans because they think you just want twinkle lights and to refuse cervical checks, you know better. A birth plan is not just a piece of paper to hand to your care provider and hope you get your wish list. It's a representation of what you want, and WHY. It means you want to be supported and respected through an incredible life experience and the transformation into a new mother. It’s your game plan for physiological birth AND emergency birth.

It means your husband, doula, or friend can encourage and support you to speak up. They can even use your plan to help advocate for you if you so desire. This helps you stay in control and prioritise. It also helps you remain in your more primal and instinctive brain, rather than expending too much energy thinking while in labour.

Your plan reminds you that you are an empowered woman. It reminds you that you have already done the hard yards of seeking out knowledge and making decisions. You have researched these things! You have good reasons behind each choice even if your labour brain is fuzzy. Now all you have to do is trust yourself and follow your plan. It’s up to you now in pregnancy to research various scenarios and options and decide on a plan that works for you.  Choose an empowered birth!

I will go over your breech birth options in Chapter 3, and your rights in Chapter 8, but first let’s look at some general options and informed consent.

Informed Decision Making: Using Your BRAINS

The intent of informed consent is not to coerce you into doing what the midwife/doctor wants but rather for them to present the benefits AND risks, then let you decide. Unfortunately, sometimes care providers forget what they are supposed to do, and instead present information as, We think this is best, and this is what we want to do. They may give you good reasons. But ultimately, if they just tell you what they are going to do, that is not true consent. If you say no and they keep asking until you say yes, that is not consent.

It's reprehensible that you have to figure this out and advocate for yourself against the people who are actually trained in it, but sadly that is the state of modern maternity care.

An incredibly helpful decision-making tool is the BRAINS acronym. Use it whenever you are presented with a choice in your adventure path, or your provider is suggesting an intervention.

B – What are the BENEFITS of this course of action?

R – What are the RISKS?

A – Are there any ALTERNATIVES?

I – INTUITION: What does your gut say?

(Also can be: What are the IMPLICATIONS of following this course of action? Will it make further INTERVENTIONS more likely?)

N – What if we do NOTHING and wait ( for an hour or 2, or a day,) before doing anything?

S - SMILE: This will be okay. Take a minute to discuss your feelings with someone you trust. (This last one is helpful in a medical situation to smile and say ‘Scuse me, I need SPACE to discuss this’. You can then talk to your birth partner, get a second opinion, search online, or phone a friend.)

As Dr. Marek Glezerman says, Keep in mind that although something may be statistically significant, this does not make it clinically significant. At the 2012 Coalition for Breech Birth conference he pointed out that if a patient presented with a temperature of 99.4 you would not look around for a drug that had a 98% chance of lowering it to 98.6. So, if you find that, for example, vaginal breech birth increases the risk of bruising to 2.3% from the caesarean-born risk of 1.2%, that is statistically significant. It is twice the rate of bruising. But it is not clinically significant because you would not do a caesarean just to avoid a 1% risk of bruising. See? Keep in mind that figures must be examined from every angle. You can present the same information many ways and get very different reactions and perceived outcomes. ⁶

If we go beyond the basic BRAIN acronym, here are some more questions you may want to ask yourself ⁷:

Do you have all the information you need to make this decision?

Does this choice align with your values?

In the future, when you look back on this decision, will you feel satisfied that what you chose was the best answer available to you at the time? (Even if it was something you had hoped wouldn't have to happen) Or will you regret the way you made the choice?

Close your eyes and do a body scan. Are you feeling any tension anywhere or is your body feeling calm? If yes, what do you think is causing it?

Research Points

Some things you might like to research before your empowered birth are:

Physiological birth: Understand that your body and baby are made to birth (even though occasionally they need help). Learn how your body prepares for and facilitates labour on its own, and the hormones that are involved. (I do a quick synopsis in chapter 5 - Tips for Breech Birth). Appreciate how baby transitions from amniotic fluid to air. Get all the information on how you can support those processes, reduce pain and discomfort, and minimize complications for you both. You could take a childbirth class, read a book, or listen to an audiobook or podcast. One of my top recommendations would be to look up Rachel Reed’s website (MidwifeThinking), her podcast (Midwives Cauldron), and her book (Reclaiming Childbirth as a Rite of Passage). She also hosts a physiology course on her website. Additionally, Sarah Buckley and Mama Natural are two others that I know specifically cover physiological birth in their materials.

Physiological Third Stage: This is the birth of the placenta. Most times it can be birthed without issues, without postpartum haemorrhage (PPH), and without intervention. You do not automatically need a shot of synthetic oxytocin (known by brand names such as Pitocin/Syntocinon) to help birth the placenta. In one study done of low-risk women, your chance of PPH with Pitocin and active management was 11.5% and without Pitocin, receiving instead holistic psychophysiological care was only 1.7%. ⁸

If you choose expectant management (to wait), you can often feel the placenta detach with the afterbirth contractions and it is a simple matter to push it out. It doesn’t hurt as it is much smaller and softer than the baby! (The afterbirth contractions may hurt though.)

The method of birthing the placenta should be discussed with care providers in advance. I have heard of too many women being surprised with the oxytocin injection and a hasty verbalised, We're just giving you a needle. as it is being stabbed into their leg. Some women also don’t find out until later that the IV drip they had for fluids got switched over to a Pitocin drip. Brief your Partner or doula to be a watchful advocate so you can enjoy your baby and not be distracted by the staff.

However, if your birth was highly medicated or induced, an actively managed placenta birth may be your best option ⁹ . A physiological placental delivery is much harder and haemorrhage is already more likely after a non-physiological birth where your natural oxytocin levels have been disrupted or replaced completely by Pitocin. You might choose to continue to have the Pitocin drip or accept a Pitocin shot after birth, to minimise the time that your body isn’t contracting on its own.

After your placenta is born, you might like to keep it for later to bury, encapsulate, or even just