Buzzfeed, would you glamorize a parent who held his or her baby out over a balcony railing ten stories up as Michael Jackson is doing in this photo?
It’s really no different glamorizing a footling breech homebirth.
Actually it is a bit different. A breech homebirth is far more dangerous than dangling your baby off a balcony.
Why? The risks of labor differ substantially for breech babies.
How?
Fetal head entrapment may result from an incompletely dilated cervix and a head that lacks time to mold to the maternal pelvis. This occurs in 0-8.5% of vaginal breech deliveries… The Zavanelli maneuver has been described, which involves replacement of the fetus into the abdominal cavity followed by cesarean delivery. While success has been reported with this maneuver, fetal injury and even fetal death have occurred.
Nuchal arms, in which one or both arms are wrapped around the back of the neck, are present in 0-5% of vaginal breech deliveries and in 9% of breech extractions.[4] Nuchal arms may result in neonatal trauma (including brachial plexus injuries) in 25% of cases…
Cord prolapse may occur in 7.4% of all breech labors. This incidence varies with the type of breech: 0-2% with frank breech, 5-10% with complete breech, and 10-25% with footling breech…
In other words:
At term, the baby’s head is usually the largest part of the baby. That means that if the head fits, the rest of the baby should follow without difficult (shoulder dystocia is an exception). Moreover, the bones of the fetal skull are not fused and can slide past each other, allowing “molding” of the fetal head letting it squeeze through the pelvis. In the breech presentation, the head is still the biggest part of the baby, but now it is coming last and there is no chance for it to mold to squeeze through the pelvis. There is a high risk that the head will be trapped, often resulting in the death of the baby.
In addition, in contrast to vaginal delivery where the baby’s arms are pressed to its sides, the arms of a breech baby may end up over its head. One or both can end up behind the head crossing the neck. This is known as nuchal arms. A baby with nuchal arms cannot be delivered because the diameter of the head plus the arm(s) is too big to fit through the pelvis. Unless the provider can move the arm(s) from behind the head, the baby will die.
Typically, the head fills the cervix as it is dilating, making it impossible for the cord to prolapse (fall out), a condition that routinely ends in death. In contrast, the breech, being smaller, does not fill the cervix, making cord prolapse far more likely.
Without immediate access to C-section, cord prolapse has a mortality rate from 32-47%.
The risk of death at a footling breech homebirth can be as high as 12%, which means that as many as 1 in 8 babies will die during a footling breech homebirth. That’s only slightly better than the odds of playing Russian Roulette by pointing a gun at your baby’s head. Would you glamorize that?
Buzzfeed, if you want to show what homebirth is REALLY like, show some photos of complications and death. Without those, your piece in nothing more than an advertizement for taking terrible risks with babies’ lives.
