Em's Breech Maternal Assisted Caesarean Birth Story.

Em's Breech Maternal Assisted Caesarean Birth Story.


On the 11th of August 2020 I welcomed my first born son Oscar into the world via a Maternal Assisted Caesarean (MAC) at Frances Perry House, Melbourne. 


Having done a fair bit of birth prep that swayed more toward the ‘my body can birth this baby naturally’ than ‘lets cut you open and baby does not choose when he is coming’, I was pretty annoyed that this was going to end up being my first birth story. I must admit though, despite all that oxytocin inducing prep, a tiny part of me did find solace in the fact I wasn’t going to have to go through the pain of labour. tiny. And it helped knowing I was going to be an active participant in my baby’s birth, rather than a bystander. A sentiment many women feel after a caesarean birth. 


Oscar was breech the entire pregnancy. Despite accupuncture, moxabustion and inversions over the couch (no swimming pools open due to covid) he didn’t budge. I decided to have an external cephalic version (ECV) at the 37 week point. This is a procedure where the obstetrician manually attempts to turn the baby to head down position (basically just a lot of pressure on a very tight pregnant belly). Mentally if this didn’t work, I figured i’d be able to reconcile the book-the-date caesarean better, having tried every possible way to flip this kid. 


The whole ECV process was…interesting. I had to pack my bags for labour, as one of the risks is that it can send you into labour (if only, I thought!). We were in lockdown and no partners were allowed at appointments, so my husband waited patiently (worried a better emotion to use here) in the carpark downstairs, with bags, while the obstetrician took on the roll of support person too-stroking my forehead and coaching me through some breaths. For this I will always be so grateful (thanks Peter Jurcevic). A drip was inserted onto my vein and a drug injected into this to help my uterus relax. It felt like I was being injected with anxiety. A normal side effect of this drug is a racing heartbeat-not helpful when you’re actively trying to relax and surrender to the manual process of the doctors hands on my belly try and turn this head up baby, down. After a few goes, it was pretty clear he was there to stay, head up, close to my beating heart. (3.5 years later, it's still his favourite position).


Having a private obstetrician afforded me the privilege of a maternal assisted caesarean-a rare option in the birth landscape back in 2020, and frustratingly still today. Public hospitals generally don’t perform MACs, and not all private obstetricians agree its worth the risks. The main being infection. In Australia, one in three women describe their birth as traumatic. With a correlation between informed choice and positive birth experiences, as well as the c-section rate at 38%, it makes sense we have more conversations about MACs with our care providers to shift the surgical lens they see c-section births through, to one where a women feels fully involved and empowered. 


On the day of my sons birth we were wheeled to the operating theatre. The final moments of just us, on the threshold, it was such an out of body feeling knowing new life was coming so soon. We met various members of the team as things were being prepped. There are lots of people! Obstetrician, assistant, anaesthetist, paediatrician, and nurses. Lots of explanations about what was going to happen made my husband and I feel as prepared as we could be. A distinct memory I have of this stage was how genuinely excited the team were for us; The OB saying ‘are you ready and excited to meet your baby?’


I was taken into the cold theatre while Paul waited outside while I had my spinal. Once I was laying back on the bed, Paul was allowed back in. I remember seeing my legs being moved by a nurse-such a mind spin-not being able to feel your legs but seeing them move. As there is only a very low surgical drape, you can really see lots of what is happening if you choose to. It shocked me how fast everything happened from here. I asked at last minute for a nurse to take my phone to take photos, I felt weird asking, but couldn’t have not, and didn’t want Paul to be distracted with that job. I also put my phone on live photo mode so I could stitch together the shots if I wanted. I donned surgical gloves with the help of the nurses, and in what felt like seconds after, I was being asked to put my hands down and pull my baby onto my chest. The fact he came out bum first did make this step a little cumbersome! The obstetrician quickly flipped him over for me to then hold my baby to my chest for the first time. It felt weird holding him with gloves but they are taken off relatively quickly. 


After some skin to skin and delayed cord clamping, Oscar was taken to be weighed and checked over while they started to stitch me up. This part is hard-the ‘need’ to take them off you so quickly, and maybe something I would question if I had another c-section. After this I got another cuddle for about 15 mins before Paul took Oscar and the obstetricians finished stitching me up and moved me to recovery. Once my shaking stopped with the help of a drug (omg was not prepared for that!) I finally had uninterrupted time with Oscar and was shortly moved back to the ward to start out new life as a family of three!