Coalition for Breech Birth - National Capital Region & Eastern Ontario

03/28/2024

This post is from 7 years ago and not much has changed since then. Ontario midwives are medical professionals who have vaginal breech birth within their scope of practice. It should never require an obstetrician's permission for a midwife to practice within their scope.

Thank you Jessica Kara Lynn Smith for sharing with us this beautiful testimony on your birth story! Welcome baby Drayton:

We would like to introduce our friends and family to Drayton Smith, born March 18th.

We just wanted to say a huge thank you to Betty-Anne Daviss, our fabulous Midwife, as well as all the staff (Midwives, Nurses, and Doctors) who collaborated on our breech birth, at The Ottawa Hospital - Civic Campus, on March 18th, 2017. We gave birth to a very healthy baby boy, the way we had envisioned; naturally and vaginally. He was born 2 days after our due date, and has already gained back his birth weight of 7lbs, 5oz. We feel very lucky to have found Betty-Anne Daviss, who helped us every step of the way.

Our delivery at the Civic Hospital involved excellent collaboration and negotiation between Midwives and Doctors, which allowed us to give birth to our son in an upright position, using a birthing stool, which required no forceps and no episiotomy. My husband politely asked the Doctor if our Midwife (Betty-Anne Daviss) could manage the birth, and the Doctor graciously allowed this to happen, which was really special for us. It was a very smooth breech birth.

Thank you all very much!

Ottawa Hospital - Civic Campus

03/26/2024

In an effort to demonstrate the need for midwives to be the most responsible person for vaginal breech births at the Ottawa Hospital, we would like to publish a series of breech birth stories. The only requirement is that they have some connection to Ontario. The connection could be as simple as a consult about breech with an Obstetrician who practices in the province. We want to hear all types of stories: births that went exactly as planned, births that nothing went as planned and everything in between.

When submitting your breech birth story, please include the year of birth and how you would like to be attributed (full name, first name, anonymous or something else entirely). You can submit your breech birth stories to the following email address: cbb.ncr.east.ont [at] gmail.com

https://cbb-ncr-east-ont.blogspot.com/2024/03/continued-call-for-breech-birth-stories.html

03/26/2024

In November 2018, in the lead up to the presentation by consumers to the hospital board, the Ottawa Citizen published an article about consumers wanting midwives to have breech privileges at TOH. One thing that jumped out at me as I reread the article is the description of the situation as "long-simmering concerns." We are now nearly five and a half years later and nothing has changed since this article was first published. People carrying breech babies are still being forced to transfer care from their midwife to an obstetrician, and are oftentimes being coerced into c-sections that they do not want or their babies are delivered vaginally without the latest evidence based techniques.

https://cbb-ncr-east-ont.blogspot.com/2024/03/group-wants-midwives-to-deliver-breech.html

03/17/2024

Around the same time as the airing of Betty-Anne Daviss' White Coat, Black Art episode, an important article that she co-authored was published. It concluded that "upright vaginal breech delivery was associated with reductions in duration of the second stage of labor, maneuvers required, maternal/neonatal injuries, and cesarean rate when compared with vaginal delivery in the dorsal position." Midwifery clients usually prefer to be upright while giving birth to a breech baby, however, most obstetricians in Ottawa continue insist that women carrying breech babies push on their backs. This is another important reason why consumers want Ottawa hospitals to respect midwives' scope of practice and to no longer require a transfer of care from a midwife to an obstetrician when a baby is breech.

Another important finding from this article is that none of the births in this study required forceps. There's an obstetrician in Ottawa who insists on using forceps for every breech delivery in order to teach this skill to other obstetricians. Forceps are often used without consent. Midwifery clients do not wish to be used to help train obstetricians on how to use forceps especially since this skill is not needed in vaginal breech births.

Here's the link to the article: https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/ijgo.12033

03/11/2024

On November 5th, 2016 a group of us gathered at Betty-Anne Daviss' house to listen to her episode of White Coat, Black Art . The group included several women for whom Betty-Anne had caught their breech babies, several women who were denied Betty-Anne's care due to TOH's refusal to grant midwives breech privileges and several people who had been babies (both breech and cephalic) that were caught by Betty-Anne.

03/05/2024

This article was published on November 4th, 2016 on CBC Radio's website. It accompanied an interview of Betty-Anne Davis that was originally aired on the same day on White Coat, Black Art. It includes an interview with Dr. Daniel Moreau who was the chief of obstetrics and gynecology at the Montfort hospital when Betty-Anne was granted breech privileges in April 2013.

You can find the link to listen to the interview here: https://cbb-ncr-east-ont.blogspot.com/2024/03/into-breech-this-midwife-says-breech.html

03/05/2024

This article was published on November 4th, 2016 on CBC Radio's website. It accompanied an interview of Betty-Anne Davis that was originally aired on the same day on White Coat, Black Art. It includes an interview with Dr. Daniel Moreau who was the chief of obstetrics and gynecology at the Montfort hospital when Betty-Anne was granted breech privileges in April 2013.

You can listen to the interview here: https://www.cbc.ca/listen/live-radio/1-75-white-coat-black-art/clip/10686076-into-breech

03/04/2024

Into the Breech: This midwife says breech births are safe and natural. Now she just has to convince doctors.

This article was published on November 4th, 2016 on CBC Radio's website. It accompanied an interview of Betty-Anne Davis that was originally aired on the same day on White Coat, Black Art. It includes an interview with Dr. Daniel Moreau who was the chief of obstetrics and gynecology at the Montfort hospital when Betty-Anne was granted breech privileges in April 2013.

You can listen to the interview here: https://www.cbc.ca/listen/live-radio/1-75-white-coat-black-art/clip/10686076-into-breech

02/28/2024

This article was published in the Ottawa Citizen on May 31st, 2015 and it highlights the Montfort Hospital winning the Hospital Integration Award by the Association of Ontario Midwives. In April 2013, midwives started attending vaginal breech births at the Montfort Hospital. Now more than 10 years later, women continue to ask TOH to allow midwives to practice within their full scope. We continue to make this request primarily due to the fact that many women are not allowed to attempt a vaginal breech birth with a midwife at the Montfort because they fall outside of the hospital's catchment area. Their next best option is TOH with an OBGYN which can vary from a coerced c-section to a vaginal breech delivery with an unnecessary episiotomy and the use of forceps without consent.

Another issue still facing TOH is the cap on the number of midwives who can practice at the Civic. This has continued since this article was published nearly 9 years ago and is highlighted in the following quote from the article:

"Montfort, midwives say, is the only hospital in Ottawa that does not have caps on the number of midwives who can have privileges to work there. It also allows midwives to do everything for which they are trained with no limits to their practice. The head of obstetrics, in fact, wrote to The Ottawa Hospital suggesting it also allow midwives with experience to conduct vaginal breech births."

https://cbb-ncr-east-ont.blogspot.com/2024/02/montfort-recognized-for-intergrating.html

02/22/2024

Here is our very first breech birth story! Thanks to Brigitte for sharing her positive experience!

Also, we are still looking for more breech birth stories, so if you have one that you'd like to share, please email it to us at [email protected]

Brigitte writes:

I have a special breech story that I would like to share from a small northeastern community.

My name is Brigitte and I live in Kapuskasing, Ontario. I have two healthy boys, ages 5 and 2. My husband and I chose to deliver both our boys in Timmins, Ontario (about 2 hours from Kapuskasing) as we felt it was the best option. Our first son was born without a hitch at the Timmins hospital with Dr. X who was absolutely amazing throughout the entire process. Of course, when I found out I was pregnant with baby #2, I wanted to have Dr. X again. Dr. X was also expecting a baby around the same time as I, which was a little worrisome but I also knew that there was a great team of OBGYNs there.

At 33 weeks, during a regular ultrasound to make sure the baby was measuring okay (I always measured small so Dr. X liked to make sure the baby was good), we found out that the baby was breech. I was shocked and devastated. My first thought was that I’d have to get a c-section which was a big fear of mine. Having a beautiful flawless no epidural delivery like my first was always what I had imagined for my second. I quickly started doing my research. I stumbled upon the Coalition for Breech Birth where I found inspiring stories of vaginal breech deliveries. My husband and I also watched the movie “Heads Up” to get some more information and understanding.

I started doing all the spinning babies techniques to try to flip the baby but without any success. I had a lot of fear as we live in such a small community that I worried that no doctor would want to attempt a vaginal breech delivery. I cried myself to sleep at night in fear of a c-section. Not to say that c-sections are bad, I just felt in my gut that it was not for me and that I could do this. I started discussing with Dr. X the possibility of doing a vaginal breech delivery as my due date was approaching and we discussed my fears. She was amazing and respectful throughout the whole process. She had suggested an ECV to see if we could flip the baby (which was unsuccessful). She was willing to do a vaginal breech delivery accompanied by another OBGYN but again as my due date approached so did hers.

We ended up deciding that Dr. Y would be the best OBGYN for my situation. He was one of the best doctors with a lot of experience with vaginal breech deliveries. I was transferred to him about two weeks before my due date. I felt very comfortable with him right away. We discussed mine and my husband's fears, talked about the pros and cons, and he explained that he had done many vaginal breech deliveries back in the day. He agreed to do this without hesitation and was actually excited to have someone wanting to do it as not many people chose to. He felt that the baby measured approximately the same as my first born and with it being my second baby, he felt I was a good candidate. He made sure that the staff at the hospital knew my situation and if I were to come in to call him even if he was not the one on call that day. I was so amazed by his patience and calmness.

When I arrived at the hospital at about 38 weeks with some contractions, I was about 3-4 cm dilated. Dr. Y decided it was best if I stayed as we live in Kapuskasing (about a 2 hour drive). The team strongly recommended for me to get an epidural but this was another big fear of mine. At the time, I wasn’t in a lot of pain and I was kind of stalled at 5 cm for quite some time so I decided against it. Dr. Y agreed that we’d revise things in the morning if there was no progress. Never at any point did I feel any pressure to do anything I did not feel comfortable with which I think is very important. At around 2-3 a.m. my contractions were very intense, so the nurses checked my cervix and I was fully dilated.

Dr. Y was there in no time, guiding me through every step. He explained that he’d let me know when it would be time to push (even though I had a strong urge to). I followed his every instruction as I knew that he knew what he was doing! He offered/suggested I take something to take “the edge off," so the nurse gave me a bit of morphine. My water did not break and he wanted this to happen on its own. He told me to lay on one side and a few minutes later my water broke and it was time to push. A few big pushes, all of which took about 10-15 minutes and out came a beautiful healthy 7 pound baby boy! Born on April 9th, 2021. Of course, with all my research I was aware that the baby may take some time to breathe. What felt like an eternity, we heard our baby boy cry and all our fear went away!

I will be forever grateful for Dr. Y (and also Dr. X for sending me to the very best of hands). If it wasn’t for the amazing team at that hospital, my delivery could have had a different ending. I feel extremely lucky to have been “at the right place, at the right time” as I know from reading so many stories of how rare it is to have this privilege. Unfortunately there probably aren’t many doctors (if any) that will do vaginal breech deliveries near here as Dr. Y retired a few months after my son was born. I am so thankful and he holds a very special place in my heart.

02/18/2024

We have updated one of our requirements for submitting a breech birth story. We are now accepting stories that have a connection to Ontario, not just Eastern Ontario. The connection could be as simple as a consult about breech with an Obstetrician who practices in Ontario. We want to demonstrate the need for midwives to be the most responsible person for vaginal breech births, so we are publishing a series of breech birth stories. We want to hear all types of stories: births that went exactly as planned, births that nothing went as planned and everything in between.

When submitting your breech birth story, please include the year of birth and how you would like to be attributed (full name, first name, anonymous or something else entirely). You can submit your breech birth stories to the following email address: cbb.ncr.east.ont [at] gmail.com

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02/13/2024

Here is an article first published on June 17th, 2009 in the Globe and Mail. This article covers the recent release of the SOGC guidelines for vaginal breech birth. One of the things that is mentioned in the article is that these new guidelines are part of the SOGC's effort to promote normal childbirth. This has not happened across the board in Ottawa as it relates to breech birth. Aside from breech births attended by midwives at the Montfort, people carrying breech babies are often still subjected to unnecessary episiotomies and forcep deliveries when a vaginal breech birth is infrequently offered. This highlights one of the reasons why we are pushing for midwives to be able to practice within their full scope and to have breech privileges at other hospitals: so that more people can be trained in physiological breech birth.

https://cbb-ncr-east-ont.blogspot.com/2024/02/c-section-not-bet-option-for-breech.html