Welcome Kannon: The Story of my Unmedicated, Vaginal Breech Birth
The Birth of Kannon Rainier
First things first: being pregnant for the first time in 2020 was a wild ride in itself. From not being able to have my husband with me at appointments, to wearing a mask during labor—it’s been a trip.
Add in a few of the bumps along the road: Perinatal anxiety/depression, a gestational diabetes scare that demanded my advocacy, switching care providers at 32 weeks, finding out baby was breech at 36 weeks & transferring care back to the hospital, doing all of the things to try to turn him head down, a failed External Cephalic Version and coming to terms with the fact that I’d be considered a “high risk” patient attempting a vaginal breech delivery. All of these things made for an emotionally exhausting pregnancy in the third trimester that would pave the way for one hell of a birth story.
Wednesday, September 23rd, 2020
On Wednesday morning, I was sleeping when my body woke me up out of the blue and seconds later I felt a gush. It was kind of like when your body wakes you in the middle of the night and you feel yourself start your period. I got out of bed and grabbed a fresh pair of underwear before going to the bathroom. I debated on if I had peed myself or if this was “it”; I determined that my water had broken. I put on the fresh underwear and a panty liner before walking out to find the piece of paper I had printed that said “When to Call your Doula”. As I read, I had another gush—this time much bigger (the panty liner didn’t stand a chance). As I was cleaning up a bit of where I had leaked on the bathroom floor, I felt another even bigger gush that started pouring out of me all over my clean bath mat! It felt like something out of a comedy movie, as I was trying to clean but dripping all over! I got cleaned up and called my doula to let her know and then called the OB on her personal cell phone number.
Side note: Finding a provider for a vaginal breech birth is like finding a unicorn--most breech births are automatic C-Section. I was so fortunate to have not one, but two unicorns to work with! The doctor I established care with and who performed my ECV—let’s call her Dr. F—had informed me that she would be out of town the week leading up to my due date, but another doctor in the practice—Dr. T—could assist in the event that I went into labor. The morning my water broke I called Dr. T to let her know that it looked like she would be assisting in my birth.
I tried to go back to sleep, but who can sleep when they realize they’re in labor? Plus, I had just started having contractions and didn’t want to wake my husband (he wouldn’t be getting a hit of oxytocin when the baby arrived, so I wanted him to be well rested). I came out to the living room and put on a movie I had seen a hundred times to try to rest before things picked up. My first request when he woke up was to go pickup my Starbucks mobile order—very on brand for me. Second request was for him to not cancel the haircut he had scheduled for that morning, because I didn’t want the first thing the baby saw to be his COVID-19 hair! Shortly after, my mom saw my text that I was in labor and hopped on a flight for Sacramento from Seattle.
By about 9:30 my contractions became less regular, so I showered and got up to get things moving again. By about 1 pm they were back in action and my mom had arrived at our home. I continued to labor all day with contractions, but I started to feel them not in my uterus, like an intense menstrual cramp, but in my back. I had heard about “back labor” but didn’t fully understand what it meant or how it differentiated from a typical contraction--I would soon learn. And I wouldn’t wish it on my worst enemy! By the evening, my contractions were getting closer together and longer in duration. Our doula arrived around 7:30 to help me cope through laboring at home. We went for a walk an hour later and I started to feel pretty shaky, with contractions getting stronger and closer. At 10:30 pm, my contractions were lasting 45 seconds to a minute and were 2-4 minutes apart, so we decided it was time to head to the hospital. The timing was right and I was showing many of the “emotional sign posts” that made it seem labor was advancing. I had expressed some doubt that it was really time to go, although on paper it seemed like I was ready. So we called Dr. T to let her know we were heading in to to get checked and then headed out.
Once we got to the hospital in Sacramento, our Doula was not allowed to walk us in (we knew this, but still such a bummer). I had to go through triage alone while Jake waited in the lobby. Poor guy—we had brought in all of our gear for labor and he sat for an hour just waiting for me to be admitted. The nurse noted that I had ruptured membranes (broken water), then did a cervical exam. “It looks like you’re 1.5 cm dilated and not fully effaced,” she said. I was devastated.
Here I was, 18 hours into labor and physically, nowhere near ready to have this baby.
Not only did it mean more hours of labor ahead, but also that I would most likely be sharing a birthday with baby (I love my birthday and I’ll just be honest, I’m not good at sharing)! My OB called and requested to have me discharged, since typically the hospital won’t discharge if your water is broken, and I was given “Atarax” to help me sleep.
The Atarax was strong enough for me to sleep, but instead of waking up at the base of a contraction to prepare to breathe through it, I woke up at the peak; this left me feeling out of control and disoriented, unable to do anything but scream out in pain. After the medicine wore off, I continued to labor all night with my contractions slowing down to about every 6-8 minutes. I slept on the couch for the few minutes between contractions and then when I felt one coming on, I would hop up to a standing position. Since all of the pain was in the base of my back, I had to have someone apply a heat pack and hard counter pressure to my back...Every. Eight. Minutes. This was my first night with no sleep.
Thursday, September 24th, 2020
By morning, I was exhausted--physically and emotionally-- but fortunately, I had a standing appointment with my OB, Dr. T, at the Davis hospital for a Non-Stress Test and another cervical exam to check dilation. I was hopeful that my sleepless night had produced some progress, but after the check Dr. T said that I was still only 1-2 cm dilated and not fully effaced. Again, I was completely devastated and emotionally was starting to fall apart. This appointment marked 30 hours of labor and still hardly any progress in my labor. At this point, it was time to start talking about what I wanted to do going forward.
My options were: Membrane Sweep, Castor Oil or a Cesarean Section. I decided to forego the sweep, afraid that it would make contractions stronger but still not productive, setting me up for more disappointment and exhaustion. And while Castor Oil works for some, it often makes for an intense labor that, again, may not prove to be productive. We decided that my best option was to move forward with a planned C-Section. If you recall, it was my birthday and I really didn’t want to 1) have major abdominal surgery that day 2) share a birthday for the rest of my life.
We scheduled the C-Section for noon the next day.
Looking back, it was either 100% my stubbornness or 100% the voice of the Lord that caused me to schedule the C-Section for 24 hours later. But in the end, I’m so glad that I did because of how this story ends.
At this point, I was just plain exhausted and wanted to rest before the surgery. But wouldn’t ya know it, contractions don’t just stop when you decide to schedule a C-Section—I had another long night ahead. I made the mistake of taking Atarax again, which left me feeling totally distressed and unable to work through the contractions with the controlled breathing and focus they demanded. My back labor had increased tremendously and I really didn’t see how I was going to make it through the night. In a total panic moment, I texted my Chiropractor asking for advice (and ideally help) in managing the back labor pain. She is an absolute saint and came to my rescue, in my home, to help adjust me! Oh mind you, I had only known her for a month because I switched to her care when we found out the baby was breech. That little detail makes it even more amazing that she came to my rescue after hours, in my home. That being said, if you’re in my area and want an amazing nervous system focused chiropractor, let me know! She observed that my sacrum was out of balance and baby was likely adding pressure, explaining why the back pain was so intense. While it didn’t alleviate the back labor altogether, her movements seemed to take the edge off for the next few hours. And I credit this adjustment as the turning point for what was to come. Throughout the rest of the evening, my contractions remained consistent—I had another long night ahead of me.
Friday, September 25, 2020
It was another night of no sleep, with long contractions every 8-10 minutes. By this time, the only position I could be in to get a sense of relief was sitting backwards on a folding metal chair. The pain was so intense that I found myself inadvertently clenching my thighs into the metal sides with each contraction—which were lasting a full 1 to 2 minutes at this point (Fast forward to the next day and I had black bruises inside my thighs from so much time spent on this damn chair). Around 3:30 in the morning I was really losing it at the thought of doing this for another 7 hours before my surgery prep.
We weighed all the options of what I should do next.
Another side note: While the provider who was willing to deliver a vaginal breech birth was based out of my medical group in Davis, the Davis hospital didn’t allow these births to take place in their facility. However, the hospital in Downtown Sacramento allowed them, meaning my provider from Davis would work as a guest OB in the Sacramento facility. The Davis hospital is known regionally for practicing evidence based care, with values that were aligned with my own (midwifery care, delayed cord clamping, water birth, delayed testing, etc); whereas the Sacramento hospital was more of your typical hospital where I might have to advocate for these things. Once we had decided to move forward with a C-Section, it meant I would now give birth in Davis. This is important to note!
Back to the labor…I was ready to throw in the towel. I wanted to go in for surgery early just to make the pain stop, but I knew the OB doing my surgery had another procedure before mine so that wasn’t able to happen. At 5: 30 am, we called my doula to run through my options. Option 1: Continue to labor at home in excruciating pain until I had to check in for surgery at 10 am. Option 2: Head to the Sacramento hospital to get checked on how far dilated I was, in hopes of being far enough along to still try for a vaginal birth (the risk here would be not being far enough along still, then not being able to be discharged since it had been so long since my water broke. I did not want to get stuck having a C-Section at this hospital if surgery was my fate). Option 3: Head to the Davis hospital early to receive an epidural, in order to be able to rest before surgery.
My body was so exhausted and I realized that emotionally I was not stable enough to make it through more of the back labor. I decided I wanted to just head to the hospital early for an early epidural, in hopes of just being able to sleep (at this point I was on hour 48 of labor with no sleep). I had come to terms with the fact that our baby boy would enter the world through a belly birth and ultimately chose to surrender my feelings and trust that God was in control. At 6 am, we called Dr. T and she agreed to the plan for me to come in early; she was on call at the hospital that morning and would see me when I got there.
We made the 45 minute trek to Davis and arrived around 7 am. When I got there, I was so miserable and ready for the epidural. The nurse told me I would be getting another Non-Stress Test to monitor baby’s heart rate, as well as another cervical exam. I vividly remember saying “Ok that’s fine--but when can I get the epidural?” I was so exhausted, but knew I just had to get through the cervical exam and then they would prepare the epidural.
At 7: 30 am, Dr. T came in and checked me. She was very quiet as she removed the scope and said “Well, you’re dilated to 6cm. Do you want to go ahead and go for it with the vaginal delivery?” I was in complete shock! After 50 hours into labor and a night of living hell, I couldn't believe what I had heard. My husband looked at me with tears in his eyes because he knew how much I wanted a vaginal delivery. I had a new rush of energy and hope that flooded over me as he looked at me with a look of answered prayer. The room was quiet as I thought through the option before me, then I said “Yes, let’s do it!”
Here’s the kicker: This now meant I would be transferring to the Sacramento hospital for the vaginal birth, since the Davis hospital didn’t allow them. Dr. T said she would head straight to Sacramento, because there wasn’t time for her to head home first. As we removed the monitors, a nurse came in the room saying “Umm, it says this patient is being discharged, but she’s 6 cm?” My nurse said, “Yes, that’s correct...it’s a unique situation.” As I walked out of the room down the hall to exit the Labor and Delivery center, the nurses all clapped and cheered us on for what was to come! Such an amazing moment and the boost of encouragement I needed to get back in the right mindset!
It was happening: I was finally in active labor and just a few hours away from meeting our baby boy—and I was going to do it vaginally!
The city of Davis is about 20 minutes past Sacramento, which meant we would be driving back into Downtown at 8 am on a Friday morning—just in time for morning traffic! I made the trip from Davis to Sacramento unbuckled in the back seat as I worked through contractions. Fortunately, we didn’t get stuck in too much traffic and made it to the Sacramento hospital at about 8 am. It was night and day difference being admitted, compared to my first visit where I sat in triage, alone for an hour. This time, I was wheeled up to the Labor and Delivery floor, where I was able to bypass triage completely. The nurse at the desk asked for my name, then looked down at a note before making a call “Lauren K***z is here.” She opened the door for us, where I was greeted by my *amazing* nurse, Amber, who immediately took me to our room. She even let my doula wheel me back, before having to leave us. I felt like a VIP!
At this point, my mood had shifted 180 degrees—you would never know that I was 53 hours into labor and hadn’t slept in that time. I was hopeful and optimistic! Dr. T had arrived and at 9:30 am I consented to another cervical exam. I was dilated to 8 cm—EIGHT CENTIMETERS! My mom and doula were watching over Zoom (and did so the whole birth) and we all couldn’t believe it! I had requested a tub be set up in my room to labor in for the remainder of my time and hopped in around 10:30 am. The tub felt amazing on my achy back. My husband crouched by the side, holding my hands, while Amber ran the hose of warm water over my back. My original plan was to have a full water birth, so having the opportunity to labor in the water for even a short time was such a blessing to me. After about an hour in the tub, I started to feel shaky—telltale sign of the transition period. I decided to get out to go to the bathroom and prepare to be checked again. It was now 11:30am and I was dilated to a 9.5 cm with an anterior lip! I was so thrilled—we were almost there!
At 12 pm, My husband and I looked at the clock and noted that I should have been beginning my Cesarean surgery.
But here we were, 9.5 cm. I had fought with every ounce of strength to get here. We had surrendered our story into God’s hands and He had carried us to the end. We slow-danced in the middle of the room between contractions as we soaked up our last bit of time just the two of us.
Soon after, Dr. T told us that she had a pre-scheduled surgery back in Davis at 1pm. Umm, what? What did that mean? Like I had to have the baby right this second or what, wait? She then said that throughout my labor she had been communicating with Dr. F—my original provider who had been out of the office all week. She was on her way back from her vacation and wanted to come straight from traveling to the hospital to deliver my baby. Phew! Another change in plans, but I was happy things were still working out. Honestly, I think after meeting me for the ECV a few weeks before, and now seeing me come back from this long labor and a cancelled C-Section to birth a breech baby, she probably just wanted to witness this crazy person finish the job. Around 12:30 pm, Dr. F came into our room, dressed in normal clothes (she literally was on her way home from vacation), to finish out our labor and deliver our little breech boy.
At 12:45 pm I had reached 10 cm and was stationed +2, with increased pressure! The plan was for me to deliver in the OR, since breech births often require a little bit of extra care for any complications that might arise. I pushed for about 45 minutes in our room, before moving to the OR.
Time to Push
The OR was a totally different environment than my light and airy room. First of all, it’s an operating room, so lots of bright lights, buzzing and beeping, and instruments set out in case of emergency. Not to mention, there were about 8 additional people in the room to watch the birth, all standing by in the event that they were needed. NICU doctors, surgeons, anesthesiologists, a special nursing team, and even a nurse who asked my permission to observe the birth, since vaginal breech births are pretty rare and she had never seen one. At this point, the more the merrier right? (Side Note: I pretty much lost any sense of modesty I had, but I’m happy that I got to be an example of breech as a variation of normal, to make that team of people more confident the next time they come across it.)
In total, I pushed for 2 hours. Most of the pushing took place with me on my back, angled to my right side, with my left leg held up at a 90 degree angle by my husband. He also applied counter pressure to my lower back with each push. After nearly 60 hours of back labor, my back spasmed with each contraction and I physically couldn’t push or hold my legs open without his assistance. I never imagined him playing such a hands on role in the delivery (nor did he), but I’m so thankful he was by my side the whole time.
A few interesting things about birthing breech was I didn’t feel the same “urge” to push as people describe—I pushed like I had to go to the bathroom, but even that didn’t feel like an urge, it was definitely forced action I just had to make myself do when a contraction hit. In a typical birth, the baby’s head often “cones” to push through the birth canal and is able to do so because the bones in their skull are able to be molded. But in a breech birth, the hip bones are pretty set in place, so there’s no molding to fit through. With each push, Dr. F physically stretched my perineum with her fingers to make room for him to come out. Yes, “ouch” is right.
My contractions were about 6 minutes apart, but lasted almost 2 full minutes, which meant I had to push the whole time to make the most of them, or else we sat around waiting for the next wave. It was excruciating and I was exhausted. As I continued to push, his testicles were the first part of him we saw that bobbed in and out between pushes (TMI but they were swollen and bruised since they were receiving so much pressure, poor guy!). We knew we were close to having his full butt descend out, so I changed to pushing on my hands and knees, which is the optimal position for vaginal breech delivery.
Vaginal breech births are a “hands off” delivery, meaning there’s no guiding the baby out, no tugging or pulling—you just watch as the baby is pushed out and then caught as they literally fall out.
I continued to push through the next contraction on my hands and knees, tuning out everything except what Dr. F, Amber and my husband were saying. I could feel he was coming out, but was honestly a little scared to look! All of the sudden, I heard the doctor exclaim “He’s peeing!” What!?! Without even thinking twice, I looked down through my legs to see his full butt hanging out of me like a hammock and sure enough, he was peeing and pooping out meconium (this is to be expected because there is so much squeezing on his body, whereas typically meconium present is a sign of fetal distress). About a second after I looked down, I saw his leg flop out and hang—it was like something out of an alien sci-fi movie, with the reddish-purply skin that was a bit slimy. Another second later and the other leg flopped out. So now his butt and two legs were hanging. Immediately after I watched an arm drop out and then the other arm. It was just his head left!
My contraction was coming to an end, but I knew the risk of his head getting stuck and just wanted him out. At that moment, I tuned out every voice but my husband’s as I heard him say “Just one more push and he’s here!” So with every ounce of energy I had, I leaned into the back pain and the stinging feeling of tearing for one last PUSH...his head slipped out and he dropped into Dr. F’s hands! Without even thinking, I reached my hands through my legs, scooped him out and brought him to my chest. He was here! Kannon Rainier was finally here.
I couldn’t believe that after 60 hours it was over and he was here!
A nurse tapped my husband saying they needed to evaluate the baby and I needed to set him down. About a second later, Kannon let out his first cry, telling them there was no need for resuscitation (I found out after the birth that it’s not just common for breech babies to need assistance breathing, but it’s more normal than not). He was perfectly and completely healthy, with APGAR scores of 8 and 9. I brought him back to my chest as they wheeled me out of the OR and back to my room.
After Birth
After he was born, I received a full bag of drip Pitocin in my IV as a precaution, since I had labored so long and did lose a bit of blood (I had consented to this in my written birth plan). We waited to cut the cord until it had stopped pulsating and turned white, meaning Kannon had received all of the blood from it. Additionally, he was not bathed at all in the hospital in order to let the vernix soak into his skin, nourishing the microbiome. I birthed the placenta back in my room and it was then saved for me to keep. I did have a second degree tear in the back that I received stitches for. Not sure how many—didn’t ask and have been too afraid to know, to be honest! Lastly the fundal “massage”, where they press on your uterus to push out clots. All I’m going to say is it is by no means a massage! I felt a little wimpy wincing in pain after what I had just gone through, but that was something I didn’t know would be happening—so now you know, too!
We delayed all newborn measurements until a little over an hour after he was born. Kannon weighed 8 lbs 5 oz and was 20 ¾ inches long! Shortly after, we were wheeled to another floor to our postpartum room and spent one night in the hospital before being discharged the next afternoon.
While the journey to get there was full of unknowns and the days leading up were challenging, Kannon’s birth was the most amazing day of my life.
September 25, 2020 will forever be his birthday, but it also marks my birth as a mother—something I know I’ll cherish forever.
For weeks I prayed, asking God to turn Kannon in my womb. I talked to Kannon asking him to turn if he could, so when he didn’t I assumed there must be something keeping him from doing so and trusted his judgment. When he was born, there were no obvious signs that would indicate why he was breech—no cord wrapped around his neck or something indicating his inability to turn. I may never know for sure why he was breech, but maybe it was to show his mama that she could do hard things. I’ve had a lot of people tell me how strong I am or how much respect I’ve earned for having him vaginally, but ultimately I’ve gained so much respect for myself (And I think I would feel the same way if he entered the world through a belly birth). Because the reality is that I tended to his growing body for nearly a year. I thought of him daily and factored him into every decision. Kannon and I worked together to be here and I am so proud of the journey.