"Labour and birth: Undiagnosed breech leading to unplanned caesarean"

I am a mid-30s first-time mum who was a patient of Bunbury's Midwifery Group Practice (MGP) and gave birth at Bunbury Regional Hospital.

I was very happy with MGP and would use the service again. I felt supported and informed. Appointments were long and regular. The continuity of care helped make me feel comfortable to ask all the questions I had, big or small.

A condition of using MGP was agreeing to be discharged from hospital within 4-6 hours of birth, provided the birth went smoothly. Even the most straightforward birth is exhausting and life-changing, so this felt incredibly short. I felt anxious about the discharge policy throughout my pregnancy, and mentally prepared to self-advocate for a longer stay in hospital to facilitate recovery. In my case, the birth had some challenges, so luckily I was not pushed into a fast discharge, however I wanted to share this feedback because it did weigh on my mind during pregnancy.

My pregnancy was uncomplicated. I attended all scans, appointments and two separate birth and early parenting classes. The Positive Birth Program was particularly eye-opening and empowering – thank you to those responsible for that program.

I was almost 41 weeks when I went into spontaneous labour. I went to hospital when contractions became stronger and closer together. About 3.5 hours after arriving, labour had slowed so I was given a syntocinon induction. Contractions intensified and I requested an epidural. An ultrasound was performed, and showed my baby was in a frank breech position.

Upon the breech diagnosis, the care team recommended a caesarean section. I consented and within about 2 hours my baby was delivered. The caesarean process felt fast and professional. My baby needed some resuscitation and thankfully bounced back. Their apgar score went from 3 to 9, and they have been a lovely healthy baby since.

I stayed in the old St John maternity ward for 3 nights in a private room with pull-out couch/bed where my partner could sleep. This was a lifesaver. I couldn't have managed those first few days without him there overnight. I was absolutely exhausted and in pain.

All staff who cared for my baby and I at hospital were attentive, warm and professional. I found it a bit overwhelming having so many different care providers see me during those few days.

After discharge, the in-home care provided by MGP and the child health nurses was fantastic. I had long and regular appointments, with a mix of practical and emotional support.

I used the hospital’s birth reflection service about 2 months after the birth, and found this to be really useful. I highly recommend it to other parents.

Since the birth I have thought a lot about the breech presentation not being picked up until well into labour. There were several factors in late pregnancy and early labour that may have contributed, and I won't ever know exactly what her position was and when. 

I have some suggestions that I think would be easy to implement to avoid a similar situation; the most important of which is ensuring women have an ultrasound closer to birth (my last one was at 32 weeks showing breech presentation) or even upon admission to the maternity ward (it was so quick and easy to do once staff decided I needed one).

Ultimately I am grateful my baby is here safely and I’m thankful to everyone who played a role in that.