33-37 weeks: Encouraging baby to turn head-down
Considering your breech birth options
If your baby remains head-down, or you choose not to attempt to change your baby's position, I can offer you an opportunity to discuss your breech birth options.Some women consider contacting an Independent Midwife, often late in pregnancy, when they find that their baby is presenting by the breech (bum or feet first, instead of head first). This can be a lonely time for women who really want to give birth vaginally, as prevailing obstetric advice is that breech babies should only be delivered by elective caesarean section before term, or a controlled forceps delivery, with the woman on her back (lithotomy) and an episiotomy. Women often feel that they have no choice but to accept this advice. But you do have a choice!

Breech Birth Network - more information about your options.
What I can offer you
I believe that the safest place for a breech birth is in the hospital, attended by a midwife whom you know and trust, and who is calm, experienced, informed and prepared to support you. However, it is currently very difficult for independent midwives to obtain honorary contracts in order to support our clients to birth in hospital (the ideal), and NHS midwives generally work shifts rather than caseloads, which means you cannot predict who will be on duty when you go into labour.
Therefore, your choices are:
1. Support for a hospital-based, midwifery-led breech birth
I am able to provide non-clinical midwifery support to you for a hospital-based, midwifery-led breech birth, with or without providing complete midwifery care before and after the birth. This would involve accompanying you at the hospital, as your support and advocate, although a hospital-based midwife will provide your clinical care. Using my knowledge of local units and their guidelines, I will help you explore the choices which are available to you and liaise with managers at the hospital of your choice, to ensure staff are aware of your plans. We will also spend time discussing the issues surrounding breech birth, and what they mean to you. Finally, I will bring with me to your birth a resource pack, based on the skills discussed at the Introduction to Breech Birth study days, to support NHS staff who are developing their skills supporting breech birth. My fee for this service is £400.
2. Complete midwifery care at home
Not every woman will choose to give birth in hospital, and I believe that women should be fully supported in their choices regardless of whether they conform to guidelines or advice. There are many factors to consider when deciding whether or not to give birth to your breech baby at home, and we will discuss these thoroughly, along with any other health professionals, such as obstetricians, you choose to involve in your care.
Please note: I am insured through the Royal College of Nurses to provide antenatal and postnatal care, and antenatal education, as a self-employed midwife. Professional Indemnity Insurance for care during labour is currently not available for Independent Midwives. Therefore, like all IM's, I work without insurance when I attend home births. More information is available from the IMUK website.
