Comments on Waterbirth for Breech
I prefer that the pools are good sized, so I can have easy access if complications arise. First the tub is thoroughly cleaned and I also put peroxide in the water. Mom and the baby are usually immune to the germs in their own home.
Personally, I have a real need and desire to be in the water, and I really enjoy watching the pull that water has on laboring women. For most, it seems to be the only thing that they can surrender to. The water enhances their ability to completely let go and open up.
When we are contemplating a homebirth or a vaginal delivery for a breech baby, there are many things to keep in mind. First, you must keep the baby warm as its body is being born, so that it won't gasp for air, thus aspirating amniotic fluid. The water keeps the baby at the same warm temperature without the midwife needing to constantly scramble to keep warm towels on the baby's body.
A serious concern with a breech is that those babies may try to breathe before their head is born. It isn't necessarily passage through the birth canal that stimulates the baby's breathing reflex; rather its the shock of the air hitting the body and the change in temperature from the warmth inside the mother to the cooler temperature in the delivery room. Actually, it's very hard to take a breath if your lungs are compressed. The babies really don't have a lot of room to try to breathe. As far as a lung infection, I've never seen or heard of one. Also, breech babies are a bit disoriented and water seems to help them to relax right after the birth.
Birthing breech babies is a lot of work, and moms benefit from receiving the comfort that the water provides. The constant warm water on her perineum helps her body as it continues, stretching, stretching, stretching :) The more strength a mother has, the more help and oxygen the baby will be getting as she is birthing. For all these reasons waterbirth seems like a natural choice and is why more and more people are doing breech births in water.
Attending breech births is a dying art, but if the conditions are right and the attendant is sure about pelvic adequacy, fetal position, fetal size, and the health of mom and baby, there is no reason why breech babies should not be born vaginally, and I think waterbirth is a very suitable method for it.
Water is a wonderful tool! I consider it to be a big part of my birth bag! The fact is, babies come out, but it's very nice to have a tool that helps us surrender to that. For me that tool is water, and it works!!!
When there are complications you need to come out of the water. I'm not a believer in leaving babies under after birth (called "slow immersion"). I bring them right out (called "rapid immersion") and into the mother's arms.