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The breech labor is in itself different from the vertex labor, and deserves discussion. In knowing what is to be expected, the midwife may free herself and her client from unnecessary concern, and be more ready to recognize and assess abnormal progress, should it occur.1. It is not unusual for the waters to break prematurely, especially in footling breeches. It is important to check for fetal heart tones (FHTs) immediately, in the event the cord is compressed or prolapsed.
2. It is common for the mother to go into labor any time after 37 weeks gestation.
3. A fairly long prodomal period (early labor) may be expected due to the lack of application of the presenting part to the cervix.
4. The mother usually experiences a backache greater than the intensity of abdominal pain, but less severe or persistent than with a posterior (face up) presentation.
5. Multiparous breech mothers may exhibit little or no discomfort in early labor, and are often more than 4 centimeters dilated before they are aware of labor.
6. The mother may feel "breathless" during or after contractions due to pressure from the baby's head against the diaphragm.
7. Labor may escalate abruptly, after the onset of active labor. This is often a surprise to the mother who thinks that this labor will be a "snap".
8. The mother often has an early desire to push, again, markedly more so with a footling breech.
9. There may be a latent phase between complete dilation and the expulsive phase of labor, the mother may even take a little nap when complete, which is to everyone's advantage.
10. Multiparous mothers need lots of reassurance because breech descent feels very differently from the vertex.
11. Meconium show is to be expected in second stage, particularly with "buttlings", and although this is normal, continue to assess heart tones continuously to rule out cord compromise.
12. Second stage contractions are often less in frequency, duration and strength than first stage.
13. The presenting part is often discolored, and may appear swollen. This is no cause for alarm as discoloration and swelling will disappear rapidly after birth.
14. It is normal for the baby to need a minute's rest before "coming around". He has not had the scalp stimulation that occurs with the vertex delivery.
MoonDragon's Birthing Guidelines: The Unexpected Breech
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