Last night I had the pleasure of listening to my beloved OB, Dr. Fred Cummings, speak to the Denton County Birth Network about vaginal breech birth. It was about so much more than just vaginal breech birth that he spoke on, but rather the normal process of birth in general. I know I often gush about my OB and maybe you are sick of hearing about him. The truth is, he is a rare gem. There is no other Doctor in this country like him. No one. Period.
My heart was full as I sat in a room with friends and fellow colleagues in the birth field. Two of my former students, who are now birth professionals themselves. My sweet doula Katie. Fellow VBA3C friends. Fellow Birth Boot Camp instructors that I don’t get to see too often. Beloved midwives in the community. Some I know personally, some I just know of their wonderful reputation in the birth community. Fellow doulas whom I love and respect. All in the same room. All listening to this amazing man talk. It was beautiful.
Dr. Cummings started his talk by talking a little bit about breech birth. He said people get weirded out by breech, but he has never been afraid of breech birth. In the old literature he says, when talking about breech presentation, it always says to attempt delivery. It doesn’t say to automatically go to a c-section. The problem today is that most doctors are not trained to do it. They are now told to do an automatic c-section. Why? Complications equal problems and it’s “safer” for them to do the c-section. Safer for the Mom and baby, or safer for the doctors? According to Dr. Cummings, no surgery is safer than a vaginal birth. Of course he recognizes the situations when surgery is needed. But vaginal birth should always be safer first.
When speaking to birth professionals, mainly midwives and doctors, he gave three points:
- Have patience. There is no reason to rush a baby unless it is critical. Why would you rush a natural process if nothing is out of the ordinary?
- Know your patient and also know their spouse. Men get weird about birth and you need to know them and how they are going to handle things in birth. If you know your patient, when something becomes peculiar in the birth process, it will be a conversation and not an argument. If your patient trusts you, they won’t have to argue with you over the situation that has come up.
- Make sure you give your patient confidence. There is no reason not to be confident in the birth process. Never lose your brains while you are in the room with your patient. If you doubt them, they will start doubting themselves.
Having had two babies under the care of Dr. Cummings, I can attest that he adhered to all three of these things. This man practices what he preaches. He had patience with me. He took the time to know both my husband and myself. He gave me confidence from the get go. On day one, he told me I was going to do it. And I did.
He went on to talk about the current c-section rate and how it shouldn’t be happening 40-60% of the time. In one of our local hospitals it happens 1 out of every 2 births. (This happens to be the hospital that I had all three of my c-sections!) This should not be. Why is this happening? Because the doctors are impatient and are ready to go home for the day. He said, “You all go online after your births and share your stories with each other. Everyone has the same story! Your baby’s heartrate was dropping and suddenly the doctor swoops in to save the day. It happens too much.”
At 32-34 weeks, he says, a lot of babies are breech. It’s not time to worry quite yet. At 36 weeks, it is time to start talking about options. The first option is to try a version to flip the baby. Know the situation first though. What kind of pelvis does she have? There is still a good chance that they will turn again, because they were comfortable in that position. He will often turn a baby 3-4 times before birth. He says that some of the techniques found on spinning babies, like the inversion, are just as effective in turning the baby. But sometimes the baby will just not turn. But then, he will deliver the baby breech. 95% of the time if you go to a hospital with a baby breech, it is an automatic c-section. Women should ask, do I have a choice? Women never asks this, he says. They just go with what the doctor says. The problem is, most doctors simply are not trained in breech delivery and are not going to do it.
Side note, if you have a breech baby and live anywhere close to the DFW area, it is worth it to drive yourself to Denton, TX. Dr. Cummings delivers breech babies all the time, and will take any mom in labor, regardless if he has seen you before or not. If you call the hospital, he said to say that Dr. Cummings is expecting you, even if he is not. They will call him if you say that. He will show up.
He said when delivering breech, if the head gets stuck in the pelvis, it’s almost impossible to push back up. This is an appropriate time to use the scissors to get the baby out fast. Most women don’t want to be cut, but will do anything if it means the baby might die. Routinely he says, breech babies will come out. You just have to be patient. If you are there with your patient, everything should be fine. You will be there to act when needed.
He went on to talk about the normal act of birth. It’s simplistic, he says. You let the Mom do it. Watch and listen. It’s hard for most doctors with all that education to sit back and let the mom dictate her birth. She will let you know if it’s going to happen or not. She will know. Women can have babies, he says. They just need someone to let them do it!
He went on to share several amazing stories of breech births. One story he told of a woman from Austin who came to him late in pregnancy because no one in the Austin area would even consider a breech birth. He said, “All of you women must have told her on the internet about this doctor in Denton, TX and she listened!” We all laughed. It’s true. We tell everyone on the internet about Dr. Cummings. He met with them, and they decided they would wait and then come close to the due date and stay in the area until baby is born. Two days later he got a call from the husband who was clearly on the road. He said they were headed back to Denton because she was in labor. She walked right into L&D and said Dr. Cummings was expecting her because her baby was breech. Once he was there, she walked herself right into the OR. She just stood there and delivered her breech baby and then said, “Thank you!” Then she walked herself right back to her room. That woman was a beast, he said. Some kind of woman!
Another story he told of a woman who was having twins. “Again,” he said, “You women told her on the internet to come see the doctor who will deliver twins!” We laughed again. This woman was walking the famous sky bridge at the hospital and the husband comes running down the hall screaming that his wife was about to have the first baby right on the sky bridge! Dr. Cummings was with another patient and went running down the hall. There she was, just rocking and swaying. And then she just squatted down and delivered the first baby right there on the sky bridge. Then they got her back to the room and delivered the second baby breech. No problems. Women know how to do this, he says.
One of his patients brought in pictures and a video of her breech birth 15 months ago with Dr. Cummings. We watched on the edge of our seats as he had to very carefully maneuver the baby’s body and head out. It can be a complicated process yes. But it’s normal to him because he does it all the time. You don’t want an unskilled doctor attempting this.” You don’t want to be someone’s first,” he said. They just aren’t teaching this anymore.
He opened it up for questions. One woman asked, what is the biggest baby he has delivered, and is there any truth to the doctors having issues with big babies? His biggest breech baby was 11 lbs 4 oz. “Very few women make babies they can’t deliver. Usually a baby can fit.” he said.
Another woman asked, as consumers, what can we do to convince Doctors to do vbacs and breech births? “Very little,” he says. “If you get sued once, you’ll never take a chance again.” She went on to say, that it just leaves us as consumers and professionals, very frustrated. Yes, he said. There just isn’t much we can do. They aren’t about to change their minds. There are some out there who will do it, you just have to find them! I personally think this was such an important point for him to make. So many women out there on the internet are out there talking about trying to convince their doctors to do this. Most of the time, they just aren’t going to be convinced. It’s better to search until you find someone who will do it.
Eventually, he said, he won’t be around anymore. He has tried to retire 4 times, but we won’t let him! Now he is completely back in business again and plans to be around for a good while longer. But one day he will stop. When asked if he is teaching anyone to carry on his work, he said he has tried. He said he has tried over the years, but it takes a certain kind of crazy to do what he does! He has hopes for this though. He won’t reveal names yet, but he has hopes.
He ended by saying that his life is not directed by the laws of man. “If I put my trust where I know it should be, I have no worries. We don’t do fear in my office. I don’t make any excuses about this, but I trust God 1000%. When I put my trust in Him, I have nothing to fear. What are you going to do to me?”
“It’s pretty easy,” he says. “You guys do all the work!”
I can’t say enough about this great man. God truly did place him on this earth for a very special purpose. We are so blessed in the DFW area to have such an amazing OB who believes in the process of birth and isn’t afraid of higher risk situations. “If I have a woman who says she wants to do this, I’m going to help you. It doesn’t mean it will happen, but I will support you completely. I won’t lose a mom or baby. I have never lost a mom or baby.”
(Me with my beloved Doctor!)
(VBA3C sisters with the man that believed we could!)