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Ep 15// Breech, Twin & Homebirth with Tori Lame

Updated: Apr 4, 2020

Tori has been married to her husband, Travis, for 10 years and they have been blessed with 6 precious children together, including a set of home-born twins, one of which she birthed with a footling breech presentation! Four of their children are here earthside with them, and two of their little boys they lost to stillbirth and miscarriage. As a result of these widely varying experiences, Tori has a deep-seated love for sharing what she has learned about birth, breech presentations, twins, advocacy and research!

Tori is also a Certified Birth Doula, Certified Birth & Bereavement Doula, and a Trained Midwives Birth Assistant. As you can imagine, the experiences that Tori has had personally, as well as what she has seen in her work, have all made educating others about birth and birth options a passion of hers.

Breech, Twin, Homebirth... I had an amazing conversation with Tori Lame about her story and we take a deep dive in breech birth. 

Vaginal Breech Birth isn't an option that is talked about much as there is a widespread lack of training. Tori lays out the studies and the benefits and risks of vaginal breech birth. You won't want to miss this episode!


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*correction* the technical follow up study for Term Breech Trial was published in 2004 not 2012

Term Breech Trial

Term Breech Trial: Follow Up Study that shows no long term risk of death(by age 2)

2012 Breech: Finland

2015 Meta-Analysis

Dr.Stu and Rixa Freeze Study

This article critiques why the “Term Breech Trial” should have been more deeply scrutinized before being accepted as firm evidence for caesarean over vaginal breech birth: including that some of the care providers, specifically where infant mortality and morbidity occurred, had no breech experience.

“Of the 13 deaths attributed to the vaginal delivery group: two were ‘most likely’ dead before randomisation; two died after discharge (one attributed to sudden infant death syndrome and the other to gastroenteritis); two died because of respiratory difficulties after birth (calling into question the adequacy of the neonatal resuscitation); one most likely had a congenital anomaly; and a further three had an abnormal fetal heart tracing, but do not appear to have been delivered by caesarean section in a timely manner. Only three died after what was described as a ‘difficult delivery’. In his own analysis of the original data, Glezerman assumed that up to five deaths in the vaginal delivery arm could be attributed in some part to mode of delivery, as against two in the caesarean arm.6 This made the delivery mode PNMR 5/1038 vs 2/1038, yielding a non-adjusted p value of 0.45: a non-significant difference.

Despite the undertaking that only a qualified person would attend the delivery, 6.7 percent of the vaginal breech deliveries were delivered by people with little or no expertise as opposed to 2.7 per cent in the caesarean arm. Over 30 per cent of the morbidity/mortality in the group delivered vaginally was from this 6.7 per cent of deliveries. Kierse provides a complete reanalysis of morbidity data.7

If one looks at infants who were born with significant morbidity, it is revealed that 22 of 69 of such newborn infants (31.9%) or infants with perinatal death were attended by obstetricians in training, by obstetricians without experience, and in 1 case by a midwife without experience, which is a situation that would be regarded as unacceptable in most institutions in Western countries.”


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