Here I am, knowing all of these things and having reassured many other women about breech presentations, and I still can't stop fretting about the future: what if the baby stays breech? what would happen then? what would I do?...
Briefly, my birthing history in a nutshell is summarized by two cesareans for malpresentation and an incredible, life altering homebirth of my footling breech baby. The simple answer is to the question you pose above is that you would give birth to him/her. I suspect that you know that, but believe me I understand the battle between the logical mind and the emotional one. Believe it or not, it was my husband who was reminding me, frequently no less, of both the research regarding the safety of breech vaginal birth and how we had arrived at the decision to proceed with a homebirth in the event that baby also preferred breech. For even though my logical mind knew that there were risks no matter whether I had a cesarean or a breech vaginal birth, fear is a powerful thing.
It's not that I am worried about a vaginal breech birth per se. I feel quite confident that I could give birth to a breech baby, and I have read extensively about the controversies surrounding breech management. But I am quite afraid of birthing a breech baby in the current medical & legal climate.
In three sentences, you have summarized the crux of the crisis of breech birth.
She knows of a few physicians who, although they currently don't officially do vaginal breeches, might be able to attend a woman if she into labor on a day they happened to be on call and insisted on a vaginal birth at the hospital. She'd have to know that this option even existed and who to ask for, of course.
As a woman who was in a position very similar to this, I can tell you, and again I suspect you already know this, that this is not adequate. Case in point, the OB I saw in my second pregnancy, after again being "risked out of midwifery care", was skilled in breech. Yet, when I asked him to attend my breech vaginal birth, not only refused, albeit kindly, but chose not to inform me that his colleague across the street very well may have agreed to attend my birth. Quite simply, it's not okay. I've wrestled fairly well with my own demons, but I cannot give up this fight on behalf of other women faced with the woefully inadequate, and even dangerous “choices” that exist for breech birth.
A massive amount of stress and worry, because I could not simply carry on with my birth plans. Instead, the days or hours leading up to the birth would be characterized by extreme upheaval and uncertainty. And there's still no guarantee I could find someone willing to attend a vaginal birth.
Okay, remember how I said that I had wrestled with my demons? Well, your quote above brings me back to those raw emotions I experienced as I, rather than fighting the establishment that was neglecting to provide me options, fought myself and worse yet, my baby. I cannot forget how I struggled to forgive my child, because he did not turn vertex despite my concerted efforts to encourage him. Obviously I'm not proud of those feelings, but every time I am contacted by a woman who is being told that breech vaginal birth is not an option, and quite often told that it is categorically unsafe, I remember how I struggled with the difference between what my intuition told me, and the implication of the only “option” I was given (please see my post on the “Illusion of Choice”), though I realize now that I need to do a second post on the "Illusion of Choice" to address the reality that there often is no true choice presented.
The best possible atmosphere for a successful vaginal breech birth is one that is the least disturbed, one with low levels of stress and adrenaline, one with laid-back hands-off providers with lots of skill and experience seeing physiological breech births.
And I am thankful every day that I had exactly what you described. It transformed me in huge ways, and I am determined to help other women know this experience.
The problem with breech in this country isn't the actual presentation and birth--it's the hostile climate that makes a vaginal birth nigh to impossible.
I couldn't have said it better, and because I think she's reading, I must give a heartfelt thanks to L, who reminded me of as much when my emotions clouded my judgment.