Consultant recommending a VB for a breech baby - first time mum - PANICKING

[MamaG]

It's my sister, her first baby and he's breech, I think she said footling position. They are going to try and turn the baby a week tomorrow (she'll be 38 weeks) and said if baby gets distressed, they'll CS at that point. if he's ok but turning doesn't work, the consultant has said breech VB.

I'm panicking somewhat - I always thought breech VBs were dangerous? This is her first baby, I don't want this to be a horrible experience for her.

If I were in her shoes, I'd insist on an ELCS if the turning doesn't work; I've had two VB and a crash CS - I was in pieces after the crash CS so my own experience may be clouding my judgement.

I have awful visions of a terrible breech VB ending in a crash CS.

Any advice appreciated so I can pass it in. The poor girl is exhausted as baby been transverse for weeks and she has barely slept having been so uncomfortable.

[MamaG]

oh and hello btw. How are you all?

[droitwichmummy]

Hi MamaG. No direct experience but my DSis was a breech baby and she is now 47! She was also a first baby and as far as I know mum was fine. It used to be routine to have all babies by VB until the 80s (I think).
If the consultant is ok with it I'm sure your sister and her baby will be ok

[MamaG]

I'm not convinced they'll be safe. I nearly died having DS2 and I'm worrying

[AdiVic]

my babay was breech at 37w, I looked into it and found some great exercises on the spinning babies website which worked for me.

I also looked into a method of accupuncture called Moxibustion - it does not involve needles just the burning of herbs under a toe! Sounds whacky but it does work and has an 80% chance of the babies staying in the right position. Manual turning turns 50% of babies, but 50% of those who turn, actually turn back, so a 25% success rate in total. One of our maternity units here uses moxibustion instead of manual and they have far fewer breech babies. It's worth a shot.

Hope all goes well whatever the outcome.

[PiedWagtail]

The consultant must be pretty sure that she will be ok, or else he wouldn't have suggested a VB! You could ask him about the midwives' experience at handling breech VBs - how many have they attended? when? what were the success rates and how many did they have to move to a CS instead? - as since most breech babies are now routinely delivered by CS, midwives are generally not experienced at breech VBs.

Your labour experience will not necessarily be the same as your sister's! How does she feel about the VB?

[MamaG]

Thanks both. She's just listening to the consultant but she's less gobby/questioning than I am. Thing is, if I'd listened to the registrar, when having DS2, he would never have delivered safely. It was only on my insistence that the MW phoned the consultant at home at 2am who told registrar to listen to me when I said something was horribly wrong.

I just feel really anxious, but there's some good points here, thank you.

[steppemum]

my friend's baby was breach, she had vb in hospital, all went very well and straightforward.

[HeffalumpsAndGoldenWoozles]

I was a breach VB, first born, my DM said it was totally fine. This was the 80s but I just wanted to say just because baby is breach doesn't necessarily mean a horrendous birth. Hope your DSis has a good experience whatever ends up happening.

[Arithmeticulous]

Google Mary Cronk and Jane Evans, Day at the Breech. Lots of info and guidelines out there.

[MamaG]

Thanks all. Am chatting with her now and passing on the info

[Ros1979]

I had a breech delivery 6 months ago with my first baby. All went fine, pretty quick delivery, no added complications. Obviously different for everyone, but I'm glad I went for it. When making the decision, we went to the consultant with quite a long list of questions, including the following:

• What are extra risks of breech delivery
  
• How will these be dealt with
  
• What stage might it go to emergency CS
  
• Will I have to have more monitoring
  
• What are their preferences with pain relief
  
• Is an episiotomy more likely
  
• How common are breech deliveries, and how experienced are they
  
• Will all consultants in unit have same opinion (i.e. could you get to hospital and a different consultant is on, and suddenly they change their mind).
  
• Why in the past has the advice been a planned c-section for breech
  
• What happens if I got to 42 weeks?
  

The answers I got were (briefly)

• Body get's through fine then head gets stuck
  
• They gently turn the head to try to get it out, then forceps
  
• If later stages don't proceed at 1cm/hr or quicker, would go to CS then as it's likely to be as the breech is causing problems which are slowing the labour
  
• Yes, more monitoring, but doesn't mean lying down throughout
  
• Epidural was an option, but would prefer me not to, as then they wouldn't know if labour was slowing due to breech or due to epidural
  
• Episiotomy no more likely than standard delivery
  
• They get one or two undiscovered breeches a month, plus some planned deliveries.
  
• Different consultants do have different opinions and some won't deliver breech (my notes said that my consultant had to be rang when I went in, and he put himself on call for 3 weeks effectively).
  
• A large clinical study showed previously that CS delivery was safer, advice over last 10 years was based on this, but the study is now discredited due to being biased as it included premature babies.
  
• Won't induce breech, will go to CS at this point.
  

Hope these help. If you're sisters quite timid, I'd recommend taking in questions that she's prepared in advance. We also set a date for a CS at 41 weeks, the idea being that I'd try for a natural birth if things happened before then, but I had a 'deadline'.

[MamaG]

That's really helpful Ros, thanks for taking the time to type that out. I've emailed her what you put as I think it will really help her

Thanks :)

[Ros1979]

happy to help. I was really stressed out when we found out (at 38 + 5) that it was breech. Felt much happy when we had a plan. Worth asking all above qus again though, as her consultant/hospital might have different answers and policies.

[QTPie]

I would say that she either needs to:

• be very confident in the approach she is going for, or
  
• be completely ignorant and go with the flow and exactly what she is told.
  

The worst thing to do is get doubts/terrified in the middle of it.

DS was breech (ELCS - which I was very happy with): there is no easy way out - risks with everything. She needs to weigh up the risks and be happy with her choice and really go with it.

Good luck to her.

[schmee]

If your sister is happy to try for a vaginal birth that is one thing, but if not she has every right to ask for a planned c section. There is a huge moment to try to minimise cesaerean levels and a concern that skills such as delivering a breech baby vaginally are being lost. The consultant will be thinking about these factors, not about your sister or her baby. I am horrified that this has been presented to her as the way it should be done. Sorry to sound alarmist and I'm sure all would be fine, but it makes me really angry when consultants deny women choice.

[wheresmespecs]

I found this earlier thread about footling breech presentation, OP - hope it's useful - www.mumsnet.com/Talk/pregnancy/770283-Footling-Breech/AllOnOnePage

[wheresmespecs]

Ps meant to say too - I think if your sister is researching risks, she would want to make sure she is looking at footling breech rather than frank breech. The risks are a bit different AFAIK.

[Bue]

Are you absolutely sure that it is a footling rather than a frank breech?? Footlings are never delivered vaginally in this country.

[Ros1979]

Apologies, think my dd was a frank, not a footling breech. She was bottom first, is that frank??

[Stardust01]

I haven't had a breech birth myself, but have a friend who had her fourth child vaginally (baby was breech), and she said it was much more painful than any of her other three labours.

There was also a thread on here a few weeks ago (or was it on the Pregnancy board?) about the potential risks in trying to turn a baby into the correct position. Worth researching.

I was told during antenatal classes that if a first baby was breech, they would always do a caesarean (this was at Queen Charlotte's at Hammersmith/Acton).

SO I think she should have a choice. Personally I think I would want an ELCS.