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Childbirth

Talk to me about a breech vaginal delivery

34 replies

ItsMyLastOne · 02/11/2012 17:56

I'm only 35+4 but my baby is breech or transverse (she keeps moving) and back to back. I have a presentation scan on Monday and if the baby is still breech or transverse I'll have to speak to a consultant about my options so I just want to start weighing everything up now.

Has anyone given birth, or attempted to give birth vaginally to a breech baby? Tell me about it please!

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Sulfur · 02/11/2012 17:59

I had my lat child as a vaginal breech.

Apart from the reaction of my birth attendants, it wasn't any different from the others.

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ItsMyLastOne · 02/11/2012 18:03

Did you already know the baby was breech? If so, what made you decide to go for the vaginal delivery?

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MrsLovely · 02/11/2012 18:03

I have!!

Nobody realised dd was breech until I was ten days overdue, and although the hopspital were keen for me to have a CS, I woke up in the early hours of the morning with contractions, dashed to hospital and had her in the operating theatre.

It was a very fast labour (much quicker than my first, normal presentation labour!) with no pain relief.

As you can probably imagine I bruised quite badly but recovered quickly enough, and as I recall I had a fairly major episiotomy to prevent tearing ( she came out bottom first).

It was a really positive experience for me, despite the hospital being fairly freaked out in the beginning, and I was very glad to avoid a CS!

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ItsMyLastOne · 02/11/2012 18:11

I'm really quite terrified at the thought of a CS. Everyone I know who's had one has had some kind of complications afterwards, not to mention the length of time they've been in pain afterwards. I also hate the idea of how medical it would all be. Although I suspect that if the baby is transverse for most of the time, as she is at the moment, then I would opt for it anyway. I just desperately want her to turn...!

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HeartsTrumpDiamonds · 02/11/2012 18:19

Few things to share on this topic...

My DBro was breech (this was in the time before ultrasounds, so I think it was a surprise). My mum is teeny and DBro was a huge baby, upwards of 10lbs and it was all ok. Extremely anecdotal of course!

DD1 was a bit early but my waters had broken and labour was not established, so they were inducing me. The consultant rocked up and took one look at me and said "Has anyone confirmed the presentation of your baby?" I had had my 32 week scan where she was still head-up, and this was 37 weeks or so, so I had not had another scan. Well, they rolled a scan machine over and sure enough determined she was still indeed breech.

I have honestly never seen people move so fast in my life to get me off the drip! I think the word "STAT" was even shouted, which I thought only happened on TV. Bit scary.

Turns out it is very dangerous to induce a breech baby, mostly for the baby (leg and cord issues) but for the mother as well (risk of tearing etc).

They gave me a choice of waiting for labour to start naturally, but there was a risk of infection of course because my waters had broken 48 hours previously. And oh, by the way, "Nobody on staff has ever delivered a breech birth vaginally!" Shock

As soon as I heard that, I signed right up for the cesarean they offered me.

Sorry, that was way longer than I intended! I guess what I want to say to you, OP, is to consider what you would like to have happen if you go overdue and the baby is still breech. How long would your consultant be willing to wait? How do you feel about an "elective" cesarean? Also check whether I'm right about the not inducing a breech baby thing - I could be wrong (it was a bit of a haze and also 9 years ago!)

Good luck Smile

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ItsMyLastOne · 02/11/2012 19:08

Thanks Hearts. I was told that if I decided on an ELCS then that would happen before my due date, so I guess maybe 39 weeks-ish.

I generally feel like I'd prefer to give it a go vaginally but I'm worried about complications. My mw said they may actually offer a vagnal delivery, especially with it being my second. I believe that there will be staff who've delivered a breech baby, just because it's a very big specialist women's hospital, but I'll discuss that with the consultant.

I hadn't even thought about going overdue so I'm glad you mentioned that. My DD came on her due date so I had just had probably unrealistic visions of this baby coming around the due date too!

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squiggleywiggler · 02/11/2012 19:54

Very briefly. You may want to

a) do some research: www.aims.org.uk/Journal/Vol10No3/handOffbreech.htm very helpful

b) book appointment with your hospital's supervisor of midwives when you have a sense of what you'd like to discuss how to make that happen. It's her job to talk through risks/benefits and protocol but also to really listen to you and support what you want. She'll be able to tell you about the hospital's experience with breech birth - it may be she can find a way for a couple of MWs experienced in vaginal breech to agree to be 'on call' for you. Rare but not unheard of.

c) use AIMS to support you if you have trouble getting what you need.

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lynniep · 02/11/2012 20:00

I have done this, and I'm not going to go into details, but it didnt go well. I didnt actually get a choice as it was undiagnosed and labour was under 2 hours so gas and air only. I was the first breech the consultant had delivered, and none of the staff on duty that night had ever witnessed one either. Thankfully DS1 recovered fully and I only required an episiotomy. Not a big un though :)

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FiercePanda · 02/11/2012 20:05

I was a breech vaginal birth! Do I get a badge? I was five/six weeks prem, too, and the firstborn so my poor Mum must been thinking "this isn't like in the films!".

If you end up giving birth vaginally and baby is breech, please please please get baby's hips double and triple checked for hip dysplasia, xrays if possible. Vaginal breech births are thought to be a big contributing factor - my dysplasia went undiagnosed for 27 years, and now I'm on morphine, crutches, and waiting to get my hips cut into bits and rebuilt. Getting treated as a baby/infant is, whilst traumatic for the parents (casts etc for months until hip bones form "correctly"), a much smoother process than getting major operations/hip replacements in later life.

STEPS charity are fantastic and full of advice if you have any concerns.

Good luck, hope everything goes well.

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Fairylea · 02/11/2012 20:05

I know absolutely nothing about breech babies. However I just wanted to reassure you that an elective section (as yours would be given that it's not an emergencyas such) can be a very straightforward and pleasant experience!

I had my ds by section 5 months ago. My choice as dd had been a very long labour etc. I found it was magical when they lifted ds up. My pain was managed excellently and I wasn't in any more pain really than my birth with the ventouse !

I was up and having a shower the next day and by the end of the week I was more or less normal and shuffling washing into the machine which ok I should not have done but just showing you I felt fine.

Stitches out 5 days later. No infections. Nothing.

Keep your options open !

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Sulfur · 02/11/2012 20:53

I had no paIn relief (didn't need any).

My midwife knew not to touch the baby until the head had fully emerged.

She put a stat call over the tannoy, but I was sat up breastfeeding before any help arrived.

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Sulfur · 02/11/2012 20:54

I had no perineal trauma -no stitches.

The bottom is not much different from the head.

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MrsLovely · 02/11/2012 20:58

The worst bit for me was once I'd delivered her body,I realised I still had the head to go!!

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ItsMyLastOne · 02/11/2012 21:10

I think I'm going to have to write a list of questions for when I see the consultant. There's just so much to think about. I think I was spoilt with DD. The pregnancy was straightforward, just SPD, and the labour was extremely long but uncomplicated and she came naturally in the end with me needing just a TENS machine and a couple of hours of G&A. This could end up so far removed from my previous experience it just feels a bit unsettling iyswim.

Thanks for all your replies, I will look at those links and hopefully I'll feel a bit more informed in time for our appointment on Monday. Smile

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HeartsTrumpDiamonds · 02/11/2012 22:47

Good luck OP. I should just add that both my DDs were born by unplanned (but thankfully not emergency) CS and both were ok. Of course I have nothing to compare it to, but like Fairylea my recovery was pretty easy and I was up and about quite fast!

I sometimes feel a bit cheated that I have never gotten to experience a "real" birth, but then I just remind myself that any birth that results in a healthy baby and a healthy mother is a successful one.

Would be very interested in hearing about your conversation with your consultant - would you mind coming back with an update?

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ItsMyLastOne · 03/11/2012 10:30

Of course Hearts, I don't think I'm done asking loads of questions and reading things on here about it all anyway! Where would I be without MN?! Wink

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NAR4 · 03/11/2012 13:17

I don't have any experience myself but, one of my friends gave birth to her 2nd, who was breech and didn't even tear. She said it was easier than her 1st who was head down.

Check out the spinning babies website www.spinningbabies.com They have exercises for you to do to encourage/help the baby to turn head down. Worth a go I would think.

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ItsMyLastOne · 04/11/2012 12:44

I've been looking at spinning babies, and doing exercises and things. The baby keeps moving position a lot but just not head down! Hmm

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theborrower · 04/11/2012 21:42

I was a breech baby - delivered vaginally - and my daughter was breech, but delivered by EMCS. It seems to run in the family, as my mum was also breech, and her mum too!

My mum was going to have a CS but the doctors did lots of scans, and seemed to think she had "good hips" and that I was in a good position, so they went ahead with a vaginal birth. She did say that she was out of it on gas and air and so didn't realise when I was actually out, but she does remember lots of people there. My dad says they rang a bell and loads of people ran in the room - poor him, he was terrified that something went wrong, and was left standing outside. I was fine. the reason that so many people watch is because vaginal breech deliveries are rare.

My daughter was only found to be breech when i was already in labour, and the midwife gave me a vaginal exam. She wasn't sure of her presentation, and so they did a scan. I was whisked off for an EMCS and had her about 20 minutes later I think! I wasn't given the option of a VB, but I believe it was because I wasn't dilating properly (the head helps to put pressure on the cervix to dilate, I think).

I would rather have a planned CS rather than a vaginal delivery for breech, because of the risks involved (baby getting stuck etc), and definitely a planned CS rather than an EMCS, which is still a possibility, of course, if you are in the process of a VB. Also, as someone else above said, you need to consider the experience of the medical staff. More breeches being born by CS means much less VB experience out there. But those are my thoughts, and you need to weigh everything up in your situation, and the advice you are given from the professionals.

And yes, make sure your baby gets thoroughly checked for hip dysplasia. DD was picked up straight away and wore a Pavlick Harness for 6 weeks. treatment is much easier and quicker when they are so little (because their bones are softer) than when they are older.

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diyqueen · 05/11/2012 16:09

You may be offered an ecv to turn the baby closer to the time - if you've had a baby before this is more likely to be successful (I tried this with dd, but she was my first and had been stuck fast in the same breech position since about 25 weeks, and it didn't work for me).

I seriously considered attempting a vaginal breech birth but in the end v reluctantly agreed to elcs. I think if it was my second baby and I'd had a successful vaginal birth before I'd feel more confident giving it a go. I decided against vaginal birth for a few reasons - the attitude of the hospital (they do few breech births and were adamant that mine would be epidural, stirrups, episiotomy, possibly forceps... Could have fought I suppose but it being my first didn't feel confident to do so), and thinking about how I'd feel if dd suffered an injury/oxygen deprivation etc. due to my birth choice. I was terrified of the cs, but it was ok and for me the biggest downside was missing out on the experience of labour and natural birth. They did let me delay it til dd's due date, and I'm glad I did as dd was still quite small then and I think might have struggled born a week earlier.

Good luck whatever happens, just look into all your options and don't give up hope yet. Your baby may decide to move into position closer to the time, fingers crossed.

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ItsMyLastOne · 06/11/2012 09:40

We had a scan yesterday which showed the baby being breech. Her head was on my right and her mum on my left. That made sense to me as she definitely moves throughout the day from transverse to breech so I knew she wasn't going to be straight up and down iyswim. My placenta is also high up and on my right.

The consultant said that because of her position, the position of my placenta and the fact it's my second baby means that he thinks an ECV is more likely to be successful with fewer risk factors involved. Also the fact she's moving so much on her own may mean it's quite easy to turn her. I really didn't want an ECV because of the stories of oxygen deprivation caused by it, but then I know there are plenty of risks with an ELCS or breech birth anyway. We decided to get booked in for Monday (when I'll be 37 weeks). He said we'll go to the delivery suite, have a scan to check everything again, then try the ECV. He said I can change obviously change my mind at any point or ask them to stop during it if I feel it's taking too much effort and am worried about the baby. Then whatever happens, they'll do another scan and a trace to see what's happened and to check the baby's heart beat etc. He said I can stay until we all feel happy that the baby is ok, and if they have concerns about her then we'll just go straight to theatre.

He kept saying he doesn't want me to have a CS, and that he really feels I'm a good candidate for an ECV and should then be able to have a completely normal delivery.

This morning the baby was transverse but with her head lower than her bum so I have faith she may turn herself anyway.

I've made DP have a day off this week so we can get the baby's stuff sorted, you know, just in case. And my theory is that if I'm ready for the baby's arrival then she'll be fine and stay put a bit longer. That's how it works right?! Wink

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NanoNinja · 06/11/2012 17:04

Hi. I had ds1 by c section three weeks ago. He had been breech for as long as I could feel him and I was pretty much prepared for a section. That being said, and due to favourable conditions (lots of space and fluid), I tried an ecv. It was uncomfortable, and unfortunately there was some mixing of blood which meant an overnight stay, but am glad I tried.

The section was fine if a bit scary. But I am still recovering and it was very hard trying to look after my baby and bond when it was difficult to move and whacked out on drugs ( I had a mild reaction to one of the pain killers ). He had some minor problems which I wasn't able to deal with as I would have liked because I was so out of it. I also had the section a bit early in retrospect, which may have contributed to the problems.

I never seriously considered a breech vaginal delivery - maybe if it hasn't been my first baby. As it was, I figured an uncomplicated section was preferable to a complicated vb. My obstetrician ( who definitely does not like c sections ) also advised against it and given that she was the one delivering, I was happy to be guided by her.

Not sure that's any help at all! I guess the thing is you never know how the alternative would have gone.

Good luck!

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ItsMyLastOne · 07/11/2012 10:21

Nano I think that's my problem, just not knowing what to do for the best. There are just so many risks no matter what I do, whereas with DD it was so simple and straightforward. I never worried about anything when I was having her, but with this one all I seem to do is worry!

How many weeks were you when you had your baby? My baby was estimated at 6lb 12oz on monday (36 weeks), which seems huge considering DD was 6lb 13.5oz when she was born on her due date, so I don't think they'd have a problem with doing a CS pretty soon.

I'm also worried about recovery if I have a CS. With DD I lost a lot of blood which meant I couldn't jump up straight away, but I was ok to walk within 3 or 4 hours, and fine 12 hours later, just sore from the episiotomy. We were kept in for almost a week due to DD not feeding and losing so much weight, but after that I was fine, able to drive, even went into work for a day after 2 weeks. I'm worried about coping physically with a 2.2yo and newborn, especially as DP owns his own business and will really need to go in for a few hours a couple of times a week at least. I'm just desperately hoping the baby turns herself soon, or the ECV goes well.

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Ros1979 · 07/11/2012 11:01

I had a breech vaginally delivery for my first baby earlier this year and it was all very straightforward. Didn't find out she was going to be breech until 38+5 and although they tried a turn that afternoon, it was quickly evident that she wouldn't be budged. Quite glad now that I didn't have time to 'overthink' the turning, as I went in to it with little knowledge of any risks, without my hospital bag and very surprised that I had to sign a consent form, and that it could lead to a CS birth!

I found making the decision on what to do (labour vs ELCS) very difficult. There's a list of the questions that I asked beforehand here - www.mumsnet.com/Talk/childbirth/a1584275-Consultant-recommending-a-VB-for-a-breech-baby-first-time-mum-PANICKING (although not sure what type of breech presentation that thread was about, my dd was frank).

Good luck with the turn, and whatever decision you make.

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