Talk to me about a breech vaginal delivery

(35 Posts)
ItsMyLastOne Fri 02-Nov-12 17:56:58

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!

ItsMyLastOne Mon 12-Nov-12 19:01:34

I had the ECV done today. It all went really well, the actual turning took 30 seconds. DP had popped for a wee just before the doctor was due to come and do it, but by the time he got back from the loo it was all over. I went all nauseous and faint during and after it, but at least it was done quickly. From their reaction it seemed like it was some kind of record!

They did a scan immediately after the turn and confirmed she was head down and everything was fine. Then I stayed on the trace for a while and the baby was fine, so after about 45 minutes they took me off it. The doctor came back and told us everything had gone well so fingers crossed we should have no more issues and should be able to have a normal delivery.

Well, that was at about 2pm, now I'm 85% sure she's moved back! :-(

Ushy Fri 09-Nov-12 19:03:04

'Its' The decision is going to be yours and it won't be easy.

Please be a bit weary of the 'spinning babies' stuff - when you actually look at the real evidence caesarean delivery is definitely a bit safer for the baby. However, vaginal breech isn't recklessly dangerous but it is a bit more risky. Even the NHS offers caesarean for breech and the NHS avoids offering caesareans wherever possible.

Something you might want to ask your consultant. ECV can turn a breech baby but the risk of an emergency caesarean is just as high.

ELCS is not that risky - the risk of caesareans is from emergency ones.

You might find this useful http://www.rcog.org.uk/files/rcog-corp/A%20Breech%20Baby%20at%20the%20end%20of%20Pregnancy.pdf

Hope it goes well

doctordwt Fri 09-Nov-12 14:05:22

OP - yes I'm sure that's the thread. It scared me as of course, the monitoring immediately afterwards didn't pick up a problem. I would think that if you are aware of the potential for a problem which wouldn't manifest as a disastrous 'gotta get baby out now' situation then you are in a better place with that - I would think a good thing to do would be to get it agreed that you would be assessed for blood flow through the cord/from the placenta prior to the ECV, and then another couple of times over the next few days?

That would be a good way to pick up on a slight compression/damage to the cord which could potentially deprive the baby slowly of nutrients/oxygen post-ECV - I gather that was what the mum in that thread deduced had actually happened. They do that kind of monitoring when you are overdue I gather (expectant management) so it should be possible??

Good luck. It's such a difficult decision, but it sounds as if you are really arming yourself with detailed facts about the actual positioning etc. I'm sure things will be fine either way.

amazingmumof6 Fri 09-Nov-12 12:34:47

I had a C section with my 4th as he was footling breech. not one word uttered about even trying to delivery otherwise, by me or by consultant.
had another 2 VBAC (I wonder if 6th was technically VBAVBAC smile) good luck.

ItsMyLastOne Fri 09-Nov-12 12:21:13

doctordwt I'm pretty sure I know which thread you mean. I saw it a few weeks ago before I found out the baby was transverse. To be honest, that thread is the one thing that has made me very very wary of an ECV. It's because of that horrendous story that I've been thinking non stop about what to do. The scan showed the cord is (currently) completely out of the way and not wrapped around her at all, and my placenta is very high up and also out of the way. It's because of seeing that on the scan that I am considering it at all. She's also not fully breech, she's sort of at an angle, almost transverse, so they have said the risks are lessened from her not needing to be turned so far as well as the position of the cord and placenta. I'm still very worried though and will be insisting on lots of monitoring, I've also booked to see the mw 3 days later. It's hard to know what to do as I know the alternative risks of a breech delivery or CS.

Nano DP will be taking off as much time as necessary, and I have family around who I won't be able to get rid of will be willing to help a lot, so hopefully it wouldn't be as bad for me having an ELCS as it would be for many women.

Alamaya sounds scary! Luckily, because of the position of the baby ATM, she's far more likely to be bum first rather than feet first, so hopefully a breech birth wouldn't be too traumatic for me.

Alamaya Thu 08-Nov-12 12:07:49

Gave birth to my second baby on 4th Nov this year. Keeping it brief it was an hour long labour that was so quick i didnt make it to hospital and we were all floored to find him a footling breech with having no warning. Luckily he was a small boy and the birth was actually easier than my first, He had cord 3xround his neck :O.

I was told they would of c-sectioned me for sure if i had got to hospital. As footling breech is the most dangerous sort. Hes lucky he has no dislocations and im lucky i got him out.

Still cant believe the midwife and ambulance crew shouting they can see feet shudder!

NanoNinja Wed 07-Nov-12 12:49:06

Ooh, and to follow on doctor dwt, I think I read that story, and it did unnerve me. To be honest, deciding to have an ecv was a harder decision than deciding to have a c section. And I was worried for the entire five days between the ecv and the section. Still not entirely sure why I went for it!

NanoNinja Wed 07-Nov-12 12:42:09

Hi,
I was 38 weeks in theory, but a couple of doctors did say he looked a bit younger. Weight was 3 kg. He did have problems with temperature and hypoglycaemia, which I guess may not have been a problem if it was later, but the blood mixing meant that the doctor advised sooner rather than later
In terms of recovery, i really needed help forthe first three days. At three weeks, I'm a little tender, but feel okay to do most things I usually do ( but not driving or exercising beyond walking ). Although I don't have another child to look after. I also spent 8 days in hospital, pretty much in bed, so had time to recover.
When my mum had my sister and brother (3 & 4), she hired a babysitter for a couple if weeks to look after the older children. Would that be an option?

doctordwt Wed 07-Nov-12 11:44:03

OP, there were a couple of threads on here a while back with a mother giving an account of a not good outcome which she attributes to the after effects of an ECV. I will link if you request it - I won't do so straight away as I really don't want to look as if I'm posting a scare story. The reason I have mentioned this is because this story really stuck in my head and made me extremely aware that monitoring immediately after an ECV might not be sufficient to eliminate all of the (VERY SMALL!) risk of something going wrong. Personally after reading that I would not agree to ECV.

I'll post a link if you wish, I really hope you don't think my post is inappropriate.

Ros1979 Wed 07-Nov-12 11:01:22

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.

ItsMyLastOne Wed 07-Nov-12 10:21:05

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.

NanoNinja Tue 06-Nov-12 17:04:36

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!

ItsMyLastOne Tue 06-Nov-12 09:40:41

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

diyqueen Mon 05-Nov-12 16:09:03

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.

theborrower Sun 04-Nov-12 21:42:29

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.

ItsMyLastOne Sun 04-Nov-12 12:44:49

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

NAR4 Sat 03-Nov-12 13:17:28

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.

ItsMyLastOne Sat 03-Nov-12 10:30:14

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

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?

ItsMyLastOne Fri 02-Nov-12 21:10:46

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

MrsLovely Fri 02-Nov-12 20:58:48

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

Sulfur Fri 02-Nov-12 20:54:35

I had no perineal trauma -no stitches.

The bottom is not much different from the head.

Sulfur Fri 02-Nov-12 20:53:04

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.

Fairylea Fri 02-Nov-12 20:05:14

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 !

FiercePanda Fri 02-Nov-12 20:05:02

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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