What happens if baby is breech? Can you still have normal birth?

(17 Posts)
Monkeyandanimal Fri 04-Oct-13 12:11:46

just curious really; i'm 32 weeks and baby is head up, and i was wondering what the procedure is if it doesn't turn. I know there's still time for baby to move, so i'm not worried, just wondering.... you wouldn't have to have a CS if the only prob was that baby was breech would you?

foolonthehill Fri 04-Oct-13 12:26:00

no...babies are born breech with low complication rates but it is less common now than it used to be. If a mother wants a vaginal birth and the baby stays breech she would need to be delivered by an experienced midwife or obstetrician who has done this before and definitely in a hospital.

Mothers are advised to have a caesarian if the baby's foot or feet are below his bottom (footling breech), or in a kneeling position (kneeling breech), the baby is likely to weigh more than 3.8kg or less than 2kg or you have a narrow pelvis or a low-lying placenta or if they have had a caesarian before.

At 36 weeks parents might be offered ECV where the baby is manipulated (from outside your bump) to encourage turning head down.

About 15% of babies are breech at 32 weeks and only between 1 and 3% at birth (this includes premature births and babies with abnormalities affecting position)...so statistically it is most likely that you little one will flip over...

that's probably more information than you needed...i got carried away.

All the best with your little one!

bundaberg Fri 04-Oct-13 12:31:23

no you can have a vaginal breech birth. sadly because they aren't so common these days midwives aren't necessarily as experienced with them as they used to be. But I do know a couple of people who've had natural breech deliveries in NHS hospitals which have been just fine!

google "hands off the breech" and "mary cronk"

Monkeyandanimal Fri 04-Oct-13 12:46:25

Thank you both. That's interesting. * Fool* , can you tell me if there are any risks or complications with the ECV?

foolonthehill Fri 04-Oct-13 13:23:56

There are small risks of placental damage and bleeding but these days it is usually done with ultrasound guidance so the risks are much less.

ECV would be contraindicated if the baby had his/her neck hyperextended, cord around neck, feet down in the pelvis or there was a query over uterine septum or other physical abnormality (and we are talking hen's teeth rarity here in case anyone is tempted to worry).

FWIW I went into labour with 2 breech babies (not at the same time) who turned during labour...as did my grandmother..my babies have all been relatively small and i wonder if the growing average weight of babies is contributing to the increase in caesarian delivery....

rallytog1 Fri 04-Oct-13 17:05:18

I have a midwife friend who's delivered two breech babies in her career - one in the back of a moving ambulance! Both turned out fine. But she's actually unusual and a lot of midwives have never delivered a breech baby, because they tend to diagnose the breech and then go straight to elcs.

Obviously no one is going to drag you into hospital and strap you to an operating table and force you to have a cs. However, if your baby stays breech they'll probably recommend to you that you have an elcs.

Fragglewump Fri 04-Oct-13 17:18:10

Some consultants are very twitchy about delivering a breech baby 'down an untested birth canal' (words of my consultant!?!) so if its your first younger have to more insistent than of you have had previous deliverys. If that's what you want of course...

Monkeyandanimal Fri 04-Oct-13 17:57:42

Well, its all theoretical as i'm expecting good little baby to turn, but I want to try to avoid CS, as i have a toddler and a preschooler so can't imagine trying to manage them, plus babe after surgery....but on the plus side, my birth canal has indeed been tested!

DIYandEatCake Mon 07-Oct-13 22:15:49

My dd (first baby) was breech and I very reluctantly had an elcs in the end. The hospital didn't do many breech vaginal deliveries, and I was told that my labour would be continuous monitoring, epidural, legs up in stirrups, extensive episiotomy and forceps. They may just have been trying to put me off, but either way their attitude to breech birth didn't fill me with confidence. I requested my elcs be delayed til my due date to give dd more time to turn, then admitted defeat. It wasn't so bad though and I'm glad I didn't take any risks with her.

Bearfrills Fri 11-Oct-13 20:52:22

I found out at 40+1 that DD was breech (2nd baby). They were going to to attempt an ECV but the scan showed it wasn't favourable and the consultant MW won't attempt them if its not favourable. As I was having niggling labour pains I had to make a there and then decision about what to do.

The registrar came down and she explained that if I wanted to attempt a vaginal delivery they would support me but there is a slightly higher chance of cord prolapse, cord compression and placental abruption in a breech delivery. There is also a chance that the feet/leg can deliver and then the shoulders/head become stuck. All of which would result in a crash caesarean and some of which (eg prolapse or abruption) carried a high risk of still birth. She also told me that breech babies delivered vaginal have a chance of slight developmental delay (I don't have stats on it). The pros of a caesarean were given as higher chance of a favourable outcome, safer for me as well as DD, and better for me to be awake for the section in terms of recovery.

Scoobyblue Wed 16-Oct-13 15:30:21

I had an ECV with dd1. I found it to be uncomfortable but not painful, although I know that some people find it to be more painful. She was turned successfully, stayed head down and was born vaginally on her due date. They needed to have an operating theatre clear when they performed the ECV in case it sends you into spontaneous labour but apparently this is rare. I was very keen to avoid a C section if possible so was pleased with the successful ECV.

Nettiemc Thu 17-Oct-13 08:38:01

I was and unexpected breech! I had been told from 32 wks that head was down, then at 39 weeks I had a mw appointment and she queried the position of the baby. A scan was book for the day before my due date to confirm the position,( only appointment available) anyway I went home upset, after being told everything was good for weeks it was all going wrong!! I explained to my husband when I got home then my waters broke!! I was taken to the hospital straight away for a scan to confirm breech baby. I was told that the only option was a emergency c section. Has this happened to anyone else?

Bearfrills Thu 17-Oct-13 10:18:58

Yes, nettiemc, my post is slightly above yours.

Community MW thought at 35wks that DD was breech when my fundal height measurements went all wobbly and she thought she could feel a head at te top of my bump. She didn't refer me for a scan because the hospital phone number was engaged hmm

When I went back to the MW a week later (same MW right the way through) she told me that DD was head down and fully engaged.

At 40wks I had a show and niggling contractions so at 40+1 went to the MW to ask for a sweep to help things along. I saw a different MW who checked me over before doing the sweep and spotted straight away that DD was breech, Doppler backed it up (heartbeat was loudest in the top of my bump where DDs chest was).

I went for a scan that day to confirm the position - flexed breech - and they booked me for an ECV at 40+3 but told me that if my labour progressed or my waters broke I needed to ring an ambulance and would have an emergency section. They have me information on ECV and on caesarean delivery, had a chat through my questions, then we went home.

On the Wednesday, 40+3, I went for the ECV but it couldn't be done as DD had the cord wrapped around her legs, the remaining cord was coiled over my cervix, and she had barely any amniotic fluid (just a pool in front of her face 3cm deep).

I'd had a big show that morning and my contractions were progressing. They explained about having a vaginal birth if I wanted one (which what I mentioned in my previous birth) but really the safest option was a section before I dilated far enough for the cord over my cervix to prolapse.

I went straight from the scan room to theatre for an emergency section - my appointment was 10:30 and I had DD at 11:30 grin

In hindsight, the MW should have referred me when she first suspected a breech. She also should have listened when I told her I wasn't getting any kicks at all, just a round bulging thing in the top of my bump (obviously a head). I was supposed to have the same MW this time and she did my booking in but I changed MWs straight after as I've got no trust in her.

fuckwittery Thu 17-Oct-13 10:20:52

I've got an independent midwife who is experienced in breech birth, but not v many nhs midwives will have experience in it now.

Emmazers Thu 17-Oct-13 10:37:21

Something I wish I'd been told with my breech was the having an ECV doesn't reduce your chances of having a c-section, even if it's successful. This is because it can leave them in an even worse position, such as transverse or brow presentation (which is what happened with DD1). I would never have an ECV again!

Nettiemc Thu 17-Oct-13 10:58:07

Thanks bearfrills. I also had very little movement but when u said this to the mw I was told the baby had less room the further in I was in the pregnancy. I went into labour at the hospital waiting on a theatre space. But when I dilated really quickly and started to push I got took to theatre at 100 mph!! I get really upset when I think about his birth, it should be a happy memory but I was in shock and so frightened. I Then I look at him and know I am lucky. It's comforting to know I am not the only one but should not really happen in this day and age.

Bearfrills Thu 17-Oct-13 17:50:49

I know the shell-shocked 'what the hell just happened ...?" feeling nettie. DD was my second baby so I was expecting everything to be straightforward and it was difficult to a crept that it didn't go to plan, especially the recovery aspect - I'm normally on the go all day every day so it was hard having to go a bit slower and being achy, etc while I healed (after DS I walked from the labour ward to the postnatal ward and was out and about again two days later).

The good news is though if you decide to have another DC you'll be consultant led. I told the consultant this time (I'm 22w) that I'm worried about the same thing happening again. He's booked me for an extra scan at 36w to check presentation and says that when I go into labour they'll do another quick scan (they have a portable one in the labour assessment suite) purely for reassurance. It does take a lot of the worry off.

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