Breech Baby - how bad is the delivery?

[Elf1981]

I know I have some time yet for things to change, but just wanted a bit of advice.
I'll be 32 weeks pregnant tomorrow with my first baby. The past two scans that I have had (one last week, the other two weeks previous) have shown that my little bub is breech. On the first scan it was an extended breech. On the second, still breech but one leg flexed, the other extended.

The hospital have told me that the usually wait til about 36 weeks to re-scan (I think at the advice of the community midwife from when they've felt the position) and then if bubs is still breech, it's up to me whether I have a "natural" birth or a C-Section.

The hospital doesn't do manual turning and my placenta is anterior and I've read they wont manually turn if the placentas in that position. I know there is the possiblity of bubs turning by themselves in the next week or so but if they dont turn, what's the best thing?

Is a C-section far safer for breech babies?
Would my chasing a "natural" delivery lead to an emergency C-section if things don't go to plan?

I'd love to hear people's experiences. Just wondered if anybody had any info for me?

[jessicaandbumpsmummy]

Elf... no advice because as you know, im in the same boat!

No scans, just midwife telling me im breach - lets just hope these little bubs of ours WILL turn!

[Elf1981]

I've only had the scans after follow ups from going to the assessment unit after bubs stopped moving and frightened the life out of me!!
First scan hospital / midwife did not seem too concerned.
This time though they did start talking about further monitoring, scans and how to deliver which scared me!!

[sparklymieow]

I had a C/section for DS as he was full frank breech, the hospital never gave me a choice as he was my first baby, I am only tiny (4ft 11 and size 8) so they thought it would be safer to have a c/s. I am glad I knew in advance that he was going to born by C/s, though what happened was I went into premature labour at 36 weeks and had an emergancy c/s, though it wasn't really as it was planned to be a c/s at 38 weeks.

[scully]

My dd was also breech and I wasn't really given a choice as to the delivery. Had I really wanted to deliver naturally I could have argued for it but the hospital really weren't supportive at all, and as it was my first, I took their advice. I was initially disappointed but the c-section went really well and at the end of the day dd was born healthy and we were all stress free, so we were happy with how it all went in the end.
I had a good experience with my c-section and would personally not stress at all if I was told it was the better option next time (next baby due in Dec).

[Kelly1978]

My twins were breech, and they told me there was a good chance I would need a section for at least the second one, but they wanted em to try for a natural delviery. i refused. I personaly would rather have a nice safe planned section than go through labour and have an emergancy one.

[Bozza]

I would just say that there is still time for the baby to turn. DS was breech at this point and turned and I know several friends with similar experience. Have you tried doing anything to make baby turn yourself? Swimming and getting down on hands and knees are supposed to help.

[Chuffed]

Have you thought about having accupuncture to try to turn it? It can sometimes be successful.

[harpsichordcarrier]

I had a breech baby too, and she resisted all attempts to turn her manually
(ECV). BUT it can have a very successful process and is absolutely worth a try, especially if the alternative is a C section or breech delivery. The NICE (National Institute of Clinical Excellence) guidelines say that if you are still breech at 36 weeks then you should be offered ECV.
So if I were you I would ask to be referred to another unit for an ECV.
There is research which suggests that it is safer to deliver breech babies by C-section (reduced risk of brain damage/death etc) but for me the most compelling argument was the lack of experience in the hospital for delivering breech babies vaginally. Ask how many babies are delivered this way - I was told NONE for the past 5 years... and I didn't want to risk it, frankly.

[chipeater]

There is a very famous midwife called Mary Cronk who is a specialist in delivering breech babies and in training other midwives to do so,including how to tell when a c/s is actually necessary.

It may be worth trying to contact her for advice.

[throckenholt]

If I were you I would be spending as much time as possible on hands and knees or leaning forward, and as little time as possible leaning back.

Otherwise resign youself to an elective c-section - at least you have the advantage of being able to plan around that .

Generally speaking I think natural breech births are much more demanding of the skills of the midwife, and the majority of midwives no longer have the relevant skills because breech births are rarely done in the UK now. So progressively natural breech births become riskier and not attempted.

[robinia]

At 32 weeks "breech" doesn't really come into it. I'm 32 weeks and baby is moving around all ways - sometimes up, sometimes down so really saying your baby is breech is scaremongering. Having said that, if baby is still breech when I go into labour I shall be fairly insistent on a "normal" delivery - but then I do know that I'm quite efficient at getting babies out Not had a breech yet but unless in a really bad position it should be fairly straightforward. Although they "won't let me" have the homebirth I want if it is breech.

[robinia]

These are interesting discussions:

AIMS discussion

ARM discussion

breech birth stories Obviously homebirth ones. (Go via "you can't have a homebirth because" ... and then "breech")

Interesting to note the emphasis on some discussions of non-intervention in the breech birth - ie. no forceps etc. -if failure to progress occurs then CS should be the route to go, not other interventions.

[scully]

I found out too late to try anything other than ecv, which was unsucessful, but was happy to have at least tried. I found it uncomfortable, but not a painful procedure. The all fours exercises didn't work either
Reflexology and Acupuncture are the other methods suggested - as you have time to make appts with both/either of these, they might be worth considering.

[Aragon]

As someone else said Mary Cronk is the expert to go to - she's a midwife who lives on the Isle of Wight and is more well read than many obstetricians out there on the subject of breech deliveries.

From reading her past stuff:

• Breech babies can deliver safely vaginally.
  
• They can be born at home or in hospital
  
• There should be a careful monitoring of progress but no major interference.
  
• Upright positions are best for labour and delivery.
  
• If progress is not being made the baby is telling everyone that he/she needs to come out via a caesarean section.
  
  She has helped lots of people birth breech babies at home and as a result is one of the most experienced people about with regard to breech births which often go straight to caesarean without a trial of labour.
  
  Acupuncture and a method of this called moxibustion has seemed effective for some women to help turn their babies.
  
  But at 32 weeks your baby is likely to turn. Less than 5% of babies are breech by the time labour begins.

[Elf1981]

Thanks for all the advice.

I'm trying to be all optimistic that bubs will turn by themselves but want to have a "back up" plan just in case.

I feel the babies head under my ribs constantly now, which is getting a little painful. I'm spending a lot of my time at work sitting on the chair leaning forwards and try to be on all fours when I can at home, but find it really uncomfey.

I think the problem is that I have no idea what to expect from child birth anyway so I cant kind of think to myself "oh, it's just a bit more effort than last time" because I have nothing to compare it to.

I think that if baby remains breech (fingers crossed they get the message and turn around!) then I will probably opt for a C-section. I think I agree with Kelly1978's point about rather having a planned than an emergency section.

[Aragon]

An article by Mary can be found here

[Aragon]

And a c-section is fine. Happy, healthy Mum and happy, healthy baby.

[throckenholt]

have you tried sitting on one of those exercise balls ? That keeps you very upright and is surprisingly comfy, or you can use it to lean over.

Also you can try sitting on an upright chair with it the wrong way round - so that you are leaning your front on the back.

[robinia]

Re. c-section - I really would rather not have major surgery if it is not necessary - I would be a most unhappy mummy if I felt I had been put through this procedure because midwives are losing the skills necessary to deliver breech babies.

[morningpaper]

Elf, I hope your baby turns!

I think that an inept breech delivery (a panicked doctor with a large pair of scissors and forceps) could cause you more physical trauma than an 'unnecessary c-section'. I think my local large hospital only had one breech vaginal delivery last year in a first-time mum. (The statistics should be readily available btw - ask for them.)

[robinia]

Totally agree mp. According to most of the stuff I've been reading (see the links below) it's when the midwices/consultants etc. start intervening ie. giving epidurals/forceps etc. that the outcomes decline dramatically. The breech birth should in theory be allowed to happen as naturally as possible. If it fails to progress it should then be taken to c-section, not forceps, ventouse etc. In this scenario, I would be happy to go for c-section, realising that this is best for baby. I just don't like the idea of being booked for a c-section when there is every chance I could deliver a breech baby naturally.

[morningpaper]

I've read that in lots of hospitals once the baby's body is delivered, episiotomy and forceps are routinely used to allow the baby's head out ASAP. There's no time for much else at this stage so it's basically getting in there with the garden shears. Elf - perhaps you could find out the detailed procedure that would be used in your hospital?

[milward]

Frank breech with the bottom first has least probs but footling breech (one foot first) is a problem. See what type of breech your baby is. Mine was a footling breech so I had a cs as it wasn't safe to deliver. I took the risks of surgery to be lower than risk of breech delivery. Just how I felt.I'd wanted a natural birht with dd2 but in the end was just relieved to have my baby in the safest way. Perhaps you baby will turn? I had a scan just before my cs to check this - but was still with foot first!!!

[Elf1981]

The current position at the last scan was one foot first, so I think that's footling. I always find the terms my hospital uses doesn't marry up to any of the pregnancy books I've got!

I've got another midwife appointment on Wed, so am hoping that there has been a shift in postion. I don't think there has been, as I still feel kicks really low down, and I'm sure its the babies head under my ribs that I feel.

The idea of walking into the hospital knowing that I'm going to have a section frightens me, but the idea of having a difficult labour with lots of intervention and possibly an emergency section frightens me more. I'm going to discuss with my midwife this week, and see if I can have a chat with the consultants at the hospital about their statistics.

Fingers crossed though for movement!

[champs]

hi elf, hope baby turns, do try the positions to help baby turn and also a birthing ball.
I found the positions uncomfortable and didn't get on with them but birthing ball was comfy and i still use it now.

someone, i think pamina, used frozen peas technique.

my baba turned, don't know what worked or if s/he would have turned anyway.