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Breeched baby at 38 weeks... don't want a CSec

(59 Posts)
Dophus Wed 12-Jan-05 11:27:45

I am 38 weeks and had a presentation scan yesterday which showed that the baby is definitely breeched. The consultant said that the bay is too tightly packed to try an ECV. The estimated wieght is 6lb 9oz and this is my first pregnancy.

I had wanted a relatively natural birth useing the water pool and home form home facilities. The consultant has saif that he will support me if I decide to go for a vaginal delivery but doesn't really recommend it as there is an increased risk for the baby. If I attempt a vaginal delivery then there is a 50:50 chance I will end up with a C Sec. I hate hospitals and I am terrified by the thoguht of a C Sec.

I was feeling extremely positive, optimistic and excited about the birth. I now feel weepy, anxious and generally miserable.

I would like to try for a vaginal delivery but don't want to put the baby at any increased risk. Does anyone know how risky a vaginal delivery is?

scabbymeister Wed 12-Jan-05 11:30:44

They found out that my dd2 was breech at 38 weeks and to be honest I didn't hesistate to have a c section. They offered me vaginal delivery but recommended c section. The way I looked at is was I have come all this way and I cant take any risks now. I understand how you feel especially being a first baby but a planned c section can also be quite an emotional experience.

Dophus Wed 12-Jan-05 11:48:36

How long were you in hospital and how long was it before you could confidently look after the baby on your own?

scabbymeister Wed 12-Jan-05 11:55:35

I had her early hours of the Tuesday morning and went home on the Friday. I was fine to look after her immediately and to be honest I found the recovery quicker than with my first vaginal birth. Without going into too much detail it was very painful and stingy down below with my first daughter (stitches) but with the c section they obviously didn't mess around down there. They say you can't drive for 6 weeks but to be honest I was ok within a couple of weeks. Its so difficult especially first time around and you are probably highly emotional anyway - hormone city - but what will be will be. I chose the c section partly because at least I could be relaxed, if you start as a vaginal birth and then they rush you down for a c section you may miss the birth altogether. If you opt for c section you can usually choose your own relaxing music and enjoy the experience. This is only my experience, it might be good if someone posted who has had a breech birth. Hope this gives some food for thought.

mears Wed 12-Jan-05 12:00:59

Hi Dophus - here is an information leaflet for you informedchoiceleaflet

The main issues with vaginal breech birth is that labour should be spontaneous, you should be mobile etc. If progress in labour is not good then a C/S should be performed. Labour should not be induced or speeded up in any way.You can have a shot at labour but have a C/S if needed. There is a 50% chance you would have a vaginal delivery.

Howver, the real big issue for you is being looked after by someone with good knowledge of breech birth. There rae independent midwives such as Mary Cronk who have vast experience. Doctors and midwives in hospital have little or no experience. Find out what would happen in if you laboured. If you are advised that you will be continuously monitored, given an epidural and transferred to theatre to be delivered lying on your back with feet in stirrups (like a forceps) I would opt for C/S.

mears Wed 12-Jan-05 12:02:39

We had a lovely breech delivery a few weeks ago, but that was only because it was missed that the breech was coming first so it was too late to do anything else. The mum was in the pool so just stood up and the baby practically delivered itself which is how it should be.

mears Wed 12-Jan-05 12:04:09

Here is how Mary says a breech should be cared for in labour marycronk

Dophus Wed 12-Jan-05 12:08:13

Mears: thanks for the link. I hadn't thought to check how a normal labour would be carried out. The scenario you put is definitely not one which I would welcome. I woudl like to give a vaginla delivery a go (if I can remain active) do you know how much increased risk there is to the baby. It is in the frank position.

SM: you positive experience of a C Sec is reassuring - thanks.

scabbymeister Wed 12-Jan-05 12:09:54

No probs Dophus - Hope all goes really well, let us know what you decide and what you have xxx

mears Wed 12-Jan-05 12:10:56

Frank breech is a good position because the buttock, not the feet, are coming first.

mears Wed 12-Jan-05 12:13:32

It is hard to define risk - there is increased risk if the labour does not progress and is forced. Risk is increased with undiagnosed breeches. Your breech is diagnosed and in a good position. The baby is not at greater risk if you are cared for by people who have experience of vaginal breech deliveries. That is why it is important to know how you would be cared for in labour.

Donbean Wed 12-Jan-05 12:15:40

Im not a midwife so cant advise you with accuracy but i can tell you of my experience if it helps.
I had a c/section (unplanned, emergency and had a general aneasthetic, undiagnosed breach) However, after the event when i asked, i was told that there were several factors which influenced the decision to not let me deliver by the normal route (as it were).
The main reason is that there is the possibility of some brain damage to baby as pressures are altered when baby comes out the wrong way up. While moving down the birth canal usually the head moves slowly and gradually altering the shape of the head to accomodate. With breach babies, the head may be delivered quicker and pressures are altered.
I dont know if this is true as a midwife recently posted on a similar thread saying that in actual fact the width of the hips can be as wide as a head and so will progress as slowly as a head would.
It may be worth bumping this up until she can get to your post as she is excellent and gives great info and advice.(not sure of her name)
For me it was the mention of "brain damage" that made me instinctively know that the correct decision was made for me in this instance.
All i can say is get as much information as you can and although a natural birth is the preferable option, at the end of the day you need to think of the safest and most acceptable option for you and your baby.
Good luck with this decision,and let us know what you decide.

Donbean Wed 12-Jan-05 12:16:49

Ah! there she is its Mears, i thought it was you..I was just recommending your services, hope you dont mind

Donbean Wed 12-Jan-05 12:22:15

Just reading back your posts Mears and the more you talk about this the more i know that the team looking after me did the absolute correct thing for me and my babybean. The information and explanations you give make me realise that i was extremely lucky to have such a great bunch on my side.
Just wanted to say thankyou for posting all that you do, it has proved to be incredibly helpul to me.x

mears Wed 12-Jan-05 12:22:57

You are right Donbean that there can be more risk involved to the baby on delivery of the head because 'moulding' is in a different direction. Doctors tend to use forceps to 'protect' the head. However, if labour has progressed will normally, it is unlikely that there will be a problem with delivery of the head. But if someone inexperienced does not recognise signs of poor progress, baby could get into difficulty. The risk is associated with the carer IMO.

mears Wed 12-Jan-05 12:24:30

Thankyou Donbean.

If I was having a breech baby I would want someone experienced looking after me. If I was in my hospital I would opt for a C/S if I couldn't hire an independent midwife.

Donbean Wed 12-Jan-05 12:30:26

Im hyjaking this ladies post a bit here (appologies) but i just have to say something positive about a difficult situation and you seem the best person to do that to as it is within your field.
As a nurse myself i get a bit fed up with peoples angry negative stories of how they have been let down by the NHS for whatever reason. I just wanted to post a positive story to you.

Twiglett Wed 12-Jan-05 12:38:52

No experience of having a natural labour (breech or otherwise) but I have had 2 elective c-sections and would like to say that they really aren't something to be scared of

Its a fairly relaxed procedure (becuase its elective) .. you get to know when the baby will be born and plan for it .. you are stuck in hospital for up to 5 days (the only downside) but are able to walk by next day and the pain is medicated so I actually think its much easier than an episiotomy where you just get on with it

Both my children breastfed virtually immediately..by the time you leave hospital you will be fully able to care for your child yourself (by 2nd day really) .. and you have a get out of housework free card for 6 weeks

please don't be miserable if you decide to have a section ... the important thing is the baby, and yours, health

mears Wed 12-Jan-05 12:41:02

Your positive experience is good for Dophus to hear. There is excellent care on the NHS, and I think my unit is excellent. There is however limited experience of natural breech birth in the NHS - the option for C/S had reduced experience. In my unit, there is virtually no experience. First option is C/S. Other units do have regular breech deliveries and therefore have experience. Dophus needs to find out how much experience the unit has, and what care in labour is being offered. I agree there is fantastic care on the NHS. For units with limited experience of breech birth, the best care option os a C/S.

Dophus Wed 12-Jan-05 12:42:16

Decisions decisions!

I'm starting to feel a little more positive about both options.

Is there any point in gettin gon my hands and knees and waving my bum aorund in the mean time? Or is it the case if it's to cramped to turn by ECV then it's most likely too cramped to turn naturally?

mears Wed 12-Jan-05 12:43:36

Always worth a try. We have had women come in for planned C/S to find baby has turned. They are usually mad they didn't get their C/S

Twiglett Wed 12-Jan-05 12:43:36

I also saw a programme where she sat with a bag of frozen peas at the top of the bump (but don't know at what stage she was)

mears Wed 12-Jan-05 12:44:19

Try the peas too. Moxibustion (sp?) is supposed to work.

mears Wed 12-Jan-05 12:46:59

A description is here

You might be able to find an accupunturist local to you who would do it. Some units have midwives trained to do it.

gothicmama Wed 12-Jan-05 12:48:08

Not sure exactly how risky it is I think ity depends on how teh baby is laying. DD was breach and we managed viginal delivery ok. At the 38 wk scan they said she was in teh perfect position for a natural delivery. The only intervention UI had was when teh consultant had to tucjk her chin under so I could deliver her and she was warmed up and in aheated cot for teh first night. I wasnot told of any risks. Hope that helps

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