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Childbirth

external cephalic version - anyone refused?

37 replies

heartmoonshadow · 24/05/2009 17:49

Hi,

I am 32 weeks pregnant and throughout my pregnancy I have had a constantly transverse baby. I have been advised that due to the 'estimated size' of the baby (done by feel alone) that it is unlikely the baby will turn. The midwife says there is no point measuring for birth size as there is no possible way of getting an accurate measure. I have a growth scan booked for 35 weeks but she has warned me that the doctor will put pressure on me to have an ECV - which I do not want as there is a risk of early onset labour.

I think that if the baby is still transverse I would like to push for a c-section at 39 weeks - any tips for speaking to scary consultants and voicing a valid argument for no ECV and a c-section appreciated.

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christiana · 24/05/2009 17:57

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christiana · 24/05/2009 17:58

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FabulousBakerGirl · 24/05/2009 18:02

I had my baby turned without my knowledge or permission and I have to say I would never have it again if I was to have more children.

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heartmoonshadow · 24/05/2009 18:08

Thanks for the advice ladies, the consultant I see is a b*h - you know when someone should not be in a job, well that is her. She is brusque, abrasive and quite rude. She speaks to me like I am a child, although I am a 35 year old intelligent professional woman. To be honest I have had to pull her up on several occasions as she talks in abbreviations and then looks disdainful when I ask for a translation - after all I am not medically trained.

This is why I think I will have an arguement on my hands about not having an ECV.

I would be more than happy to have an ECV if it was done by someone I could trust not to be perfunctory and to treat me like a human not an inconvienient incubator.

We will see - maybe the baby will turn on its own - who knows!

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christiana · 24/05/2009 18:10

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heartmoonshadow · 24/05/2009 18:13

I have tried changing consultants but the option given was to change hospitals as apparently they are all as bad as each other! To be honest I am going on the theory that I have only a maximum of 10 weeks under her 'care' and then it will be over. I just wanted to see what others had said to ensure they got their own way rather than getting swept up in what the consultant wants because it is easier for her.

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christiana · 24/05/2009 18:14

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heartmoonshadow · 24/05/2009 18:15

Sorry forgot to say this is my one and only ever pregnancy. Due to my age and the fact that it is a miracle because I was told I was infertile when I was 26. I must admit I have not enjoyed pregnancy especially now and just wish it was all over.

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christiana · 24/05/2009 18:16

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christiana · 24/05/2009 19:10

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ChocEclair · 24/05/2009 19:31

You are def within your rights to refuse the EVC - you don't even have to give a reason!

My baby was breech for most of my pregnancy and the mw's kept going on about how I would have the baby turned - I just kept saying firmly but politely that I would not each time! They never really pressed me for a reason.

There are recognised risks - I did a fair bit of research - placental abruption is the main one.

They did seem surprised but they can't make you. As it turned out she turned on her own eventually without me doing any of the things recommended! I never had a horrid consultant though - sounds rubbish!

Good Luck!

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MrsJamin · 24/05/2009 19:36

ECV was totally an option for me, I had it and then went into labour 9 hours later (it was ok though as I was past 39wks). For me it was excruciating, but it doesn't seem to be that way for everyone (there's quite a few opinions from others on breech threads). You are totally within your rights to refuse an ECV though. They should be able to shortcut you straight to booking your date for a c-section.

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hedgiemum · 24/05/2009 19:45

heartmoonshadow - they wouldn't want to try the ECV until at least 37 weeks anyway (I know this for certain as I'm trying to get my consultant to do one earlier as I've had my last 2 babies at 35 weeks and they won't!)
There tends to be one consultant who specialises in ECV.... at my hospital its one I've had a previous run-in with and can't stand, but I really want ECV as can't bear the thought of a c section...

Stick to your guns if you really don't want ECV. No-one can or will make you.

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TheCrackFox · 24/05/2009 19:54

I had an ECV (didn't work) and in the unlikely event I needed to have one again I wold refuse.

It is your body and ultimately your decision. You would need to sign a consent form for it anyway so tell them to bugger off.

Good luck.

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elvislives · 24/05/2009 20:30

I had an ECV, but they made it clear that it was my choice. They gave me the option of going straight to CS instead.

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SympatheticConsultant · 24/05/2009 22:55

ECV is an option to manage breech presenting babies at or after 36 wks (it is simply a process where the baby is manually turned by pressing on the abdomen). After appropriate counselling by your Obstetrician as to the risks and benefits it is entirely YOUR CHOICE as to whether you want to proceed with it or not. No Obstetrician will force you to have one against your will.

We have 4 Consultants who offer ECV during their dedicated weekly LW sessions.In most units the success rates are probably at best 30-40% (but even a 1% success rate is one less unnecessary CS!).
It tends to work best in:

  • Mums who have had babies before
  • Pregnancies where the breech is not engaged in the pelvis
  • Pregnancies where the baby is small or average size

In most cases where it work the baby tends to turn round with very little effort.Although it can be a little uncomfortable excessive force is never used and the process should be stopped if mother is in obvious/significant discomfort!

Hope this helps some of you out there.
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heartmoonshadow · 25/05/2009 20:55

Thanks everyone for your replies and I was particularly interested about the success rates.

As yet I don't know the size of my baby other than the fact that I am massive because he has been transverse all the way through and therefore measurements are not reliable.

To be honest I think he is possible just very very long as hubby is 6ft 2in and most males in my family top the 6ft 4in+ side of things, I on the other hand am only 5ft 2in so that could be why the baby has no room to manouvere who knows?

Anyway I am armed now with the facts and can refuse to my hearts content - roll on the next 8 weeks!

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doulalc · 25/05/2009 22:10

Try not to worry too much at this point. Most babies will become vertex by 34 weeks and even more so by 36 weeks. Majority of ECVs are done at 36-37 weeks on the off chance baby does need to be delivered or you go into labour, and to try and prevent them changing position again.

Have you tried other means of encouraging baby to turn? An osteopath or chiropractor trained in the Webster Technique might be one consideration....have had some nice success with this in the past with several mothers. Do you know what your consultant's success rate is with an ECV? Much depends on baby's position (transverse has higher success than any breech position), location of placenta, amount of amniotic fluid, and how much experience your doctor has. For some it won't even be an option due to low experience and success rate, and not too many parents want to let their consultant gain experience on them, but some will have a quite high success rate.

Definitely try some alternative means of encouraging baby to turn.

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hedgiemum · 25/05/2009 23:39

Yes, ask about success rates for sure. The only consultant who performs ECV's at our (large) hospital claims a 70% success rate, so all the other consultants leave it to him. Everyone just wishes he would develop a better bedside manner though, he's very abrupt - sometimes even rude.

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Hersetta · 26/05/2009 11:33

I refused an ECV at 37 weeks for breech DD. They tried very hard to persuade me to have it done but when i said i definitely didn't they booked me in for a cs at 39 weeks. in the end DD turned the day before my CS and i found out on the op table and was sent home to wait for nature. Ended up having an EMCS 8 days later anyway!

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christiana · 26/05/2009 18:13

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StarlightMcKenzie · 26/05/2009 18:29

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Hersetta · 27/05/2009 09:03

Christina,

She woke me up in the night as she was squirming so much but I never actually knew she had turned around - they was no huge movement where i just knew she had turned.

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JetLi · 01/06/2009 18:15

Hi heartmoonshadow - take a copy of the NICE guidelines with you and visibly wave them around. That may help. Here - page 38 is a bit you may want to highlight:
Recommendation on breech presentation
Induction of labour is not generally recommended if a woman?s baby is in the breech presentation. If external cephalic version is unsuccessful, declined or contraindicated, and the woman chooses not to have an elective caesarean section, induction of labour should be offered, if delivery is indicated, after discussing the associated risks with the woman.
Then the other guideline to waft about is here - page 280 is where all the bumpf starts about breech and evidence for ECV - it really ain't that successful.
A friend tried moxibustion to turn her baby (You'll need to see an acupunturist) - sadly it didn't work for her but could be worth a try for you maybe? She declined ECV and went straight for a section - her situation was not disimilar to your in that this was her only baby after 6 tries at IVF - she wasn't taking any chances at all with ECV causing problems.
I'd personally be against ECV - for instance how can they know that baby isn't transverse because the cord is wrapped around their neck - and then surely turning could make that worse? Don't want to frighten you but I'd want them to be 110% sure of what they were doing before they started faffing around.
I'm with christiana - write to the hosp and elect for a c-section. After being told you'd never have children, I'd want the munchkin out of there as swiftly and safely as possible. You've waited too long for them to muck around with you!
Is there someone who can go with you to the appointment and help argue your point?
{{{{{ hugs }}}}}

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crokky · 01/06/2009 18:42

Totally agree with JetLi.

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