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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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Original poster

To turn down ECV and go straight for a c-section?

69 replies

Wibblypiglikesbananas · 15/10/2013 15:58

So, 2 years ago, DC1 popped out vaginally no probs. Quick labour, bad tear and stitches but all healed and no negative side effects.

Now 38 weeks with DC2 and he's breech. Options are c-section or ECV, then c-section if this fails. I'd just about decided on c-section but saw a different Dr this morning who said I'd be a good candidate for ECV and was pretty persuasive, so am now in two minds again.

Reasons for not trying ECV include the risk of placental abrubtion (small) but also an element of control in my own head. I'd rather know what I was letting myself in for than try ECV, it fail and end up in theatre anyway. Or try ECV, be induced and then end up with a c-section anyway, if that makes sense.

I'm in the US, not the UK, so pls don't comment on costs to the NHS etc as it's not relevant in this case. Everything is covered by health insurance so it's basically my call.

An extra consideration is that being overseas, we don't have family on hand (though my mum is coming over in a few days) so c-section recovery could be tricky with a toddler. However, I don't want to base my decision on that - if it comes to it, we'd have to get a nanny temporarily.

DH is trying to be supportive but to be honest, I don't think he could ever really understand somehow. So - wise Mumsnetters, would you go straight for the c-section?

TIA

OP posts:

stopgap · 15/10/2013 18:48

I'm in the US, too, and they don't really do breech deliveries here (certain home birth midwives aside, and I don't know where you are in the US, but there are one or two doctors in NYC that do breech--such as this one: www.roshmfm.com/about-us.asp--but they're honestly rarer than hen's teeth).

DarkVelvetySilkyShiraz · 15/10/2013 19:46

Go straight for section.

bimbabirba · 15/10/2013 20:01

I would go straight for the section too. I'm not even sure that c-section is a second-best option compared with vaginal birth in terms of pain/risk/recovery. Plus the idea of manipulating the bump freaks me out.

Serialdrinker · 15/10/2013 20:08

Section. I had an emergency first time- recovery was not pleasant. Planned (ish) second time- different experience with a better recovery AND and toddler to look after. Scar (only one as same incision) is hardly there if thats a worry? Big fat belly is though but to be honest I blame cheese on toast....

TallulahBetty · 15/10/2013 20:14

DD was breech until 36 weeks, and I was planning on going straight to section too. Heard too many horror stories about ECV, especially with an anterior placenta, as mine was. I know sections carry their own risks but I had weighed it up. DD turned by 37 weeks

MrsAmaretto · 15/10/2013 20:14

I had one but for first pregnancy but it didn't work. I was told there was a greater chance of it working if you've had previous pregnancies.

Agree with pp that you should find out the "stats"/ success rate of whoever is going to do your ECV to help you make your decision.

This time I had a failed VBAC, emergency section, husband went back on oil rig 3days after we got home (had used leave waiting for 40+13 baby) Although my mum came to stay with me for 2 weeks, 2 year old refused to leave the room I was in, would pee every time I put baby to boob, wound got infected, wound started to gape (had to move quick from angry toddler) So basically it was shit, hell on earth & why I wanted to avoid a section! If you are confident in your team & have good odds for success I would go for it.

Pickle131 · 15/10/2013 20:18

I'd definitely go for the section, I have nothing but fond memories of mine and the recovery for a planned section is very good. I wasn't in pain, put it that way. It's going to depend on how much you want a vaginal delivery, I'm biased because I wouldn't ever want another.

Original poster

Wibblypiglikesbananas · 15/10/2013 20:25

Thank you all so much for sharing your experiences. My fear would certainly be that everything ended in an emergency c-section anyway as things are so medicalised here, so I'd rather go for the planned approach and avoid as much bruising as possible, panic etc.

I think if I had a vaginal birth it would be quick, as DD was born so quickly, but given there's no gas and air here and you're straight into an epidural anyway, it's already getting medical (not saying that having an epidural is anything like a c-section, but it's starting on a medicalised pathway). The other option is a vaginal birth with either pethidine if there's time or nothing! Now, that makes the c-section sound appealing!

OP posts:

nextphase · 15/10/2013 20:30

Ok, so sounds like my first idea to consider is out - breach delivery. When DS2 was breech at 36 weeks, I broached that, expecting to be laughed out, but was greeted with "great plan".

So, if that hadn't been the case, I think I'd have gone for CS, and I was adamant I didn't want a cs, its just that ECV sounds sooo brutal. I think bubbas that are head up permanently are usually like that for a reason - short cord etc, and are best left as they know how. If they are flipping back and forth, they aren't going to stay like that, so no point in ECV at all!

racmun · 15/10/2013 20:30

I've just had to make this decision, and after lots of research no way was I going for an ECV.

A section isn't ideal but tbh I'd rather rough it out during the recovery than risk complications with the baby.

starkadder · 15/10/2013 20:33

I had an ECV while already in labour (7cm!) and it was fine. But DD was 4 weeks early and the consultant has told me the for early babies, C sections are best avoided if possible - plus I was already there and felt like we might as well give it a go! It did hurt a bit. But then I had a baby and that hurt more...

Original poster

Wibblypiglikesbananas · 15/10/2013 20:42

But then I had a baby and that hurt more - you made me laugh with that!

I think that as we know in advance - and he's been this way for ten weeks - there has to be a reason for him not flipping. This morning's Dr went on about success rates as I'd already had a successful vaginal birth, blah blah, and said that an ECV was more likely to work with a second than a first pregnancy but I'm still not convinced.

Racmun - you summed it up perfectly.

OP posts:

Finola1step · 15/10/2013 20:44

Hi Wibbly. I had an ECV with my dd. My first pregnancy with ds was v straightforward until he went breech at 38 weeks. He then turned himself back a week later and was then born at 42 weeks, no interventions etc. prior to going breech, he was transverse and he was very active.

Then in my 2nd pregnancy, dd went breech at 37 weeks. But she showed no signs of moving back. So after lots of reading up, I decided to have the ECV. It was painful, I had a bit of gas and air. The ECV worked really well and dd was born at 41 weeks in a planned home birth.

However, and this is the biggie... I was treated in a London hospital that has amazing work going on with pregnant women and babies. The consultant was probably one of the most experienced at ECV in the UK. I also had experienced midwives with me. I was in a delivery room opposite the theatre (which was on standby) so if I needed a c section, I would be in there within minutes.

An ECV should not be entered into lightly. I would strongly urge you to ask questions of your medical team about their experience of ECV before making any decisions. If you are not comfortable with it, go with the c section. I did find that the process of the ECV made me feel really quite vulnerable and I would say that the stress involved, if you are not sure, could make the process very difficult indeed. Keep us posted.

Original poster

Wibblypiglikesbananas · 15/10/2013 20:52

Thanks Finola - the process here is an epidural for the ECV and then you're literally steps away from the OR (operating room) if anything bad happened, like the placental abruption. As you've got the epidural already, you'd go straight into the c-section. It would be the same Dr doing both, and I think it's fair to say he's experienced (25yrs+ of these procedures) and the hospital has a great reputation etc. There would be two Drs working on the ECV together.

With both pregnancies, I always thought I'd have done anything to avoid a c-section but it seems that's the best of my options right now. I'd never so much as had stitches until DD was born so operations etc still strike me as big and scary!

OP posts:

Finola1step · 15/10/2013 21:04

I really understand how you feel. I too had never had any hospital treatment before my pregnancies. It does sound like to me that you have perhaps have made up your mind. Seeing the different doctor may have given you pause for thought but, no matter how persuasive he was, go with your gut feeling.

If you are really worried about having the ECV then that additional stress in the process could make it less likely to be successful. Good luck.

CrazySexyCool123 · 15/10/2013 21:06

I was told DS was Breech at 40+10app. I was offered ECV but decided against it and had CS the next day. Weighing up the risks I believe that it was the right thing to do.

TallulahBetty · 16/10/2013 07:18

This is fascinating - why don't they have gas and air in the US?

M0reC0ffee · 16/10/2013 07:26

I had that ecv 11 years ago. eeoooo. to say it was unpleasant would be an understatement but it was not painful. It worked. I had been booked in for a c section and then got a big shock when the baby turned after the ecv. my baby was only transverse not completely breach though. ecv was weird. a weird weird sensation. I had two 'natural' births though so can't really advise.

Parttimelover · 16/10/2013 07:34

I was in exactly your shoes with a straight legged breech baby and I refused ECV and went straight for an elective c section. I watched you tube videos of how they turn the baby, which looked as someone said above, very primitive and bruisingly painful. Then I checked the likelihood of it working for my baby's position/pose of breech - less likely to work than other cross-legged poses. Then I read that they can flip back over to breech after the turning procedure so you can end up needing a CS anyway. No option at my hospital (in uk) to deliver breech baby vaginally. Unless you really feel strongly that you want to try the version in hopes of experiencing vaginal birth this time around I would say go for the booked in CS. The first two weeks afterwards are hard so you will need help with running the house and both children but that stage passes. In my experience CS was right thing to do but I would keep talking to your doctors and reading up until you are happy with your decision. Best of luck whatever you decide.

Booboostoo · 16/10/2013 07:42

The assessment of risk is always a subjective matter as it depends on how each individual evaluates the risks benefits involved. Two people with exactly the same facts may come to different decisions about the desirability of the outcomes simply because they fear and want different things to different extents. There is no problem with that, it's perfectly rational and it might explain why one doctor suggests one option and another doctor suggests another.

However, I would be worried why the second doc suggested the ECV is easy and unproblematic as that is a misrepresentation of facts. He should have given you the success rate of ECVs, talked you through the risks of it not working and then explained why he is still in favour of it (perhaps he has a personally high success rate? perhaps your case has some individual features that will lead to an unproblematic outcome?). From the information you give it does not sound like a very good consultation.

AnotherStitchInTime · 16/10/2013 07:50

I would go straight to CS and I have had two EMCS and maybe looking at another CS for my third due in Jan.

How about trying lots of other techniques to see if he will turn? I posted loads of ideas on this thread. The lady on the thread was 38 weeks and breech and managed to get her baby to turn.

Bosgrove · 16/10/2013 10:20

I went for the ECV was DD2 (my 3rd) was breech all through my pregnancy. Went in for the procedure and she had turned herself. It is counted as a successful procedure on the hospital stats!, but then I am on blood thinning drugs and the thought of major surgery scared me silly.

I stayed in hospital and was induced to make sure she came out before she had a chance to turn over again.

SugarHut · 16/10/2013 10:26

I had an elective C-section. It was the easiest thing in the world, no pain from start to finish apart from the first scratch in my hand of that drip thingy. I would have another tomorrow, and be entirely unphased about it. If you want to, PM me and I'll go into more detail about it all, but for me it's a no brainer, literally the whole process was effortless, the only slight negative was my nerves at not knowing what to expect. Now I know what happens, it's the only way I would ever have another child.

CocktailQueen · 16/10/2013 10:27

In your position I'd probably go for it as you've had a successful vaginal delivery already. It's worth trying. I had one with dd (which was unsuccessful, due to the cord being wrapped round her neck) so had a CS with her. I then had a VBAC with ds. I felt SO much better after the VBAC than the CS, so that would be a major factor for me.

CocktailQueen · 16/10/2013 10:28

I'd also try all the optimal foetal positioning tricks possible -swmiing breaststroke, cleaning kitchen floor - down on hands and knees, move pelvis in a figure of eight - see the spinning babies website for more info.

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