To not want a breech vaginal birth?

[jonsnowssocks]

I live in France, so dealing with the French system rather than the NHS.

I'm 36 weeks pregnant and at my last scan baby was breech. Routine appt with anaesthetist was today, and I've been told that if the baby stays breech I won't have the option of a planned c-section. They will try to deliver the baby vaginally and if there is a problem have an emergency c-section.

I really don't want a c-section - have been hoping all along for a natural birth with the least intervention possible - but given the situation and research on breech births I would much rather have a planned section then an emergency one, or even a vaginal breech.

I never thought I'd be the kind of person who'd go against what the doctor said was best, but this has really scared me. The anesthetist said the only thing I could do would be to discuss with the doctor while I'm in labour and they might agree to an emergency c-section but equally might push on with a vaginal breech even if it's expressly against my wishes.

AIBU to want a planned c-section if the baby is still breech?

Another one with vaginal breech here. Mother and baby fine but I could have sold tickets given the amount of viewers.

Try to find somewhere that does acupuncture and moxibustion. It has a good success rate and has no risk (unlike an ECV).

That's useful evidence: it's your choice to make, not that doctor's.

Your baby sounds like my DD who was all over the place during pregnancy, always kicking and thumping around, until she got big (overdue) and wedged her head under my ribs! She never stopped moving or wriggling before or after the birth. Now 9 years old and remains a physically active fidget!

I had undiagnosed breech. There wasn't time to have c-section or even epidural so ended up having to do on gas N air. He's my only child so can't say if was more painful or not! We had bloomin loads of staff in the room as natural breech is so uncommon in the UK but frankly couldn't have cared less by that point.
There is a greater risk to child and mother and planned c-section is hell of a lot better than emergeny so I would certainly be asking again if you can demand one even though I had a "positive" experience . Hopefully it will be moot point and will turn by then.
I did have to have an episiotomy which was the one thing I didn't want but that can happen in any birth. Also had loads of visiting medical staff afterwards including a wonderful retired midwife who told me how she had delivered loads of breech babies including demonstrating the particular wrist action needed 😀 she did agree though that it was much better these days with the c-section option.

Also just to note following on from your concern breech could indicate something else wrong - mine was breech as I have a heart shaped womb so he was stuck in a smaller area without room to turn, nothing to do with him.

If I chose to have any more I would be automatically considered for c-section early on as almost 100% chance would be in same position. Caused some issues with the placenta so was fun and games for me after birth but baby was fine 😊

Ds1 was undiagnosed breech. I stuck at 5cm. New midwife came on duty and realised he was breech - previous internals hadn't twigged.

One emergency csection later, I had a healthy boy! It was fine, by the way, so try not to worry.

DD was a complete breech and no one realised despite clear indicators that she was head up rather than head down. I was in early labour when they twigged and had an in depth scan done by the head midwife to see if turning her was a possibility. It wasn't. She had barely any amniotic fluid, only a 3cm pool in front of her face, and had the cord wrapped around her legs in a figure 8 with the remainder of it wedged between her bum and my cervix. If I'd dilated any further it would have probably prolapsed and if it didn't prolapse it would almost certainly have gotten compressed or even snapped as her legs and bottom descended. I went directly from the scan room to theatre for an EMCS.

Because I didn't know I didn't have chance to do any research of my own so don't know stats or anything but the hospital told me that vaginal breech deliveries carry a higher risk of placental abruption, cord prolapse, newborn breathing difficulties and an EMCS under GA. The surgeon also told me that research indicated babies who are born breech have a higher instance of developmental delay compared to those who are born head first or who are born via section. Again, don't know stats or anything, just what I was told.

I found out my DD was breech at 41 weeks. I really wanted to avoid a c-section so opted to try the ECV, despite being given a less than 25% chance it would work. It took less than 5 mins and they'd turned my 8.45lb baby first attempt (they didn't use the drugs to relax my muscles).

I know you said that you'd ruled it out because of the risks, but they are actually very low (based on the scientific studies I read). I just wanted to tell you in case you'd consider looking into again. It gave me the opportunity to have an unassisted vaginal birth and I'm incredibly grateful to the fabulous midwife who carried out the procedure.

It's difficult to find good research on vaginal breech but there some out there. The main problem is that lots of the evidence is based on the Term Breech Trial which was ended prematurely due to higher rate of neonatal morbidity in the breech arm but it was a completely flawed trial and so nothing can be based on their results other than those that show no difference age 2yrs in babies delivered vaginal breech and CS. There's a lot more recent research but smaller studies that show that vaginal breech is much safer than previously thought and for combined maternal/neonatal outcome as safe as section as long as breech babies are in a certain position, labour isn't augmented and labour proceeds at a good rate. The safest of all the options for combined outcome is successful ECV and vaginal cephalic birth (although there are risks of ECV they are lower than all other options) but even with that you're more likely to have a section than in any other cephalic delivery.

Also there are a lot of HCPs in the UK that are experienced in vaginal breech births, we still do quite a lot especially in twins, and it's part of everyone's training. Asking your local unit for their stats and your midwives/obstetricians for their personal experience is probably better than believing that there's nobody in this country that can do them because we section everyone.

The RCOG have a guideline on breech delivery that's got some useful information on it and might be worth a read and as previous posters have said a lot of people have success with acupuncture, reflexology and moxibustion.

My first baby was a breech, DD was born bum first, then her legs, all fine. One thing I experienced is there is wasn't the burning sensation of pushing out a baby head first.

There were also a lot of viewers.

The Term Breech trial is pretty good evidence when you dig below the headlines.

Midwife outcomes for breech deliveries are good; obstetric ones not so good.

No intervention breech is the way to go (hands off the breech). If intervention free is not possible (ie no epidural, syntocinon, stirrups, etc), then straight to c-section.

A frank breech (basically baby folded in half) is not more complicated than cephalic. Other breech presentations will result in a stall in labour, and should not be accelerated or manipulated - they should be delivered by c-section.

Dozer yes it does seem they should offer me a choice rather than force me down a particular route. DH has also unearthed a study that includes the hospital I'm due to give birth in, so I'll have a good read and take it along to the midwife when I see her next week. Poor woman, can't be anything more frustrating than a total amateur who's 'done some research'

mini I have a mental block when it comes to ECV. I've heard a couple of bad stories, and honestly don't even like the midwife pressing hardish during appointments! I'm so glad it worked for you (and lots of others) but I think I'll try moxibustion etc instead. I'm so irrational.

betty lots of useful info; thanks for posting it. I'd heard the same about the limitations of the Term Breech Trial study, and it seems the French essentially read it, largely discounted it and decided to press on with natural births, hence the situation I find myself in now. French research is fairly limited though (I've only been able to find one dedicated study) but says that, if a range of criteria are met, vaginal birth for breech is as safe as doing a c section, and in fact safer in some cases.

There is no way on earth I would want to delivery vaginally a breech baby. I sit and listen to the poor mum who was trying to do just that while I was giving birth to DS (solid brick walls and two closed doors between us too). Eventually the ambulance arrived to take her for a c section (didn't leave me enamoured of midwife led units either tbh)

I honestly think you need to discount the UK in your thinking here. We've made our own situation - we send our breeches to C-Section making our midwives and obstetricians deskilled in natural delivery of breech births, then say 'it's safer to have a C-Section'.

(It's similar to our ICU situation: so many patients 'have to come to ICU' now because 'the wards can't look after them' because they started sending them to ICU so the ward staff didn't get the chance to look after them. They're no sicker than they ever were. We've just deskilled our staff.)

Vaginal births are better for babies, on the whole. The birthing process squeezes the amniotic fluid out of the lungs and prepares the baby to breathe. At the end of the day, I do think that you should get the final say - it's your baby, but if the advice is for a vaginal birth I think you should carefully consider it.

Thanks lougle; I do need to discount the UK, esp as I know that French health care is excellent, but it's proving hard to disengage!!

toffee how on earth is that comment supposed to help me? It's not like I've chosen to have a breech baby, or this is happening through negligence or bad choices. Nor can I decide that actually, on balance, I just won't give birth at all, given how incredibly painful you have described it to be. I'm trying to make the best decision I can based on a lot of conflicting evidence, and you see fit to throw in that little story? I hope you enjoyed telling it because it was a really fucking selfish and inconsiderate thing to do.

jonsnowssocks believe me, screaming is a part of many a woman's labour and I don't think it necessarily correlates to the amount of pain, either. Some women scream for England and other women go very quiet....whatever gets you through.

lougle I plan on being calm and dignified throughout

Went for a rescan yesterday and brilliant baby has turned around and is now head down! Fingers crossed that she stays like that until the birth, and thanks so much to everyone who took the time to offer their knowledge and advice... really helped me to calm down when I was feeling very panicky and under pressure!

Pardon me I thought it was a site where people posted insights and opinions based on personal experience.

I'm sure you will get a avalanche of people who will reassure you it will be fine. But if you don't want the converse opinion it's wise to add something like "reassurance please" and not bite a posters head off for saying there is no way they would want to do it.

I also thought from your comments you intended to challenge the decision. Based on my experience of the poor mum next door to me I certainly would. I'm sorry if you find giving that opinion selfish.

I'm shocked that planned c-section is not an option for you.

My daughter didn't turn until very late, 38 weeks. The options presented to me were manual turning and/or planned c-section. Delivering vaginally wasn't on the cards.

I flatly refused manual turning and would have caused a real fuss if they'd tried to force me in to a vaginal birth, had the baby remained breech.

I was about to post how I'd never touch a vaginal breech or ECV and read your brilliant update. So pleased for you OP, good luck

Bonne nouvelle, OP!

Missed that update. Congrats

Great news that the baby has turned OP and hope she stays that way.

Thanks chaps

toffee sorry about that. I really was seeking a balanced view but as you didn't know the woman or speak to her about her experience, the post came across as gossipy and sensationalist rather than balanced and informed.

My knee jerk reaction was definitely to challenge the decision but I'm not sure it was the right one, going on what I have learnt these last few days.