is there really no option other than CS?

[MacMomo]

Just one last check to make sure I really have to have an ELCS.

At 37+4, (first) baby still breech and I have very low amniotic fluid (oligohydramnios) - measured about 4.1cm on Tuesday and 4.8cm last week.

Doctor basically told me I was having a CS next week (at 38+6) because they will not induce a breech to allow vaginal. I can try a vaginal if she decides to come early of her own accord, of course. But obviously that isn't entirely likely and we can't wait longer for her to come as the lack of fluid is not good and might be causing problems.

Baby is extended breech with feet and hands in front of face, slightly transverse as well and I'm not sure which way she's facing.

Really wanted to try to have a vaginal, so I'm very disappointed. Also a bit worried that the senior/experienced surgeons will all be on holiday and I'm going to get the junior one - CS booked for New Year's Eve! Just want to make sure I don't look back and realise I could have done something differently that would be better for the baby. Thanks for any advice.

Hopefully you'll get some advice here soon from someone who has had a similar situation, or breech birth.

Just wanted to say with such an unstable lie, you could end up putting yourself through an exhausting and unsuccessful labour, ending in an emergency CS anyway. Emergencies leave you more prone to infection, not to mention starting life with your baby far more exhausted!

I laboured with my first baby, even though he was in an oblique posterior position. I couldn't push him out and after saying I didn't want a CS, I ended up with a lot of intervention from hands/ventouse/forceps resulting in a nasty tear.

I wish I'd just had the CS as when it came to my second pregnancy with my daughter, she was smaller than her brother, in a perfect position, yet had to be an elec CS because of the damage to my perineum and subsequent ops to repair it from the first birth.

I could have cried at how unnecessary it felt from her point of view, but had no choice.
He should have been the CS and she the VBAC, but being so determined for the vaginal birth the first time ruined it for the second time IYSWIM.

Don't know if any of that will help but if you plan on more it might help give you some perspective.

Good luck with everything.

Don't worry that all the experienced surgeons will be away, it really doesn't work like that!
If you have a planned cs, it will all be done on a normal working day for whoever carries out the op.

Personally, I would go along with the elcs. With the way your baby is lying, there would be a high chance of having an emcs, and having had both, an elcs is non-scary and calm in comparison!

I can't advise medically as I now nothing but my fist baby was born by emergency section. I had polyhydromnious. We very nearly lost him and tbh the fact he is here and safe now is what matters. I have had 2 more babies since which I had "normally" but that section means no more babies for me so I have mixed feelings about my section but would always say having a section then and saving baby one was worth it even if it meant that I couldn't have baby 4. HTH (but well aware that it probably doesn't).

I guess what I am trying to say is it generally doesn't really matter how baby gets out as long as they do.

My DS was the same as yours and I was offered a CS or to see what happened if I went natural. They did say that it could end up having to be an emergency CS and it would be riskier.

Despite really wanting to go naturally I decided the best thing for the baby and me was to have the CS and I have not regretted it.

They also said it was riskier to have an vaginal birth than to have a CS.

IARFN - quick uestion: why no more babies? (not sure I understand)

No more babies because my scar nearly ruptured when having dc3 and it was only because I was able to push him out as quick as I did that I didn't end up with a section under GA. It was touch and go for both of us.

I am spouting this off top of my head, but might spark more valuable contributions.

Don't they try to turn babies any more? Can't remember what it's called, but is that procedure not an option?

Iirc, the best thing with trial vaginal breech delivery is to attempt it as part of spontaneious labour with NO interventions, and then go to EMCS if there's failure to progress. I think that's what Michael Odent recommends (guru of the Homebirthing movement). So your consultant's reluctance to induce would be consistent with Odent's perspective on how to keep it safest.

ELCS can be a nightmare, too; friend who had 3 EMCS and one ELCS said the ELCS was horrendous in comparison. There's no guarantees, no easy way to have a baby.

Don't feel too bad, be glad that modern medical care at least gives you choices.

My baby was turned. I have posted before about what happened but I don't think it is a common situation.

thank you all for your posts. ragged the turning is called ECV, and they wouldn't try it on me because of the lack of amniotic fluid, which was a real blow as it was my only hope. And yes, you're right, the Odent way (which is what I was hoping for) is to wait and see what happens after birth starts naturally then go to EMCS very early if the progress isn't good. However, because of lack of fluid, they will only wait one more week before the CS - so if she comes before then, we get to try it.

I think you've all put my mind at rest that I have explored the options and the ELCS is the right thing for us. Unless she comes of her own accord in the next 7 days...pineapple on order for 30 January!

By the way, something I thought was interesting was that the more junior doctor admitted that the clinical advice to always have a CS for a breech has meant that many MWs and doctors are now so inexperienced with birthing breeches 'normally' that they are afraid to try, hence they always try to persuade a CS. A bit of a catch 22 for the medical staff really: because they rarely do them, they never want to do them. It was nice for him to be so honest. A different (male) obsetrician commented that "all the female obstricians always have ELCS even for non-breeches because they see all the bad vaginal births" (he was trying to reassure me that the ELCS is the best way to have any baby, I think).

Thank you all for your help this afternoon, very much appreciated by us and I think I can now accept it and be positive about it.

I had an elcs with my (first) DD, and it was actually a really calm and positive experience. I don't feel like I've missed out at all.

Just wanted to reassure you that an elcs can be great

Oh, and one more observation just in case anyone is interested: when I discussed birthing options 8 weeks ago (when everything was or appeared normal), the consultant banged on about how bad a CS was, how difficult for me, how many things can go wrong - aparently 3 total hysterectomies due to surgical mistakes at my hospital in the last 5 years ).

Then when they want to persuade you to have a CS, and suddenly it's a "minor, easy procedure, nothing to worry about"! I did tell them that and they looked a bit sheepish.

I have heard that 15 minutes on your hands and knees 4 times a day can encourage baby to turn.

That's very true MacMomo.

Look, there are risks with every birth, every operation, and every hospital has a CS rate to keep down.

As others have said (thereabouts), the healthy baby you want must come before the birth you want.
I think you will find ELCS a lovely experience.

Also interesting to hear about the lack of amniotic fluid. The midwives all seemed positive my baby could turn from his odd position in labour, from living with that tummy day in, day out, I knew it was all baby and not much fluid which would make turning tricky.

I think you've made the right choice IMHO. I await your birth announcement!

ECV would have a chance of working if your baby's legs were bent rather than straight.

If you really want a vaginal birth, an independent midwife would be your only possibility. If you had the money.

FWIW dc1 was frank breech like yours, elective c/s. Dc2 was ventouse. Dc3 born at home nearly in water (no time!).

And Dc1 had her foot in her chin so looked squashed, but only for a short while (days). And used to sleep with her legs straight up from the cot!!! But that didn't last long either!

My first was a footling breech, one foot down one in front of face. He was elective cs, and the medical evidence do who that is best. If the legs are folded neatly in front the odds are much better for a vb, but they still might not want to induce.
I went on to have the next two "normally", the last one very fast so was nearly a homebirth.

Actually having a first by elective is the most convenient as you don't have toddlers who want to be picked up etc.

BTW before the cs they did an ultra sound to double check the baby hadn't spontaneously turned.

yeah, down on your elbows with bump/bottom on a bed, is supposed toget them to turn, too. There's loads of advice about positioning online yourself to encourage baby turning.

I spent a few weeks doing the whole head down, legs up thing to no avail (using sofa, steps, bed head)! A MNer directed me to spinningbaby.com which had good advice, and there are acupunture procedures, too, but the practioner I spoke to said not to try with low fluid. Sometimes when she's really thrashing around I do think she's trying to turn and I just hope she's not stressing herself out because she can't.

I think I'm ok with the CS idea now, it just took a while to adjust my mind to. I'm feeling rather grateful that it was seen early enough for me to have time to get used to it, rather than have to deal with it during labour and make a decision. Seems I'll be having a December baby, not a January one! I am genuinely grateful for people's comments and advice, don't know what I would have done without MNers .

Hi MacMomo,
i had a breech vaginal birth with my 2nd baby, he was foot and bum first.
The birth itself was ok, apart from the fact that he was undiagnosed breech and they didnt know until they his bollock!
Although the birth itself was fine, and a really positive experience for me, aferwards was a different story and he ended up in the NICU for 2 weeks, but not sure if this was related to the undiagnosed breech birth or not.
At the end of the day, the doctors would not have said to have a CS for no reason.

Glad to hear that you are ok with the idea now. Think of the positives- you can prepare better!!