Breech baby - (homebirth plans out the window!) vaginal delivery vs c-section - please share your thoughts/stories

[MadreInglese]

So after planning a lovely drug-free homebirth for DC2 it seems the little monkey has other ideas and has decided to remain head up (just goes to show you really can't plan anything to rigidly re childbirth!)

Looks like my options now are between a vaginal breech delivery (may be possible) and a c-section (probable)

The thought of c-section recovery time fills me with dread but of course if it's the safest for the baby then it's the way to go

Would appreciate your thoughts, thanks

Have you been offered ecv? I had it with dc3 and although it was horribly painful (due to other factors) it worked and I went on to have him naturally a week later. Others report it to be mildly uncomfortable.

This one is also breech. Plenty of time to turn, but mine generally don't - they get comfy!

I'm not sure if I'll go for ecv again as I again have the other factors, so if it stays breech I'll be having a section.

My mum had me breech, naturally, and when I said I might not opt for ecv again, she went a bit pale and said 'you won't try naturally will you?' as she knows my feelings on sections (for the same reason you don't want one!).

I'm sure others will be along singing the praises of natural breech delivery to balance this post, but it's not for me, or my mum, or the three other people I know who've done it and then wished they'd opted for sections! (BTW, all of these people had natural cephalic deliveries previously so knew what to expect with labour and birth.)

What experience do the MWs and consultants have?

Personally, if I knew that the MW had done plenty of breech births and that she was ahppy and confident then I wouldn't hesitate to try for a vaginal delivery BUT since many breech babies are automatically delivered by section I think there are fewer and fewer MWs with the experiece.

A friend had a breech baby, she went for a section in the end. There was just one consultant at her hospital who was happy doing vaginal deliveries and of course no guarantee that he would be working when she went into labour. She decided that a planned section was much better than going into labour and ending up with an EMC if he wasn't working.

Yes had an unsuccessful ECV yesterday, much more painful than I'd expected actually. They have offered to try again another day but apparently because of a high anterior placenta it's not looking hopeful

One of the things concerning me about a vaginal breech delivery is that at our hospital they strongly recommend an epidural and lie-flat-feet-in-stirrups delivery neither of which I wanted and which seems to conflict with research I'm finding recommending active natural birth in a standing squat position

They have said I'll need to have sizing scans and risk assessments before they let me go ahead if that's what we choose but they seem very keen on a c-section, although one dr mentioned this is hospital policy based on statistics and the lack of staff experienced in breech deliveries (also getting conflicting advice as the 1st dr I saw told me that vaginal breech deliveries where against hospital policy )

I'm currently feeling rather robbed of choice and f*ed off that since finishing work at 37 weeks my three weeks of expected relaxing feet-up time and catching up with friends and excitement about the baby is now filled up with hospital appointments for ECVs and scans

I had a section with my first for breech and although the recovery was longer, it was a positive experience. As far as I was told a vaginal breech would have been with stirrups and an epidural so I'm not sure how 'natural' that would have been!

that's the thing 4pudding, from what they're telling me it looks as though my only options will be either a c-section or epidural-stirrups-episiotomy-forcepis insistant that, once risk-assessed, a natural active breech delivery is perfectly possible with the right experienced staff attending

My head's swimming with it a bit and I can't decide which is better/safer for the baby and me

I feel much more emotional about it than I expected and tbh really wanted to give birth and I think I will feel a total failure if I go for a c-section (not at all against anyone else making that decision, it's just how I feel personally for me), but then I don't want that to cloud my judgement over the safety of the options and the health of the baby

I'd be inclined to discuss vaginal birth with head of midwifery rather than consultant and see how you feel then.

I was faced with this choice but luckily ECV worked. If it hadn't, I think I'd have gone with the c-section. It's planned, calm and everyone's happy. I'd have hated to try and labour for a breech delivery then ended up with EMCS if it wasn't working.

Good luck and I hope your baby arrives well.

My DD is now five, and she was breech position. We were offered the option to turn, but there were other factors which was going to make it more difficult (anterior placenta being one) and my b/pressure had shot up around the same time as them being concerned about the positioning, so we declined.
The hospital were keen for me to have a section, which I wasn't massively keen on, but they were a bit reluctant to allow a breech delivery with a first baby. They said if I'd had one natural delivery, they would let me try, but they were uncomfortable letting me try for a natural breech being the first.
I ended up with a section, which went well. They are not the easiest thing to recover from, but at the moment, I don't have anything to compare to (currently over due with second baby, trying for a VBAC).
My friend has had four babies, baby 1 was natural, baby two was c-section for breech position, babies three and four were natural. She prefers the natural and wouldn't opt for another section, but whether part of that was because she had the two babies to look after afterwards (the first was only 13 months old), whereas my recovery only involved looking after one baby, I'm not sure.

sorry don't know what happened to that paragraph, it should say:

"it looks as though my only options will be either a c-section or epidural-stirrups-episiotomy-forcep, even though a midwife friend of mine (not in my town though) is insistant that, once risk-assessed, a natural active breech delivery is perfectly possible with the right experienced staff attending"

There is a world of difference between a vaginal breech delivery (in theatre, in stirrups, with epidural and forceps, etc) and a vaginal breech birth (on all fours, hands off). This article by Mary Cronk goes into much more detail.

DD1 was breech. The hospital told me they'd offer and ECV and, if that didn't work, a section. When I asked about vaginal breech they grudgingly suggested a delivery. By then I was out of energy to fight for a breech birth on the NHS (and had concerns about finding an NHS MW with strong breech skills) so we booked IMs, where we could be very sure of their breech competence, and had a HB. I quite enjoyed it - and it was certainly less painful than head-down DD2, even though DD2 was >3lb lighter than DD1!

How to bring a breech baby into the world is a very personal decision and there's no universal right answer. However, whatever the HCPs may say its your decision. You do not have to have the scans - although it's prudent to know whether you've got a frank/extended breech (which safest), a footling breech (higher risk of cord prolapse) or a stargazing baby (if the head is flexed back the risk that the chin will get stuck behind your pelvis is increased, leading to a very bad situation). Unless they get you sectioned under the Mental Health Act they do not have any authority to "not let" you attempt a vaginal breech birth. Hospital policy indicates what the hospital employees are expected to offer - as you are not an employee you are not bound to follow those policies unless you choose to.

If you want to find out about the breech skills of the hospital MWs, talk to the Head of Midwifery. She should be much better placed to tell you how many breech births her MWs have undertaken and what their outcomes are than an Obstetrician (who is, fundamentally, a surgeon who will rarely see normal birth).

I've got to run as have to take DD out, but will happily answer any questions later. Or do a search on my previous posts - breech is something I tend to expound upon

I 4h baby was breech until close to term, and I remember doing the research you're doing now. There are some other reasons why having a c section would be especially bad for me (severe drug allergies) so I researched a lot of the Mary Cronk stuff. He turned at the last minute.

You know, the hospital cannot put you into stirrups and put in an epidural against your wishes. That would be assault. I second the idea of talking to the head of midwifery at the hospital. Also to your community midwife - mine was saying that she'd delivered quite a few unexpected breeches in the community, and could come to hospital for the birth.

had a perfectly normal delivery with DD with no intervention and my bp is always low so no risk factors there

DD is 13 now so bless her between her and DP I will have plenty of help for a c-section recovery (no idea how people manage it with toddlers!), and of course a planned one is preferable to an emergency one

Oh gawd I don't know

After months of vomiting most of the day (still) and feeling crap and knackered my brain is fuzzled, I don't want to agree to something that I'll regret later, but then I guess just getting the baby here safely is the most important thing really

Speaking to head of mw is a good idea, thanks

You could always ask your hospital about being supportive for a natural delivery. My hospitals sticking point was the fact that my body had not experienced labour, so potentially would find a breech delivery more difficult than somebody who had already had a delivery iyswim.

I had DD on the Thursday, was out of hospital on the Sunday. The worst pains I had getting over the section was back ache, standing up straight was painful for a while.

Elf (and others who have has CSs) - how did you find the normal things like lifting/changing/feeding your baby, getting up and down stairs, etc? Were you able to do them or did you need lots of help?

DH had paternity leave for two weeks, and then I was on my own. Carrying and feeding DD was fine, no problems. getting around was fine too, though did get back ache if walking too far, but I think that it could be because of the natural reaction to try to slump over iyswim.
I found it difficult getting out of the bath to begin with, but I guess if you have a shower that's easier.
I didn't drive straight away, problably just after my six week check.

Thanks Elf, that's reassuring

I guess I have this daft idea that with a CS I'll just be a useless vegetable for weeks

The consultant midwife at my local hospital is experienced in breech birth and has said he will do them at home in certain circumstances. Do you know what type of breech your baby is (frank?- bum down, footling-feet down). I would try to find out if any of the senior midwives are experienced in breech birth, or would you consider an independant midwife at home?

DD2 was delivered by section (did all sorts of acrobatics in the last 6 weeks and turned from head down to breech at 41 weeks so still time to turn). All breech deliveries are done by c-section where I live (Asia), plus she was measuring big on scans.

Discharged from hospital after 3 days, managed to get up 2 storeys to bed (lived in town house) and back down again the next day. Took care and rested during baby's naps (DD1 just at primary school) and was driving after 11 days with knowledge of obstetrician and insurance company. Can't remember having problems feeding / lifting baby / climbing stairs but sure I took my time (plus oodles of calendula and arnica tablets!!!)

Had a relatively difficult induction with DD1 including a 5 day hospital stay for retained placenta and swore after DD2 that sections were definitely the way to go!

I don't think I feel confident enough to try a breech birth at home

it's bum-first at the moment with head tucked in which is apparently better than feet-first and 'stargazing'

DD was one leg up by her body, the other foot down. Always been an awkward one

yes I'm hoping this doesn't set the trend for this baby being an awkward one!

That's v interesting - ds was feet first and this one is too judging from the well aimed kicks. So if ecv is not an option /fails then I wouldn't be a wimp for choosing a section anyway? I shall feed that back to DH if I'm right. Never having experienced labour etc he's full of guff about it!

just wanted to add 14 months ago i felt exactly like you i was expecting dc8 who was breech but couldn't have an ecv because despite having 6 easy vbac in between dc1 had been a cs 17 years earlier .

i hadn't even considered a c section as a possibility , not helped by the juniot dr who said ok baby breech c section booked for this date now goodbye . i'm also a control freak and had questions to ask and do not like being told you will do this because we say so etc.

cue 2 weeks of no sleep , major stress anxiety , many discussions with dr's and scouring mumsnet .

the hospital were very anti a vb and the last breech had been more than 5 years ago.

i was 42 nearly 43 and had a late mc 4 years before so knew the devastation of loosing a child .this in the end was what made me decide to accept an elcs .

it was a very very difficult decision as it was so grey no one could say your baby will definitely be damaged if you have a vb and no one could say she wouldn't be .in the end the decision for me was between running the risk of having an uncessary section or having a vb which could have resulted in the unnecessary death or disablement of my dd and in the long term which of thes 2 options would be easier to live with.

the elcs was not as bad as i feared , the staff were lovely etc.i was home after 2 days , could probably have left after 1 , walking climbing stairs easily by day 2 if not day 1 . driving at 2 weeks etc. only thing that was difficult was lifting heavy objects .

the emotional recovery has been more difficult still wonder "did i fail" "not give birth properly" etc deep down i know this is not the case. i also often find myself wondering if i'd had a vb would everything have been ok etc should i have given it a go but i put dd's safety above my own needs . everytime i hold dd or hear of a stillbirth, i do know i made the right decision for me and her.

good luck whatever you decide and enjoy you lo

I was also born breech (my mum was booked in for a section, but then I decided to come the day before, and very fast, almost had me in the back of an ambulance!). DH does wonder whether my and DD's lack of direction stems from not knowing what way was up in the womb

In terms of the feelings of having a section, I agree, it is something that can make you defensive, but I am "over" it now, I know I chose the safest delivery for DD, and TBH the idea of having a planned section with DH able to attend always sat better with me than the idea of pushing for a trial delivery, and ending up with an emergency section.

Bum first is much safer to birth than feet first (although that can be done too, although there is a higher risk of cord prolapse).
Some links that might be helpful-
www.breechbirth.org.uk/
www.aims.org.uk/Journal/Vol10No3/breechCSvsNormal.htm
www.rcmnormalbirth.org.uk/stories/do-as-you-would-be-done-by/normal-breech-birth/
nctpregnancyandbabycare.com/info-centre/information/view-41

so sorry for your loss cyril

your post makes a lot of sense, it is about weighing up the risks and ultimately what decision/outcome would be easiest to live with