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Childbirth

Share experiences and get support around labour, birth and recovery.

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

49 replies

MadreInglese · 17/05/2011 09:45

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

OP posts:
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MadreInglese · 17/05/2011 11:43

lol Elf - DP has a remarkably crap sense of direction so we have joked this baby must have inherited it from him!

thanks for the links Selina, I've already seen the aims.org one but will take a look at the others

OP posts:
MadreInglese · 17/05/2011 12:36

bumping for the lunchtime crowd....

(must add I'm also trying various upside-down positions, all fours positions and moxibustion in an attempt to get this baby to turn!)

OP posts:
iloveholidays · 17/05/2011 13:54

Hi MadreInglese

Just wanted to add my story... I had an EMCS 8 weeks ago for breech. It was only an emergency because I had started labouring, so was still very relaxed.

I have to say I was absolutely petrified at the thought of a CS, I tried everything to get DD2 to turn, but no luck. I had been in tears loads - thought I'd faint or be sick during the op etc etc. But... it was surprisingly a really lovely experience (and you'll get a lot of other mumsnetters saying the say, although if you're like me you might not believe them!! :))

I suppose in a way I was lucky I didn't have any waiting around to do (waters broke at midnight, DD2 was born at 2:22am!!). We were laughing and joking all through the op - the staff were fantastic at putting me at ease and of course the adrenalin kicked in. I was just so excited about meeting my baby. Also - I have to say there was a very (although very slight) grateful feeling I didn't have to go through all the contractions again, even though I had a very text book labour/birth with my first.

Recovery was loads better than I imagined... first 24 hours were tough, but I was up and walking after 12 hours although it was very painful getting on/off the bed. But... I didn't care, I had my beautiful little girl next to me and I didn't care I was in pain. After 24 hours it just got easier and easier. I had a 2 year old at home, but all was fine. I felt okay but have played it very safe re lifting. It was actually quite nice being spoilt and looked after - all I had to do was look after my new baby (I didn't have this with my first - was up cleaning etc a few days after!!).

It was a really positive experience for me...

I hope everything goes well whatever you decide.

iloveholidays · 17/05/2011 13:56

Feel free to ask any questions... (if you're like me you'll have loads!! :))

latermater · 17/05/2011 14:11

I wanted to try for a natural delivery with breech DS but was put off by NHS advice (I was 41 so they were probably even more cautious than usual) but even more so by the fact that hardly any midwives at the large hospital at which I was giving birth had ever witnessed a natural breech delivery, never mind felt confident about supervising one. So the combination of those things made me opt for a CS, which I must say was a surprisingly joyful experience. I was home 2 days later with DS and 15 month old DD and recovery was really good - much less pain than the aftermath of my natural delivery (when I had not realised that you needed to ask for pain relief to get any!) Good luck with your decision and don't assume CS recovery will be slower - it wasn't for me.

mercibucket · 17/05/2011 14:19

I don't have any direct experience but I can tell you that if you are in a UK hospital it is absolutely not a question of having to choose between c section or epidural/forceps

all of those are medical procedures which cannot be forced upon you - you must consent to them. as the alternative is a 'hands off the breech' delivery, by not consenting to lie on your back/have epidural/forceps you are in fact choosing a 'hands off, natural birth'. as I understand it, in essence this means the midwife is not supposed to do anything at all. to a lay person that sounds quite easy to achieve!

you are also perfectly within your rights to still have a home birth should you so wish

sounds like the hospital could do with improving their communication skills for a start

DialMforMummy · 17/05/2011 14:28

My story is similar to iloveholidays in that my recovery was ever so quick after a (bit) painful 12 hours.
Mine was an ECS as we did not know babbins was breeched. Anyway, as he was in distress I was left with no choice really. I was so surprised by how pleasant the whole experience was.
I never had the feeling that I did not really give birth, ever.
I would like to give birth the regular route for my next one but quite frankly, I don't really care as long as my baby is healthy.

Elsjas · 17/05/2011 15:14

I had my first baby turned (ecv) as she was breech. I know that some people find it painful but I found it to be very uncomfortable rather than painful. The baby stayed head down and I went on to have a straightforward vaginal delivery. Might be worth investigating if you are still keen on the home birth option. I didn't go for a home birth but am glad that I didn't have to have a cs as I was irrationally freaked out by the thought of it.

Good luck with whatever you decide.

theborrower · 17/05/2011 19:17

OP I had an EMCS last year as I had an undiagnosed breech (only found to be that way when I arrived at hospital in labour). I was told I was having a CS and wasn't given an option - I queried this as I myself was a breech baby and my mother had a vaginal birth, so I knew it was possible, but that was that. I wasn't too happy but the consultant's decision could have been based on DD's position/lack of staff experience etc - I'm not sure. I think you need to take the consultant's advice - it could be based on his evaluation of staff experience and resources, because as someone else said, less breech babies are being born vaginally which means less experience out there etc. The safest way is the best way to be born, in my opinion. Physically, I recovered fairly well although it has taken me more time emotionally, although I think this was more the EM bit rather than the CS. I'd much rather have an ELCS rather than a EMCS, which may be how things end up. I'm not trying to be pessimistic, just saying that sometimes we have to put aside our hopes about how we'd like things to go and go with the flow. It is sometimes possible to have a 'natural ELCS' (seeing the baby be born, skin to skin) - there was a thread on here recently about it.

Tangle I'm not sure how helpful your choice of language is regarding delivery/birth. The baby is born - I don't think using language that suggests someone is not involved in the process is helpful - it messes with your head, as it did mine.

scaryfairy28 · 17/05/2011 21:03

Haven't read all the other posts but just wanted to say I had an ELCS last Thursday for breech baby I felt great post surgery and don't feel to disappointed despite being set on a water birth. I ended up with a totally perfect birth experience. Recovery wise I feel fine tired due to mega night feeds but figure I'd feel worse if I was doing them after a long natural delivery! I tried moxobustion prior to ECV neither worked but the moxobustion made her move ALOT so think if there'd been any chance of her turning that would have done it! But honestly recovery wise if your reasonably fit I dont think it's too bad or maybe I've been very lucky!!

Tangle · 17/05/2011 21:12

theborrower - I'm not sure I understand you. To me, there was a vast difference between a hands-off breech birth (which is what I was happy to try) and a medicalised breech delivery (which I would have had a CS to avoid). There are different ways to "manage" a vaginal breech - the birth I had involved me and DD, with two breech experienced MWs keeping a watching brief whilst sitting on their hands. It was a very different experience to the version of vaginal breech that the NHS registrar offered me - where they would, fundamentally, have delivered my baby from me (in theatre with a large supporting cast). When I was trying to decide how the best way for my breech baby to come into the world I was very keen to know what the options were, and I wanted to be very clear what version of vaginal breech was on offer before I did decide.

IMO taking the consultants advice needs to be done from a position of information. Consultants are, by definition, surgeons who get called in to solve problems when things go wrong. I'm very glad they're there and have strong surgical skills so that the problems can be solved in many cases. But depending on the individual, that doesn't necessarily mean they will give impartial advice when one "solution" (breech being seen as a "problem") is surgical and well within their comfort zone, whilst the alternative is something they may well have little if any experience of.

I completely agree that the safety of a vaginal breech lies in the experience of the attendents. And that MWs skilled in breech birth are getting harder to find. But that doesn't mean they don't exist - many Independent Midwives have these skills and, as the experience on this thread has shown, they are not extinct within the NHS. Consultants are not the experts on the skill sets of the MWs within the unit they work in - that's the role of the Head of Midwifery. If a unit has a HoM that is supportive of vaginal breech, then there may be a number of MWs who have the confidence and experience to see breech as an "unusual variation of normal". And the HoM will be aware of this.

Trying to define the "safest" way is not trivial. Birth - CS or vaginal, breech or cephalic - comes with risks attached, risks that may not be directly comparable. Those risks will be different for every woman - depending on the exact position of her baby, the skill sets of the HCP's available to her, her personal medical history and any plans for the future expansion of her family. They will also be perceived differently depending on that woman's life experience and personality. To me, there is no universal "right" or "best" way to get a breech baby born (or any baby born). There's just the way that's most right (or least wrong) for any particular woman at a given point in her life.

One thing I'm glad about is that we knew DD was breech from 28 weeks so we had a lot of time to get our heads around it, to do as much research as we could, to talk to as many experts as we could find and to make our decision. Being told, whilst in labour, that your baby is breech and "we have to give a CS or the baby will die" (as happened to one lady I know of) makes it very hard to do anything other than take the consultants advice, especially if you haven't had a chance to research the midwifery skills within the hospital before hand. But MadreInglese has the opportunity to do that research, if she wishes to, and can make her decision accordingly.

If, as an individual, you wish to put your trust in the consultants and not question their advice, that is your choice. I'm not trying to tell you you're wrong or right to do that. Equally, if you choose to question the consultants and get a 2nd opinion from another consultant or an experienced MW then that is your choice. I'm not trying to tell you you're wrong or right to do that either. All I'm trying to do is make women facing a very difficult decision aware that they do have a choice, if they want to exercise it.

buttonmoon78 · 17/05/2011 21:23

Well, I've now done some more research (thank you Selina for the links) and am even more convinced that if this one stays as it is, and if I can't face going through with ecv, then I'll be requesting a section.

A 6% rate of cord prolapse is quite high TBH, and I'm in no way risk averse.

It seems a shame to have a section after 3 successful vaginal deliveries, but the thought of ecv again simply brings me out in a cold sweat and I would rather go with the 'safest' option. Safest for baby that is.

I know I'm probably jumping the gun, but I've been here before. The scenery is mighty familiar Grin

MadreInglese · 18/05/2011 20:06

Thankyou all for sharing your thoughts and stories, it really helps to get some different perspectives on the matter

We're going for a second ECV attempt on Friday so there's not much we can decide just yet until we know the outcome of that so fingers crossed for now

OP posts:
theborrower · 18/05/2011 21:13

tangle re delivery vs birth and choice of language

What I meant was, defining different types of birth as either 'delivery' or 'birth', in my opinion, contributes to the feelings of failure and inadequacy that some women feel when having a c-section, or, indeed, a birth that wasn't the intervention-free event that they hoped for, because they feel that they have not 'given birth'. Using the term 'delivery' suggests the mother is not playing a part in the birth of her child. I have read plenty of stories on mumsnet of women feeling that they have not 'given birth' after having a CS (or assisted with forceps etc) and the distress that this can cause. This is what I meant when I said 'the baby is born', and that I thought your choice of language was unhelpful.

DialMforMummy · 19/05/2011 08:31

theborrower excellent point.

buttonmoon78 · 19/05/2011 10:12

I agree. I always refer to a mother as having given birth, regardless of how the baby actually came out. It wouldn't occur to me to do anything else, even in my own mind. Otherwise it somehow (in my mind) negates the previous 9 months.

And if I do end up having a section with this one I shall be saying that I gave birth. Not that 'the baby was delivered' (with me having nothing to do with it).

Tis semantics really, but some people (esp those who have had a difficult time) can be enormously hurt by such applications of semantics.

Tangle · 19/05/2011 21:50

theborrower - many thanks for clarifying. I genuinely did not intend to cause hurt or distress and I apologise if I have done so to anyone.

Please can you then help me in finding a way to describe these different methods of vaginal breech that is less hurtful? Once the baby has arrived then it, has most definitely, been born - but as a woman who has been in the position of being known to be carrying breech and facing the decision of whether or not to have an elective CS, understanding what different HCP's were talking about by their definition of "vaginal breech" became both challenging and very important to me. I have no wish to cause additional upset, but equally I have no wish to add additional confusion to what is already a very difficult and emotive decision. My recollection from when I was trying to make that decision for myself was that the terms "vaginal breech birth" and "vaginal breech delivery" were both reasonably common in the literature around breech babies - sometimes used interchangeably but sometimes used very distinctly, as in the article by Mary Cronk I linked to earlier. I found understanding that distinction key to reaching a conclusion on what my order of preference would be for bringing my breech baby into the world - and I'm not sure how to share that distinction without using some form of semantic differentiation Confused.

Checkmate · 20/05/2011 09:35

Tangle - I knew exactly what you meant, but have researched breech births myself and have come across those 2 terms used to describe those 2 different methods, as you've explained.

The only other terms I've heard to describe the 2 techniques are a hands-off-the-breech-birth and a consultant-managed-birth. A bit wordy!

Stangirl · 20/05/2011 13:52

OP I really hope that you have the birth that you want but I just want to reassure you about recovery from ELCS. Mine was very straight-forward, painless and I was pushing a pram by the end of the week. This time round I will be having one and taking care of a 17month old - I have no qualms about it.

MadreInglese · 20/05/2011 17:32

Well we tried again with an ECV today and the little tinker did not want to budge, in fact it hadn't moved one jot since the previous attempt, despite all other things I've tried. This second ECV felt more brutal but they did give me gas & air (after I'd made a half-joke about what a shame you can't have gas & air for this, ha ha) which really helped me, so anyone worried about getting through an ECV ask for G&A as it wasn't offered until I mentioned it.

They also discovered that it's wedged in feet-first, so a vaginal delivery is out of the question now as I think I would have only attempted had it been bottom-first, so it'll definitely be a c-section. Typically the person who co-ordinates planned sections was off today so it'll probably be some time next week but we won't know until Monday. It is the complete opposite of what I wanted but I guess at least we haven't had the tricky decision to make, we've been given no other option and once the baby is here I'm sure that how it got here will not be important in the long run.

Thankyou all for your advice, and I hope you other ladies with breech babies manage to get yours turned round the right way!

OP posts:
buttonmoon78 · 20/05/2011 17:38

Well, I'm sorry you're not getting what you want, but I'm glad you're so philosophical about it! As you say, it won't matter in the long run and your health and that of your baby are most important.

Funnily enough, DH and I were talking last night about it cos ours is currently feet underneath and he was absolutely 100% section, which was a surprise TBH as he knows how much I've tried to avoid them in the past!

Let us know how you get on - me in particular as I think I'm headed down the same route!

Checkmate · 20/05/2011 18:08

Good luck to both of you. Hope c section/s go smoothly.

theborrower · 20/05/2011 18:58

tangle thanks for reposting. I just wanted to mention it because I was a bit Shock at your such clear distinctions. Perhaps 'assisted birth' and 'hands off birth' ? Ach, I don't know. I just wanted to mention it because, like I said, it can be distressing for some people to have the birth of their child referred to in this way.

madre I hope all goes well for you with the ELCS. You now have the opportunity to get prepared for it which is great (remember a CD of your favourite tunes!), and I wish you all the best. Like I said, I recovered fairly well physically - make sure you take full advantage of the midwives in hospital and your OH when you get home, great excuse to put your feet up and rest rest rest :)

buttonmoon you too

mawbroon · 20/05/2011 20:22

I see you have your answer, but I wanted to let you know that I completely understand the dilema that you faced. I hope it goes well Smile

DS1 was breech. At the time, the consultant went through the choices. I recall very clearly that it went like this:

"There are two choices. Well, actually there are three. The first is vaginal delivery which we don't recommend. Then there's ECV which may or may not work, and there's a CS"

I remember feeling after that conversation that vaginal delivery just wasn't a choice, and I was kind of railroaded into a CS, but it was my first birth, and I didn't really feel that I had much of a voice tbh. Sad Like you say, robbed of choice.

So, I tried ECV which didn't work (bi cornuate uterus, ds1 was stuck with one leg up by his ear and the other underneath), and ended up with an elective CS.

It wasn't a barrel of laughs at the time, but ds1 is 5.6yo now and I hardly ever think about it tbh

DS2 had similar ideas, but he was smaller and managed to turn at 37 weeks and I had a successful VBAC. I would really have considered a vaginal breech for him because I was on crutches with a broken ankle and the thought of CS recovery whilst on crutches was just not something I wanted to even think about!! But luckily it all worked out well in the end.

Good luck Smile

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