Would early induction be a possibility with a breech baby?

[TeWihara]

DC2 is currently breech at 35 weeks, I know there is lots of time for this to change - and we're also a family with a lot of breech births so am pretty clued up on the options and am not worried about attempting a vaginal breech birth if conditions are favourable.

What does worry me is that we're also a family of speedy births! My mum's 2nd labour (me) was both breech and 45mins long - I was only born in hospital as she was there for an antenatal class.

The hospital that would deal with this babies birth (should he stay breech) is in a high traffic area and not that close to us, it could easily take us 2 hours to drive to hospital if I went into labour at a peak time - and I really, really don't want to give birth to a breech baby in the car!

Has anyone ever opted for induction for a breech baby purely to ensure you are in hospital when you go into labour? Would it be considered a good enough reason to induce?

The only other way I can see to get around my speedy labour worries is to have an ELCS but I am worried about recovery time as I have a toddler at pre-school and no car.

you'd need to find out from your chosen hospital exactly what they 'do' with breeches. many wouldn't consider 'letting' you have it vaginally (which is just bloody wrong but happens). If they have midwives/doctors who 'do' breech births whether they'd induce you would be a whole different matter.

generally with breeches (look up mary cronk) it is ok if labour is progressing 'normally' without intervention, which i suspect inducing rules out.

Thanks for answering!

My MW seemed confident that they would let me try for a vaginal birth if that was what I wanted as this particular hospital deals with them a lot and has a good team there, so hopefully it is an option depending on babies exact position (and all the other factors!).

But sounds like it will just be a question of asking the consultant whether they'd consider induction not-normal enough to refuse to do it with a breech... hmm.

Might have to develop an ELCS back up plan.

I'd check with MW but I was reading the NICE guidelines on inductions this evening (for my own reasons!!) and I think it suggested not inducing at all in breech presentation but as I was skimming for other reasons I may have remembered incorrectly.

Would you consider a home birth? I wouldn't fancy giving birth to any baby at the side of the road and given a choice between staying home and waiting for help or taking the risk of not getting to hospital I'd probably stay home! If they have a lot of experience with breech babies then there's a good chance they'd have a MW that would be happy to support a breech in the community. Or you could look into IMs near you.

I'll 2nd the suggestion of Mary Cronk! She has a very hands-off approach to breech birth (and a huge experience). Her starting point is that if you are going for a vaginal breech then labour should start completely spontaneously (I think she'd even advise against a sweep) and progress completely naturally - and that if these conditions are met there are rarely problems later in the birth.

I've had one breech baby (born at home - decided to come out as footling breech in the end), and am currently carrying another at about 35 weeks. Still pondering options and trying to decide what to do should LO not turn of its own volition. I need to find out exactly what the hospital considers "normal" for breech - the options they gave me last time were one of the reasons we stayed home. Its such a difficult decision - I hate being back here!

Annoyingly, I am scheduled for a homebirth and was really looking forward to it - especially the reassurance that everyone would be coming to me! 'My' homebirth MW does have lots of experience with breech babies as it happens, but they don't allow homebirths for breech babies here. (Well... I could push it I suppose, but I know not all the MWs on the team do have experience and I wouldn't want a MW that hasn't dealt with one before )

It is a really hard decision! Good luck, and I hope both our babies conveniently turn around

Oooh - you've just hit one of my buttons (or your PCT has!). To quote Mary Cronk "Allow is not a word to use to a mentally competent adult!" You PCT may have a policy of "no home birth for breech" but that is very different to having a legal leg to stand on re. saying you're not "allowed" one. Your body, your baby - your legal choice (unless you have been sectioned under the Mental Health Act and the PCT get a court injunction). Of course, as a mentally competent adult you are expected to consider the risks of the course of action you intend to take, and bear the consequences of doing so - personally I figure I'm going to be living with the consequences regardless so I'd rather choose which consequences I'm exposed to!

If you'd consider a HB for a breech then I'd talk to your (supportive) CMW about it and ask for and appointment with the Head of Midwifery. If you already know of at least one CMW that would be confident then its more of a scheduling issue than "we don't have MWs prepared to do that". And the HoM should be prepared to engage with you to try and help come up with the best care plan for you as an individual. Apart from anything else, I can't help thinking it would be a really good idea for you to have a backup plan: CS is normally scheduled for around 39 weeks if the reason is a breech. What's going to happen if baby's still breech and you go into spontaneous labour before the CS date? (To me, a prudent move at that point would be to find the closest MW with breech experience and call her to you, possibly calling an ambulance at the same time. The MW would then need to evaluate the situation and decide whether you'd be better off staying home or trying to transfer in. The ambulance would come in handy if they had a strong preference that you try and get into hospital - and you'd then have 2 paramedics and a breech skilled MW with you for the journey).

Definitely hoping they turn! I've been seeing an osteopath to try and make sure there aren't any constrictions making it harder than it should be - but I am starting to worry there's just not enough room left (DD1 was 9lb12 and this one doesn't feel small either!).

Yes - you're right even if I do decided for a ELCS I am going to have to have a back-up plan, because I'm really not confident about getting in the car after I've gone into labour in the circumstances...

Have you got lots of breech babies in your family? My sister and I were both footling breech's, Dsis was turned and then flipped back and I wouldn't turn at all apparently. All my aunt's and my uncle on one side all were as well.

I don't think this one is anywhere near 10lb, but can see the difficulty with turning a bigger baby... there's only so much space to turn in!