ECV with SPD or should I refuse and consider ELCS? <acronym overload alert>

[Sockspence]

Sorry about all the letters

I'm 36 weeks and baby has been stubbornly breech all along. If, after my MW appt next week he's still head up, I'll be sent into hospital for a scan and offered an ECV.

While I was all up for a vaginal delivery, I do have honking SPD and am worried that such full-on external manipulation is going to make it worse.

Also.. I did have a bloody awful time with my vaginal delivery of DS1 (back to back labour, forceps, episiotomy, infected stitches )

So all things considered, would they agree to an ELCS instead? I assume I can refuse an ECV?

you can refuse anything, totally up to you what medical interventions you consent to. here in ireland i think ECV's aren't that common as there are risks involved and baby could turn back after an uncomfortable if not painful procedure for mum (am open to correction though, no personal experience).

if it was me i'd let the fates decide. if baby turns themselves (which could happen right up til you go into theatre) then go for vaginal, if not, refuse the ECV and have a section.

or a breech vb?

I didn't have any of the other issues you have (breech, bad birth experience etc) BUT I did have SPD. I was advised a water birth but was at home anyway, I assume you'll be in hospital so you could ask for a watrebirth.
The SPD meant I couldn't walk and ease the pain and actually giving birth was worse pain-wise than the others put together. The SPD alone would make me press for an ELCS if I got pregnant again - I am not planning on it
However, recovery after is another matter. I very quickly got relief from the SPD and had no major surgery to recover from.
In all truth I would have refused the ECV as too painful for my SPD and taken my chances - leaning towards a CS if still breech (fast deliveries so a problem for Breech VB)
Good luck.

I don't even know what I'm asking, tbh just musing things through, I suppose.

You can decline an ECV.

I had an ECV with pregnancy number one. Baby was breech all the way through, and I had an ECV at 38 weeks. It was painful (I didn't know at the time that you can request G&A for the procedure - it wasn't offered to me, and I had no idea that you could ask for it) and long (lots of very physical manoeuvres which took some time). It was successful on paper in that the baby turned, but despite me trying to deliver him vaginally, he got into distress and I had an EMCS. Turns out the cord was wrapped around him twice and I could never have delivered him vaginally. I would have been better off having ELCS in the first place. Isn't hindsight a wonderful thing?

This time round, when baby was breech, I refused an ECV from the beginning. It isn't an option for me, given my experience last time. The midwife was fine about it - just recorded in my notes that I had declined an ECV.

If you do decide to have an ECV, this would be my advice:

1. Ask for G&A and whatever relaxant they can safely give you before the procedure

1. Ask what the consultant that is doing your ECV's chances of success are, and the hospital's chances of success

1. Ask for a scan after the ECV to tell you where the cord is after the procedure. If I had done this, there would have been no need for em to go through a 3 day labourr, only to have EMCS at the end.

Good luck, and I hope the SPD is manageable going forward.

thank you, Happy - that's really helpful. I'm rapidly going off the idea of an ECV and think I'd rather wait to see if the little tinker turns.

i had EVC and all i can say is it bloody hurts!!! mine didnt work and had to have cs, i didnt have spd tho so cant really help with that, although i didnt feel any pain afterwards, i wasnt sore or anything., just left me quite shocked and shaky.

have you asked or considered vaginal breech birth? would it be something you might go for?
given my time again i would definalty have liked to have a go at vaginal birth. mostly to do with lack of help i got afterwards recovering and with the baby.
but if you have good support that would be so much of an issue.

good luck in whatever you decide

What would bother me is the possibility that the baby is persistently breech because it can't turn - eg if the cord is around the neck.

Was reading a thread only yesterday with a poster saying this - they had declined ECV and were thankful that they did as otherwise they might have lost the baby.

This alone would make me decline ECV - although I see that another poster has mentioned a scan to check position of cord - presumably they'd do this prior to ECV too, for that reason?

The option of leaving it to fate seems a good one, especially as you had a hard vaginal birth last time. FWIW I have had one birth by EMCS, it was fine - I imagine ELCS would be a totally ok experience.

i was given a scan before ECV to check te baby was still breech and the position of the cord, but not after

doctor the scan that they did before the ECV was to check the positioning of the baby and not the cord. It just confirmed that the baby was still breech before they did the ECV.

The scan afterwards again didn't check the position of the cord. It just confirmed that the baby had been turned.

Maybe different hospitals have different policies. This is only my experience, but it it did make me decline ECV this time when baby was breech (it has turned of its own accord since).

happy to have helped, sockspence