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Childbirth

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

choosing vaginal breech delivery

31 replies

bright0nmama · 24/03/2015 15:47

Hi there

I'd love to hear about the experiences of women who opted for a vaginal breech delivery here in the UK.

I'm 36 weeks with my second. Was v lucky to have super straightforward (head down!) homebirth with my first. I'm weighing up all possible options for this birth. I'm booked in for an ECV next week, but not sure if I'm going to go ahead with it.

This lil fella has been v happily head up since 28 weeks and despite all my lying upside down/chiropractor/moxibustion/you name it, he hasn't budged. Maybe he's just happy and wants to come out that way.

I've done a lot of research about the risks of breech delivery both via c-section and vaginally, and I've seen a lot of wonderful stories from women who've chosen to have a c-section. It's harder to find stories of women who chose to have a vaginal delivery, and I'd love to find out more about it.

Thanks!

OP posts:
PrincessOfChina · 24/03/2015 15:50

I've only looked into this a little as I was actually determined to have a CS regardless. However, I believe the reason you don't see tons of accounts of great outcomes of vaginal breech delivery is because it can be a life threatening situation. I would take medical advice very seriously.

Beloved72 · 24/03/2015 15:59

here

This is a really good leaflet setting out the issues in a non-fear mongering way (thanks PrincessofChina Hmm)

Beloved72 · 24/03/2015 16:01

From the leaflet: (published by Kings hospital)

"The balance of benefits and risks is uncertain, particularly for
women who have had a previous birth. Results of a trial of over
2,000 women around the world giving birth to babies in breech
position was published in 2000. The study concluded that it is best
for a breech baby to be born by caesarean section as the risk to the
baby was higher with a vaginal birth.
In the three-year follow-up of this study, there were no long-term
differences comparing the immediate outcome of breech babies
born by caesarean section or by vaginal birth. More research found
that the differences in outcome between these two groups was only
short-term, although most doctors have still recommended that
breech babies should be born by caesarean section."

Suggests that for women who have had a previous birth and have an uncomplicated breech, the risks and benefits of c/s vs v/b aren't clear cut.

SeattleGraceMercyDeath · 24/03/2015 16:08

The Hannah trial has been widely discredited although the knock on effect it had has been to make practitioners less familiar with breech, resulting in fewer experienced breech care givers, so it's turned into a bit of a self fulfilling prophecy.

With breech the things I'd look for is ensuring you are delivering somewhere that is confident they can facilitate a breech birth with practitioners who have done them before. I wouldn't be augmenting or inducing a breech labour, if it ain't coming on its own, don't force it out. Other than that you're a reasonable candidate having had one svd before so research your options and your caregivers and have a lovely baby.

missmakesstuff · 24/03/2015 16:18

I was looking into this for a while as dd was breech and this baby ( due yesterday) was for a while. There's lots of good information and support on the fb breech birth page, might be worth a look.
I think you will always be given scare stories, no matter what you choose, I'm having a home waterbirth after c sec and have just kept plans to myself as I have done the research and am confident it is the right choice. as long as you feel confident and supported in a hands off, natural breech birth (not an extraction, it's important that the hospital understands the difference) then you've every chance. My midwives were quick to reassure me that I could give it a go, at least go into labour naturally, and take it from there, they also understood 'hands off the Breech' (Google Mary Cronk)

Good luck, you're right though, some babies just need to be that way.

missmakesstuff · 24/03/2015 16:21

Meant to say though, this baby was bum down till 34 weeks and turned after a week of listening to Maggie Howell hypnotherapy track at night. Might have done anyway, but it was full of positive statements about baby being the right way up for them etc and was very relaxing!

Funkytown · 24/03/2015 16:25

my son was foot long breech from my 20week scan until 37+5 days
the day before my procedure he turned (not that i was going to let them manually turn my baby anyway).
in all honestly is depends on the type of breech you have aswell not just if you want to do it or not my son was footling breech so i couldn't of birthed naturally

CSLewis · 24/03/2015 16:46

If you're in London, I can highly recommend an osteopath whom I saw when my baby was breech for a couple of months quite late into the pregnancy. I also did moxibustion. I was not going to have ECV.

When my midwives checked the baby's position a few days after I'd seen the osteopath, the baby had turned.

Anecdotally, I have 2 friends who have had breech babies vaginally, one at home (with very experienced midwives, it must be said). Both were straightforward, one said it was one of her easier births!

When I was actually in labour, the midwife thought that my baby had flipped back into breech position, and pushed fairly hard for me to transfer into hospital. I refused - nothing was going to get me out of that pool! - and gave birth less than half an hour later, by which time she was head-down. We'll never know if my baby had flipped and then flipped back again, or if the midwife had mis-diagnosed her position, but if I had attempted the transfer, I'd probably have given birth in the ambulance (or on the way down my three flights of stairs!), so I'm very glad I didn't.

I was confident in my body's ability to birth babies, had had 5 quick and 'easy' previous deliveries, and had faith in my midwives' skills - tho I did also explain that I took full responsibility for staying at home, and didn't expect them to do anything other than 'keep their hands off the breech'.

As well as googling Mary Cronk, I also recommend a book by Benna Waites called Breech Birth: a very measured look at the data available for the whole spectrum of breech birthing experience.

PM for details of my osteopath if you want, and good luck! Thanks

CSLewis · 24/03/2015 16:48

www.homebirth.org.uk/breech.htm has some breech birth stories, tho the accompanying information is not very up-to-date.

VeryPunny · 24/03/2015 16:57

I chose vaginal delivery with DD, my first baby. Consultant and doctors extremely supportive, midwives though I was bonkers for refusing elective CS. Eventually wound up with EMCS as DD got distressed after she was quite a bit of the wasway out. However, I know I tried everything possible for a vaginal delivery, to the point where I was pushing wasin theatre and the registrar was sitting there with hands clasped as he said there was no need to do anything at that point. However, DD's heart rate dropped suddenly and didn't recover, at which point they swung into action and DD was born within seconds.

I had an epidural as it was excruciating (hypnobirthing be damned) which saved me from a GA. Breech deliveries tend to be all or nothing - DD was 6 hours from nothing to delivery. There was lots of meconium - breech babies are squeezed like a tube of toothpaste during contractions, it's not necessarily indicative of distress. DD was frank breechbreech which is one of the easier breech presentations to deliver.

We had planned a home birth but decided against trying for a home breech delivery.

VeryPunny · 24/03/2015 17:00

Sorry,tablet went bezerk.

Am very glad I was in a proper obstetric unit though. The experienced medics were the most supportive of all the staff; junior medics took their lead from the senior registrar. We had a lot of interested midwives - many of them hadn't seen a breech delivery in o long while.

Bit gutted that I didn't get to deliver her vaginally but it wasn't to be. Had a successful VBAC with DS.

FirCoat · 24/03/2015 17:05

I'd second CSLewis' link above - some great info and breech birth stories on there. I've never had a BB myself but know several people who have birthed breech babies at home without problems.

The midwife Mary Cronk is an authority on the correct (hands off) management of breech birth and has held a conference 'A day at the breech' which you might be able to find online.

I would be cagey about accepting an obstetrician's advice on natural breech birth as they don't do them. They usually perform breech extractions where the woman is passive. You might like to think of it as a birth (in which you are active) rather than a delivery (in which you are passive).

The French obstetrician Michel Odent has also has written extensively about natural breech birth and is a brilliant resource.

In your position I would be looking for a midwife experienced in hands off breech birth and avoiding a 'managed' delivery.

Good luck!

SeattleGraceMercyDeath · 24/03/2015 17:09

Google Jane Wvans as well, if it's worth knowing about Breech, she and Mary Cronk know it. I've had the privilege of seeing Mary and Jane teach and it was fantastic. Just found this e-book by Jane, I haven't read it so I don't know what it's like but might be worth a look?

www.amazon.co.uk/gp/aw/d/B008BAG5CI?ie=UTF8&redirectFromSS=1&pc_redir=T1&noEncodingTag=1&fp=1

SeattleGraceMercyDeath · 24/03/2015 17:10

*Evans

VeryPunny · 24/03/2015 17:16

My experience (2013, so recent) is that obstetricians are very aware that correct management of breech delivery means as little intervention as possible. We were moved to theatre as a precaution due to worries over DD's heart rate, all intervention was at my request. You can't use forceps on a bum so if things head south you have very limited options, hence our desire for a CLU.

Obstetricians are not the enemy! This was at a large teaching hospital which routinely delivers undiagnosed breech babies.

addictedtosugar · 24/03/2015 17:37

Talk to the MW about experiences at the hospital you are likely to end up at, and make sure ou know the breac position - ie bum first, not footling.

Mine was very supportive, and basically said "fine". Baby turned round anyway.

If the midwives say "noone in the hospital has delivered a breach in 15 years" I'd stay clear, much as I'd hacve been anti ECV or ELCS.

CSLewis · 24/03/2015 17:56

VeryPunny, sounds like you were very lucky with your hospital. Do you mind saying which it was?

VeryPunny · 24/03/2015 18:06

It was Addenbrookes - they were indeed excellent.

bright0nmama · 25/03/2015 12:05

Oh my goodness! I am SO grateful to you all for your thoughts. This is mega. Lots of wonderful wisdom and insight and experience here. For those of you who did want and go for a VBB, did you still try an ECV? Am I just being weird and contrary to want to resist it? Did midwives back in the day try to turn breech babies themselves?

I found a great article called "To ECV or not to ECV" that is clear and helpful, but still can't decide whether or not to go ahead with it on Monday (apparently the consultant who does it at the Royal Sussex in Brighton is great).

Another resource I've found is the website belonging to the author of the above article: breechmidwife.wordpress.com

Anyway THANK YOU all of you who've contributed to this thread. I'm printing out Mary Cronk and co to read on the train home...

OP posts:
bright0nmama · 25/03/2015 12:08

Oh and the hospital seem to be game for a VBB if I choose it, and there's experience across the team. But an experienced community midwife said she would feel nervous attending a homebirth with a known BB. I've more than made my peace with going to hospital. I'm just waiting to hear back from a senior midwife about their statistics (how many breeches they delivered vaginally last year, what the outcomes were) before any final decisions.

OP posts:
Queenofknickers · 25/03/2015 12:22

Can I make a comment from the baby's point of view? I was a vaginally delivered flex breech baby and because of this I have had a life time of hip/ spine issues as I got stuck. I wish I had been born by c section!

VeryPunny · 25/03/2015 12:36

Yes, I tried ECV twice but no dice. DD just wanted to be head up - even now she sleeps with her head jammed up against the headboard!

I think hospital is the right place, given that for breech babies you want to do as little as possible. It's much easier to do nothing knowing that if you need to, a theatre is down the corridor; midwives would be quite keen to transfer at the slightest hint of trouble during a breech home birth.

Queenofknickers - good point. My understanding is that maternal outcomes for breech deliveries are broadly comparable with normal presentations, whereas there is a slightly greater risk for the baby. All breech babies should have a hip scan at 6 weeks to check for hip dysplasia which is more common in breech babies.

Happy to answer any more questions and good luck! It took DD a few weeks to straighten out post birth - if you put her on her back, her legs stuck up!

blowinahoolie · 25/03/2015 14:42

I know of one mum who gave birth to her first child vaginally who was in breech position and she managed it successfully. There were no complications from what I remember. Her child is now nearly 8yo now.

It can be done, but most women would probably just take the CS route.

BethMetal · 25/03/2015 20:54

I had a breech vaginal birth 3 days ago :-)

Second baby, had been identified as breech at 37 weeks (though I suspected before - think he managed to fool the midwife before). Tried ECV twice but unsuccessful both times. The first consultant was pushing for CS but after extensive research I decided I wanted a normal birth. I didn't have any of the risk factors described in the RCOG leaflet abd the second consultant I saw agreed that I was an ideal candidate for a vaginal breech birth.

In the end I went into labour on my due date and after a 12 hour slow build up I had a 1.5 hour first stage then pushed him out in 7 mins in a squatting position on the bed. It was tough using just gas & air (other pain relief makes it riskier) but 100% worth it! Baby was absolutely fine, breathing and crying straightaway so we had lots of lovely skin to skin and a physiological third stage. I had only a tiny tear (compared to extensive stitches following my first baby) and went home the following morning.

I read Jane Evans' booklet 'Breech Birth: What are my Options?' (downloaded from the AIMS website - see publications) as well as lots of articles by Mary Cronk and Shawn Walker. I definitely recommend finding the Facebook group "Breech Birth UK" - a great place to ask questions.

BethMetal · 25/03/2015 21:00

Oh, and I'd originally planned a homebirth btw. I knew this was still an option (though would have required me to hire an independent midwife) but personally wouldn't have felt confident. I was fully prepared for a possible EMCS if needed and the hospital is 20-30 minutes away...

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