ELCS likely, how to be OK with it?

[newbian]

I'm 32 weeks and baby is in breech position. Was the same at 28 week scan. I really want a vaginal birth and the thought of a CS terrifies me. I was born EMCS and my mother still has regrets about it. Also there's lots of evidence that CS babies are more prone to allergies and asthma - I have both and don't want the same for my child if I can avoid it. I also want to breastfeed and worry it will affect my ability to do so successfully.

My doctor says it's still early and not to worry but as baby gets bigger I don't see what will make her move. I have already tried yoga, acupuncture, moxibustion. So how can I mentally prepare myself for CS and stop feeling bad about it? I know so many moms who would love ELCS but for me it's my worst nightmare. Thanks.

Hi Newbian,

Remember that once your baby is here the way he or she was born will seem pretty irrelevant, and you will have a million and one other things to worry about. I do think you need to keep a sense of perspective; the safe arrival of your baby is clearly the goal here and there is unfortunately limited experience in most UK and US settings of delivering a breech baby.

The study you mention suggests that a baby's exposure to bacteria in the birth canal is a major influencer on their immune system. You can 'innoculate' your baby once they are born by using a vaginal swab (I did this with DC3). Also breastfeeding for as long as possible will reduce the risk of asthma and allergies.

Anecdotally, I have 3 DCs, all born by c section, perfectly healthy, no asthma or allergies, despite them running in the family. They are very rarely ill at all. I did the 'innoculation' with DC3, didn't know about it for DCs 1 and 2.

Best of luck for your baby turning, and failing that, a safe and straightforward delivery by section.

You still have ages for the baby to turn. You really do. I had my baby turned by ECV at 38 weeks. Even then they thought there was a chance she would turn by herself!

I had DS by elcs due to breech. It was fine. Great in fact. Calm quick and easy. I am ebf him, he latched on himself within about 30 minutes of birth and has carried on well since.

I was born by cs. No asthma or allergies. I imagine your baby is more likely to have them because you do rather than as a result of a cs.

I started out not even thinking about csection - and by the end of my pregnancy was terrified baby would turn and id have to actually give birth! So many more variables with a natural labour.

Thanks ladies. I realize most important thing is a healthy baby so if I need ELCS then that's what I'll do. But it's just so not how I was planning to deliver so very disappointing. I also had some surgery a few years ago and remember how tired and worn down I felt afterwards. With a new baby I don't want to be recovering from an operation.

BBQueen was the ECV painful? I've read mixed things about it and my doctor is ambivalent about offering it. He's essentially said if not turned by 36 weeks we need to book ELCS, although he said in the past he's cancelled them because baby had turned by day of the operation.

At my hospital they don't check for breech until the 34 week midwife appointment anyway so it's very early to be worrying about that. DS turned at 35 weeks but was a section anyway for different reasons.

If your mum had an EMCS please keep in mind that they are a totally different experience to an ELCS. Also when she had you there probably wasn't 24 hour surgery, and since then medicine has moved on (e.g. they didn't even have scans when I was born!) so the c section of today is very different.

Mine was the highest grade of emergency and premature. Even with that we could do skin to skin pretty soon after and was breastfeeding later that day. The only bad things about it were the emergency nature if that makes sense?

With the research, I'm not sure on the exact study you are referring to. But in ones I've read the emergencies are often included with the electives. So from the start the research is comparing high risk women with low risk as in the UK most c sections are performed for a medical reason. In countries where section is the norm and vaginal birth is for those that can't afford the medical care, the studies show the opposite. So have a good look at the methodology of the studies you are reading before making your mind up.

It's hard not having the birth you want - it took me a while to get over not having a big term baby in a water birth. But when it comes to it, the safety of you and baby are most important. An emotional reaction to not having the birth you wanted is quite common it seems though.

Hope all goes well

Its very early to worry.
We were advised to Di moxibustion etc at 37 weeks.
Have you looked into a hospital that specialises in breech birth? City hospital in Birmingham have some experience if you are near there.

Op, I know you don't want to be recovering from an op with a newborn, but try not to forget that you will be recovering from childbirth, whatever form it takes! A lovely calm ELCS could be a lot easier to recover from than a long and difficult vaginal birth. If course there are some women who have 'sneeze births' ;) and feel fine pretty quickly, but for most of us there is some recovering to do so an ELCS Is not necessarily the worst option!

It's too early to fret! Have you looked at the Spinning Babies website? Lots of tips and tricks on there.

I don't know how you are financially but you could consider hiring an independent midwife, they are often more experienced and confident in vaginal breech births.

I have a friend who managed to get the supervisor of midwives to agree to a vaginal breech birth at her local hospital. She did actually end up with a caesarean, but it is worth exploring if you get further along in your pregnancy and baby is still breech.

What exactly is it thay frightens you so much about an elective caesarean?

And trust your baby! Often babies are in a certain position for a reason. Short cord, for example.

To offer a slightly different perspective, I never really made my peace with it but the anticipation is the worst bit. Once it's done you just have to deal with it (mentally and physically).

I was planning a home water birth with an independent midwife. I ended up with a planned section at 34 weeks, due to growth restriction. I hate hospitals and it was the worst thing that could have happened for me (at least an emcs wouldn't have given me the weeks of anticipation). Telling the surgeon my fears and having a supportive husband got me through. But I still can't drive past the hospital without feeling the anxiety rising in my chest. But she's here and safe and I'm out the other side of it.

So I would say that you might never be completely happy with the mode of delivery but if I can get through it, so can you!

Another who had great experience with ELCS (breech), procedure really straightforward, recovery uneventful (driving again with GPs blessing 3 weeks later), skin to skin contact within a min of birth, BF exclusively for 5 months. Quite surreal - pregnant and reading a magazine in the waiting area and an hour later it's all over and there's a baby! I've had dental treatment that's taken longer (and hurt more!).

Take it easy afterwards though and get lots of rest.

I wasn't offered ECV but wouldn't have accepted one, my understanding is that they carry a risk to the baby, however small.

Having had an emergency caesarean and possibly having an elective caesarean, I've heard many horror stories about emergency caesareans but literally not a bad word said about electives. I absolutely hate hospitals and will be guaranteed panic stations if I have to have one next Friday, but I also know and trust the medical team to look after me and baby, it's so routine for them. If you need one you'll be in very safe hands.

I have had 4 sections and breastfed all my dc, none have allergies and only one has asthma. Oh and incidentally dc2 and dc4 were both breech and turned head down 2 days before my sections and they weighed in at 10.9lbs and 11.6lbs :). Baby has plenty of room to turn yet, don't panic!

I've heard good things about the Spinning Babies website, if you want other ideas of how to turn the baby.

The ECV was painful, I can't lie. But I had gas and air and they would have stopped at my request.

Oh yes and after my emcs i breastfed exclusively for the first 6 months and then combined until he was nearly 2. Never had any problems other than the crap support in the hospital! My son was born on the 25th percentile and jumped to the 91st and stayed there within the first 10 days. Caesarean clearly didn't impact on feeding whatsoever! And he has absolutely no allergies and very mild eczema on his feet. Given that his dad has eczema and hayfever and asthma, he's done pretty well

2 c sections, no exzema or any allergies (that I know of).

Sorry posted too soon

It's really not that bad, particularly electives. Despite the risks the surgeon will outline, you could think of it as more straightforward than a VB as they can have so many different outcomes!!

Emcs thirty years ago vs an elcs now are light years away from each other.

I know it's disappointing - I wanted a vb too and I have to have an elcs. But it's what's best for me and the baby. It took me a few days to come to terms with it (I think also the realisation that a vb would kill me and the baby, but that's beside the point...)

It's one day in your baby's life, the important stuff is afterwards, how you bring them up. It's like worrying your married life is a failure because you didn't have a big white wedding.

Don't fret about athsma and allergies, both have a significant genetic component and multiple environmental components - a cs is not going to turn a child who has no predisposing factors into one with allergies or Athsma.

There's zero clinical evidence for acupuncture or maxi busting, so don't waste your time time or money. The spinning babies website is pretty good, and movement can encourage a breech to turn. As for an ECV, they can work, but there are risks and I'd be looking very closely indeed at how many the person concerned head done and their success rate.

Finally, realise that if there's a reason they're breech (cord wrapped round them, short cord etc) then absolutely nothing you do will get them to turn.

Moxibustion - autocorrect. Sigh.

I think it's important to try whatever you think might help, within safety norms of course.

As a researcher myself, acupuncture and my limited research into it has not convinced me. But - after spending sixth and seventh month in utter agony with pelvic and leg pain, I've gone for weekly acupuncture since the start of month 8. My pain has vanished. I do understand correlation causation etc. I just know I'll keep on at it and I've been sleeping very well.

Remember, whatever way baby arrives, through the letterbox or sunroof - you'll have a lovely squishy baby to cuddle with you :-)

OP, I just wanted to say that the data linking CS born babies to asthma/eczema/allergies was heavily flawed. The researchers did not identify babies born to families who had hereditary asthma, etc, nor to families of smokers.

FWIW, I have had an assisted vaginal delivery (ventouse delivery and episiotomy) and an ELCS. The ELCS was a better birth, and I healed in a predictable way. I understand it is scary - I requested my ELCS and still felt very nervous. But, if you look at is as your baby's birth, rather than an operation, it becomes easier to deal with. You have a degree of control with an ELCS; you have pain management. It is an everyday procedure and my experience was a positive one.

I hope that you have a positive birth experience

I think you have a good chance of baby turning :-)

FFwiw I was very frightened by my elcs too, I'd have loved a vaginal birth and it's taken me a while to recover mentally and physically. However lots of people have calm elcs so try to think what will be will be.

Birth is often worrying but a healthy baby is most important :-)

Hi, loads of responses, but thought is add our story of an unexpected c-section.

Found out in early labour our little one was breach. Within the hour we were in surgery at st Thomas'.

We had prepared for a home birth hypnobirthing water birth... So you can imagine our shock. But I can honestly say it was a positive experience because staff were so respectful and included us in the process of deciding.

Recovery takes a while with Caesarian but within a week my partner had healed relatively well and is up and about (gently!) the day after on post-labour ward was hard, because of the catheter. But the Caesarian itself really was a special and precious memory. Not the harsh and horrible one we had been led to expect. You can still have delayed cord clamping and skin to skin if all well, music in surgery etc. baby is healthy and happy. It was not traumatic!

So by way of an update I've had another scan at 34 weeks (BTW I'm not in the UK and it's a private system so I'm being seen every 2 weeks with scans every time). The baby is still in breech position and her growth has slowed as well, measuring a week behind all of a sudden. So now I'm worried more about baby's progress and less about my own issues.

The doctor explained ECV and I don't think that I want one as if it doesn't work and I go into labor I'll end up needing an EMCS anyway which I understand to be far less pleasant. If she doesn't move then we'll be booking the ELCS in two weeks for the end of October.

Thanks all for your stories, I'm starting to get my head around this being a real possibility and that whatever is best for the baby will be the right choice.

SIL had 3 sneeze VBs, her kids all have excema/ allergies/ gluten intolerance.

I had a VB for DD1, recovery took literally years and I was in a mess, BF was v. difficult to establish.

DD2 was ELCS, easy recovery, BF easy to establish. Consultant also explained that CS is the safest form of delivery for baby.

Read up about lovely ELCS success stories and a bit of practical prep for the immediate recovery period.