C-Section and Breech Baby

[lilwelshyrs]

I'm currently 35+2. First baby. Baby is breech at the moment. I'm getting a number of mixed messages from midwives and consultants and was wondering if anyone can shed some light on the situation for me!

I am seeing a consultant at the end of my 36th week. Last time I spoke to her (end of 31st week), she told me that if baby was still breech then we'd have to go for a C-Section...

I'd really prefer to not go through a C-Sec if it can be helped and I'd have thought they'd try an ECV on me before making this decision.

If baby is engaged in the breech position, am I right in assuming that nothing can be done to flip baby if they're bum down?
But if baby isn't engaged then there's no point booking a C-Sec... Right?

I'm a bit confused! The consultant seemed quite keen for me to have a C-Sec after she had seen I had a fibroid... Which is 11cms diameter but well out of the way of baby... Even the sonographer was amazed to be scanning me as my notes clearly state that my fibroid isn't in the way of baby and hasn't gotten any bigger.

Can anyone shed any light on this?!
Thanks!

I had a c section for DD2 as she was breech, however they were very keen for me to have ECV. I was against that so declined it, they gave me a hard talk about the risks of ELCS but like baby I wasnt for turning and they booked me in.

They are likely to explore the option that involves the least intervention and easiest recovery i.e. would likely advise ECV to see if it meant a VB unless there was a clear medical reason.

As to the fibroid they were maybe unsure earlier in pregnancy of the risk of its size and position, for DD1 I had extra scans as they were worried fibroid was low n could cause complications for either VB or CS. However it flattened a bit once baby grew, maybe they're waiting to see what happens to yours.

I'm 37 weeks with a breech baby and I've been told that I'm not a good candidate for ECV because my amniotic fluid is on the lower end of normal. I also have a small fibroid. So I'm booked in for ELCS at 39 weeks. I really want a VB but not at the expense of potential causing fetal distress and early labor if ECV is not a fit for me. Ask your consultant why they're not offering ECV, there is probably a good reason.

Mumberjack - It's nice to meet someone who has fibroid experience! The sonographer was quite pissed off that she had to scan me as you could feel where my fibroid was lol. But having had no knowledge of fibroids, i was glad of the scan (as got to see bubba!) but also because they were worried it was going to get in the way of baby going head down.

Newbian - i've not been told anything is unusual in there... I'm not sure why she hasn't mentioned an ECV. I'll definitely bring it up at my next appointment (a week friday).

If baby is breech still, they can turn right up until labour, though, right?
So why do they seem to push for an ECS when there's still time?

I had an elective section last year as dd turned footling breech at 36 weeks....was planning hb before this! I tried all sorts but declined ecv.
If the bum is engaged I think they can lift out the pelvis during ecv-not sure of success rate though.
I know quite a few first time ladies who have had breech babies that turn just before labour. They booked their sections at 40 weeks but their babies turned before this.
Some consultants and midwives see breech as a variation of normal and encourage breech birth (birth not extraction which a lot encourage for breech) but doesn't sound like your consultant does!
If my DD had been frank breech I would have aimed for vaginal birth but I didn't want to risk with footling. For what it's worth the section was lovely (had gentle section plan) and much nicer than first ventouse, episiotomy etc. And easier to recover from. I am hoping for vbac this time as long as everything stays 'normal'. X

Lumpy - just curious, but why did you choose not to have an ECV? Gosh, i didnt know there was different types of breech either!
How many weeks are you now?
I hadn't thought about not worrying about episiostomys or forceps etc with regards to a c sec! This is a positive side. How long did it take you to recover?
I'd really love to experience being in labour and pushing... But obviously not at the expense of my child!
Also - what do you mean about having a vaginal birth with a breech baby? I thought breech = c sec every time?

Sorry for all the questions!!
X

Don't apologise!
Regarding the ecv, I just went with my gut. I felt like there was some reason that she had turned breech and many times she tried turning back but would get half way and then flip back. It just didn't seem right to me to do it.
I'm 20 weeks now! Recovery was relatively easy, I took it easy and only looked after the baby-my family took dc to school and I waited 6 weeks to drive, but I never had a lot of pain or anything. The episiotomy I found horrendous to recover from and still had issues months down the line.
You don't have to have a section, it is still your choice. My midwife was happy for me to stay at home as well if I wanted! The problem is that many hospitals don't encourage women to labour and birth naturally and want them hooked up to monitors and do routine episiotomys and extract the baby with forceps when breech (this all stems from some research done in the 90s which is heavily flawed).
I recommend reading through AIMS book about breech (it's on their website and can be bought on Kindle or phone with kindle app).
x

ECV can work, but doesn't always, especially if it's a big baby. You can end up very bruised and uncomfortable.
Breech can still be delivered vaginally, but there are fewer and fewer midwives and doctors with experience of breech births as so many people opt for section. They would probably be happier if it was a second or subsequent baby rather than a first (easier to deliver a breech second time round I think).
Wait and see, a lot of babies turn. I thought I was in labour at 39 weeks with my third - it was just him turning right way round...

Yeh, bubba has made no moves to spin around... I havent felt anything crazy... Just a generally wriggly baby. So hard to tell where he/she is lying... Sometimes i feel a big round thing under my ribs... I'm pretty sure it's the head... Although I felt the hiccups quite low today. Midwife appointment tomorrow so hopefully she can have a jab around and work it out!
20 weeks - how exciting! 20 weeks feels like an age ago! Do you know the sex? These next few weeks are going to feel like an age too lol. I think i'm going to miss being pregnant despite PGP, fibroid issues and now the awful PUPP rash!!
I might get a few but I'm hoping to do hypnobirthing so therefore as little intervention as possible (totally up for the gas and air though!).
Will have a look at the AIMS book :) thank you.

I think my hospital is going to want to deliver me c sec if bubba is still breech. Is it better to just agree to a c sec at 40 weeks than to just wait and see? Or does it not matter?

Thank you for all the replies! this is so helpful and i feel a lot less in the dark about it all!!
Xx

I know, another 20 weeks seem ages away! Don't know the sex yet!
If you have a section, the hypnobirthing will still help when having epidural, cannula etc to keep you calm.
With regards to planning section, your hospital will probably want to schedule one for 39 weeks so that they can plan staffing etc but you can ask to be scheduled later or some even ask to have a section once they are in labour as babies benefit from a labour and you know they are ready to be born.
Do some reading/research and speak to the professionals. Whatever you decide will be right for you x

Thank you so much, Lumpy! I feel a lot clearer on the whole subject now and have some more time between now and consultant appointment to get some more questions down :)

Good luck with your pregnancy :) i hope you get your vbac :)
Xx

Vbacs even... D'oh!

I had a breech baby and ended up with a c section. I also was offered an ecv and took it. Was quite uncomfortable and have a low success rate. I think it depends how baby is sat too as some positions are too difficult to turn.

I this they also book the c section at39 weeks as they would t want you going into Labour before hand and end up with an emcs.

I refused turning baby as I'd heard a few sad stories around that time.. So went for c-section. Baby turned himself beforehand but I'd got used to idea of section so still had it. It was all fine

Had my second ante natal class today where they talked about c sections and medical interventions... I don't feel as worried as I was about it.
Midwife had a feel and she reckons bubba is head down but not engaged - so fingers crossed :)

Oh and coz of my fibroid, they will probably be hesitant to do an ECV as it'll get in the way anyway.

I've been breach this pregnancy but at 37 weeks had switched to back to back
Tbh I would opt for a planned section vs something which could likely end in emcs