Breech birth vs C-section

[gingerlou84]

My baby is currently breech at 36+4 weeks. I had an unsuccessful ECV yesterday, which was quite painful, but baby is also back to back which apparently makes it harder to turn. I'm scheduled for another scan tomorrow and will have another go at the ECV if baby has moved to back to front. If that's unsuccessful, the hospital offer the choice of vaginal breech birth or ELCS. I am really uncertain which to go for. This is my first baby and DH and I have hopes of a large family (4+), however we want to look out for the wellbeing of this baby rather than future children who don't yet exist. Has anyone got experience either of a vaginal breech birth, or of a C-section who then went on to have several children? Thank you very much in advance.

[ispymincepie]

Personally I would decline ecv and attempt a vaginal delivery. However you would need to be very well informed of the physiology and risks of breech birth and be confident in your care providers. Good luck OP.

[Lugeeta]

I think the ECV is far more risky than a breech normal delivery. Advance search on here as babies have died as a result of this. I also know someone IRL who lost their baby because of ECV. I would research before you consent to this again.

I think breech is a variation of normal and if you have people skilled in breech delivery that would be a far better option than a section.

Basically with breech, you need hands off, to be mobile and to deliver on a birth stool/ on knees or in the pool.

[BizzyFizzy]

I was my midwife's first breech birth, but she was brilliant. She went into automatic mode from her training. She only realised DD was breech when she saw the buttocks emerging, and she did a STAT call for medical help. She then left me alone until DD's neck appeared. Text book.

[Mehfruittea]

I had an ELCS booked then went in to spontaneous labour. Had a prosession of midwives trying to change my mind during a very short labour. I went from 2cm with no contractions to 9cm in theatre within 1 hour. MWs wanted experience of breech vaginal birth - not looking at what was in mine and my child's best interest.

The big factor for me in deciding an ELCS was that they can never guarantee who will be on shift when you go in to labour, and if they will still be on shift when you deliver. Having promises of the most experienced MW is probably true, but no guarantee they have ever assisted at a breech delivery.

Also check out your maternity unit - how many times in the past 3 months have they closed their doors to new admissions and sent ladies to other local maternity units? Is there a risk this could happen to you? It was a factor for me.

I hope it all goes well for you.

[toffeeboffin]

DS was breech, only found out once I was 5cms dialiated.

Offered a section or breech vaginal : opted for the section. Whole experience was fantastic, recovery quick, no harm to DS.

Good luck op.

[BizzyFizzy]

A frank breech isn't much different from cephalic. If you don't intervene and Labour progress at a reasonable rate then there is nothing to worry about,

If labour stops, then straight to c-section but not in a rushed way that would require a general anaesthetic and vertical incision.

If the baby is in a sub-optimal presentation, then straight to c-section, ELCS.

Mary Cronk has good articles on breech.

I agree with tpa who says to have a c-section with a back-to-back breech as there is a real chance of the chin getting hooked around the pelvic bone. The last thing you want is medics accelerating with syntocinon/pitocin.

To another pa, there are specific forceps for breech births (istr piper) but no breech should plan to use these - strictly emergency.

[sycamore54321]

Just one other thing that occurred to me - if you have an elective section, then there is plenty of time to make the ideal incisions etc which will leave you in the best situation for future pregnancies. If you try to deliver vaginally and end up needing be section, there is a possibility of that being really very urgent and so the surgeon may need to use the fastest possible techniques ('smash and grab') including possibly a vertical incision which really increases risks for future pregnancies. So you may also want to factor in to your decision that the choice you are making isn't elective section vs breech birth, but rather elective section vs attempting a breech birth.

Honestly, I really wouldn't risk it km your shoes. But please discuss all scenarios in detail with your doctor.

[DoctorBeat]

I really wouldn't go for a breech birth if you are also back to back and it is your first if I were you. I had an ELCS for my breech dd and it was fine.

[VeryPunny]

DD was breech and I attempted a vaginal delivery, after failed ECV and with the full support of my consultants. To be honest I had drunk the hypnobirth kool aid and was very against a section. Went in to labour day before scheduled section but DD got stuck most of the way out, and as a previous poster alluded to, you can't use forceps on a bum. Cue an EMCS which was a lovely calm experience (skin to skin and feeding in theatre whilst they stitched me up) but the section was far more complicated than it needed to be due to DD being a long way out. It could have easily gone wrong, and in hindsight, I probably could have saved myself a lot of grief going for an ELCS.

DS arrived 19 months later with a VBAC so no problems there. I also know people who have had 3 or 4 sections.

[Whatthefreakinwhatnow]

DC3 was breech- then turned the morning of my c section! They scan here before you go to theatre to check still breech and he'd turned, has still been breech the night before! He wasn't a small baby either, over 9lb, so wasn't like he had loads of room, he just managed somehow so perhaps you'll be lucky and the same will happen to you.
Was born naturally 2 weeks later

I opted for the section over trying for a natural delivery after weighing up the risks to both, and felt that the section was the best choice for me.

[fruitpastille]

My first was elcs due to breech. Second ', failed' vbac as didn't progress and then my third was another elcs due to breech again! All of the above went smoothly and I have had zero problems apart from now being advised no more as my scar was very weak at my last birth. It's a good thing my last I've was breech again as vba2c would not have been a good idea. I feel fine about my births overall.

[perfectlybroken]

My first was breech, I opted for vaginal delivery, but had emc due to lack of progression, no baby 24 hrs after waters broke. My second baby was not breech and I went for vbac but had emc again.
I really regret both my births, and feel disappointed as I suspect the 'medicalisation' of my births due to being breech and then vbac is what caused the failure to deliver (flat on my back strapped to monitors).
First section was smooth and recovery very quick, the second involved complications, including inadequate pain relief, and took about 2 hours. I was on high dependency afterwards and in a lot of pain.
Sorry to share rather negative experiences but I thought it might help you to be aware.
The positive thing is though, that whatever decision you make will have minimal impact on your baby, both mine were fine, breastfed well etc, and while I don't have great memories of their births, it has had no lasting impact. I have been told only 1 more c section and that will be risky for me, so I get your concerns about wanting a large family.

[lorelairoryemily]

I can't really offer any advice, I had an emcs, recovery was pretty quick though and not as hard as I expected, have you seen the Facebook page 'gentlebirth mums'? If you search for it and join, the lady who runs it Tracey Donegan is a midwife and there are loads of midwives on it who would answer your questions, she's amazing and familiar with birth practices all over the world. Best of luck whatever you decide

[futurelotterywinner]

My 1st was back to back, 36hrs, horrendously painful, sick on every contraction, had every paIn relief going. My 2nd was undiagnosed frank breech, literally found out when she was 'crowning' and pooed all over the bed lol!!!! Her labour was 1hr50, only had gas and air, it hurt but was bearable and didn't need the pain relief I needed on number 1!
On the face of it, I'd take the second labour, bum 1st, 1 million times over first labour.
However,

1. I was lucky!!! Breech birth is undoubtably more risky (friend is a nicu nurse and told me after a lot of the babies she sees are result of breech birth).
   
2. The panic I felt (and so did everyone else who flooded into the tiny room) when they realised I was breech was terrifying.
   
3. At the end, although glad I didn't have a c section as all was ok, I found it really scary that the outcome could have been very different!
   

I think what I'm trying to say is, although in my experience, breech labour was a breeze in comparison to head first first baby, I was lucky. It could have been very different! My first back to back labour was hell and I wouldn't wish that on anybody. I was traumatised for weeks after and wish I'd had a c section as it was an ordeal! I know csection and after recovery isn't a piece of cake, however, I felt so shattered after my marathon, had stitches in places that shouldn't have stitches, and a tired baby who took a week to feed properly, I wished I'd just had a c section as back to back made it so difficult!
Also, although number 2 was easy in comparison, breech is always risky and would have chosen a c section if I'd known about it before labour started!!!
I'm waffling, don't even know if any of this was useful, but, in essence, choose a c section and save yourself the stress of picking a 'risky labour!' Hand on heart, I would choose the planned c section x

[DramaAlpaca]

My DM had me, a breech baby, by c-section, and went on to have my brother as a VBAC. This was back in the 60s, so not a new thing.

I have a friend who's had four c-sections, but she's the only person I know who has had so many.

In your shoes I'd be going for the c-section.

[kel12345]

I was breech, and my mum had a c section with me and was fine. She also went on to have 2 more children by c section (she said she wouldn't have wanted a natural birth anyway).

[Jodders]

My first was breech and I opted for an elcs. To be fair the option of a breech vaginal delivery was never presented to me.
My second was a very straightforward non medicated VBAC.
I'm now expecting my third and hoping for a repeat of my last VBAC.

[SVJAA]

I had a breech birth with DD (because we didn't know until her feet and hips were out, in the hospital car park!!!!) They did say afterwards that had they known they'd have advised a section and I was monitored heavily with DS2 a few months later.
Although my breech birth went perfectly, apparently that makes me and DD very lucky. I'd do some research and see how you feel. Btw she was back to back and footling breech. She came out with her eyes wide open in shock apparently!

[Notsleepingeveragain]

If baby is back to back it will make labour a lot more difficult- longer a d more painful.

I had a cs section in your exact circumstances. Recovery was quick. Actually a lot better than my vaginal birth the next time round!

One csection will not affect the future health of your other pregnancies - they just monitor you a lot more and take some options away.

[yearofthehorse]

I had a breech after one CS and one vaginal delivery. I went into it with the understanding that if anything went wrong, I'd go straight to theatre. We were both fine and home the same day.

[gingerlou84]

Sycamore - I guess I just meant that from my inexperienced standpoint the C-section seems like the less frightening and probably less painful option. That may not be the case and I'm sure it's a popular misconception that C-sections are the easy option, but I'm trying not to let that cloud my decision-making.

Thank you all so much for these responses - it's so helpful.

[Beansprout30]

I had a vaginal breech delivery for my first in the summer. It was only discovered that she was breech when I was in the pool pushing! I was at a maternity unit which only has gas and air for pain relief and only has midwives on site.

There was an ambulance on standby to take me to the main hospital 15 mins away but my midwife and her team made the decision to deliver my baby. I had no idea how risky it could be, good job really otherwise I may have panicked, I had an audience for which I thought was assistance but perhaps was for the experience! Luckily all went smoothly and was pretty quick but If i had known she was breech I would have gone for c section.

[welshwench]

Thanks so much for starting this thread OP, I've been in the same position! 37+4 with a frank breech. We've decided to go for the ELCS but also because he's 7lbs already and I have gestational diabetes. And they're worried about his heartbeat now too. But I still know what you mean about feeling like an ELCS is the easier option.

I feel especially guilty about the fact I've chosen his birthday rather than letting him come in his own good time! However, MY ECV midwife convinced me it was the right thing for me when she said 'imagine you attempt a breech VB, you get the legs out then discover the head's too big for your pelvis [I'm quite small]. How do you get the forceps around his head if he's the wrong way round?'

Decision made swiftly afterwards :)

good luck with whatever you choose!

[FlappyRose]

I attempted a vaginal birth with a breech baby (against my better judgement, but that's another issue). It resulted in a cord prolapse, which is obviously rare but was my experience. In hindsight, I wish I'd pushed for the ELCS.

[sycamore54321]

OP I'm interested to know what you mean by "Still undecided though and I don't want to be making the decision based on what feels "easier" for me". To my mind, that would be a perfectly valid consideration amongst others. Why shouldn't it be included in your decision-making?

However in this scenario, I think it is a question of who bears the risk. With vaginal breech, the bulk of the risk falls on the baby. With a section, it is on the mother. So to my mind, a section is a brave and loving choice to make in these circumstances, not just the "easier" choice.