Vaginal frank breech birth or elective c section? HELP!

[laulou82]

Hi everyone, I am 38+3 and have just had my second ecv to try and turn my frank breech baby. It was again unsuccessful and very painful this time! I am now booked in for a c section next Wednesday but still have the option of trying for a vaginal breech delivery and really don't know what to do. I so wanted a water birth which I can't have anyway now and the thought of a c section scares me but I've been told it will be safer for baby as this is my first pregnancy. Has anyone else had to make this decision and what happened? Really at a loose end at the moment :-(( please any advice would be appreciated xx

Our first was Emergency c section after hours of labour in breach. It was much safer, and much easier on everyone. Care on recovery is essential. And a planned csction means less pressure at the time to get the baby out if it's going wrong. Looking back my wife wouldn't have done it any other way.

C section. Without question. Don’t put yourself through that.

I wasnt given the choice, after an unsuccessful ecv i was told i would need to have c section but its the choice i would have made anyway. P.s. you were very brave to put yourself through a 2nd ecv. Ouch!!

Another vote for c-section. My Dd was footling breech, so I couldn’t labour at all, but honestly, I would go c-section. It’s not easy - what birth is? - but it’s controlled and usually recommended for breechies.

Best of luck whatever you decide!

Yep....another one who had ECV's ..... Breech .... And especially Frank breech...give yourself a break and go for the CS. Good luck and congratulations!

Had one 20 years ago😲
Still ended up with a section
Second child was a planned c section as it turned out that I had a narrowing of the pelvis

Hi, Ive had 2 breech babies and also 2 sections, one awake and one was an emergency.

The 2nd child was a breech and they told me that as she was a small baby and my pelvis was a good size there would be no problems.

However she was 8lb 8 and although thats not massive its by no stretch small. The birth was a struggle and she had breathing difficulties and now she's much older she has several problems which could have stemmed from oxygen deprivation after birth. I don't know for certain if it was that and I'm not prepared to harass the hospital as I'm just glad that they managed to get her safely out alive and mostly well.

However, from this I would NEVER ever recommend a vaginal breech delivery because it's not worth the risk to the baby. Unlike a normal birth where the baby can breathe once it's head is out, a breech baby can't and the cord supplying oxygen is compressed as well, meaning that the baby has to be very quickly delivered. Also, the worst case scenario is that the head gets stuck and then what? You can imagine the implications of this I'm sure.

A section isn't to be taken lightly but I recovered perfectly well and although just after birth the scar was MASSIVE, it soon shrunk to nothing much. years later its pale and doesnt show much. The most annoying thing is the fact that due to scar adhesion you can see a sort of bump where the scar is, when I say bump .. its very small indeed and hard to describe but its like the scar sticks to you and so a tiny ridge of fat develops. A bit like a muffin top above the scar, but if you're slim as I am, it's only a mild annoyance.

For my childs safety, the scar is a price worth paying.

I think my daughter almost died, the room was flooded with consultants and doctors and a resuscitation team and I wouldn't wish that feeling on anyone.

Good luck and I hope you can make a decision you're happy with :)

I’d go for a C section personally. Very few midwives or doctors have good experience in delivering breech babies these days - because most women who have that presentation opt for C sections. I don’t think it’s worth the risk.

C-section

What's more important, your birthday experience or not having a brain damaged baby? Section without a doubt.

Section.

Birth not birthday!

A generation or so ago a vaginal birth would be a much more reasonable option. Now, as pp said, most midwives just don't have experience in breech births so even I would reluctantly choose cs.

The evidence for or against vaginal breech birth (VBB) is not as clear cut as some on here are suggesting, and 'my baby nearly died' personal experiences are not good evidence to base an important choice on (though I do understand the need to talk about traumatic experiences, I don't feel it's fair to use specific individual circumstances to scare other women), nor are over-dramatic, and unhelpful ' do you want a dead baby' comments. Additionally some of the comments on here are not accurate (e.g. in a well progressing VBB with a well positioned baby the cord is NOT compressed as it's protected by the chest wall fold).

There is no 'risk free' option for you or for baby. The primary indicator for a safe vaginal breech birth is the experience level in vaginal breech of those attending the birth. If your midwives are very experienced and all else is well with you and baby (scans show baby is a reasonable size etc.etc.) then it's certainly something you could consider. In your shoes I would want to know exactly who would be attending my labour and birth (should I decide to opt for VBB), and what their level of experience in vaginal breech was.

Other key factors to consider are the fact that this is your first baby, and the type of breech. Frank breech is the safest and best type of breech to birth vaginally, but as it's your first baby you are more likely to end up needing to move to emcs at some point during the process.

On balance, given the limited information I have available on your circumstance, I would probably be moving more toward elcs were I in your shoes, but do be aware that this also carries risks to you and to the foetus in future pregnancies - so there's no 'no-risk' choice. You must make the decision that feels right for you, but be prepared for that decision to change as your situation unfolds.

This might be a useful infographic for you to look at to start weighing up the evidence to decide what's right for you to do: rixarixa.blogspot.co.uk/2018/01/risk-benefit-calculus-for-breech.html

Thank you so much everyone, I knew deep down that a c section seemed the safest option for baby but one of the midwives yesterday made me feel as my baby was bum down that a successful vaginal breech birth was possible so made me doubt my decision but your comments have really helped me with that. Unless she turns in the meantime, looks like we will be meeting our baby girl next Wednesday :-)

I had a failed ecv. I didn't even consider a breech vagina birth - the thought terrified me! My c-section was an amazing experience and I recovered really well. No regrets. Good luck x

I tried for a vaginal breech baby (frank breech), probably driven by a hypnobirthing course which was very anti intervention. Labour started naturally and progressed very quickly but wound up in an EMCS. Consultants were all supportive of breech delivery; it was in a major teaching hospital which routinely dealt with undiagnosed breech births.

To be honest I should have gone for an elective section which would have been far less stress for everyone. DD got stuck halfway out and as you can’t use forceps on a bum, they had to shove her back up to get her out through section. The section was absolutely fine and I had lovely skin to skin and a feed in theatre whilst they sewed me back up. I do think it could have been much worse though, and to some extent I was lucky. Loads of meconium during the birth because of the way breech babies are squeezed as they try to exit.

DS was born “normally” less than two years later; section recovery was absolutely fine.

If you had Mary Cronk attending you I’d absolutely say have a vaginal birth.

But with the nhs and a spontaneous labour you will have no guarantee on who will be looking after you. It will be whoever is there on the day you turn up. And knowing how rare vaginal breech births are and the lack of exposure 95% of midwives have had to breech births I would say section. You could get lucky and have someone very experienced......maybe it depends a bit on your hospital. I hear Sheffield are very pro vaginal breech births so maybe the midwives there are more experienced, but think they’re the exception rather then the rule.

If you go into labour before then you can always see how you get on, with the understanding that you go to section at any point.

Agree, it really depends on who is attending your birth
i was given the choice but their description of the process, the fact that the head squashes to come out when coming out first made my mind up for me.

I’m 40 wks on Monday and in your situation would definitely have an elective c. There is nothing magical about water birth - the magic starts when the baby is born. The birth just needs to be safe.

I would only consider having a breech birth if the midwife and consultant had delivered breech babies before and were experienced in the manoeuvres necessary in case of emergency.

If that couldn’t be guaranteed then I would elect c/section without a doubt.

I'd have a CS.

Breech vaginal birth is more dangerous for babies than c-section. That doesn't mean all breech babies will die or be injured if delivered vaginally. It does mean however that some babies will die, who would otherwise have been alive with a c-section. Similar for serious injuries, including brain injury, that are a clear risk of breech birth. The problem is that there is no way of telling in advance which babies will be fine and which will have awful outcomes. So unquestionably if I were you, I'd have the section.

This nonsense of a golden age when wise experienced midwives could cancel out the risk of a breech birth of just bull. Years back when there was limited access to sections and when sections were less safe due to greater anaesthetic risk, then yes midwives and doctors saw more breech. But that doesn't mean that breech was safe - it wasn't then and it isn't now.