breach / unstable lie at 38+6 given until tomorrow am to decide

[lickencivers]

baby number 4 - previous 3 were all spontaneous vaginal deliveries with no complicatins at term. Was breach before but confirmed cephalic at 37 weeks, so has turned and I haven't felt it.

No other health concerns, no PMH

Saw MW today who sent me for presentation scan as due for a HB, baby is breach / unstable transverse.

Saw the Dr this evening whos basically scared the crap out of me and said dead baby at least twice. I don't want a C section, an ECV sounds crap too, a stable induction sounds hideous. I wanted my uncomplicated HB. FFS Any advice gratefully received as we need to call at 8am and tell them if we want the C section or the ECV on Friday.

I’d go CS , why take the risk?

Hey OP, I can understand you not wanting a csection but I have had both and although I was disappointed, it is most important to keep you and baby safe.

I would be surprised if they let you try a HB if baby is breach.

A planned csection can be a really calm experience and recovery can be good if you are well prepared and ensure you have support.

Hope it all goes ok for you x

I had an ECV with baby 2, I think (don't quote me) that it's more successful with second and later pregnancies as uterus is more flexible/previously stretched! It wasn't pleasant but got me the home birth I wanted. Good luck.

I’d just get a ceaserian, It’s not worth the risk of leaving it to chance. They don’t scare you or offer our caesarians for no reason. The ECV carries a small risk to the baby and may not work, or the baby may turn again, so in my personal opinion it’s not worth it (but I don’t think there’s a wrong choice either way). I can understand how frustrating it must be, especially when things have gone so smoothly before, but you and your baby are healthy, it’s just the birth plan that is changing. I hope things go well for you whatever you decide

I object to being told what I may be "let" to do. It's my body. My choice. I could chose to give birth unassisted in a woodland if I wanted to. I'm not asking for permission I was asking for experiences.

Yes I appreciate risks - however the reasons they advocate one route over another may not necessarily be patient led. More like cost / control etc.

You asked for advice, not sure what else you wanted people to say I hope someone else can give you the answers you are looking for.

What’s more important here? You spending a few hours of your life giving birth the way you want, or a baby’s lifetime being healthy?

Consultants don’t recommend c-sections for the fun of it. If that’s what is being said as the safest option I’m not sure why you wouldn’t take it.

it's not about a few hours v a lifetime its a major operation if have a C section

It’s still no contest though? Are you honestly asking whether you should push for a homebirth with a breach/transverse baby? Because that is quite ridiculous.

I had an ECV with my first and it was fine, and it was successful, which meant I went on to have a vaginal delivery. In your shoes I would definitely attempt that as the first instance and then make your decisions from there.

Good luck, I hope it all goes well for you.

Why does the ECV sound crap? Give it a go and see if baby sticks head down? If it does have a homebirth.

If baby is transverse you cannot delivery vaginally. No one can tell if baby has changed position accurately without scanning facilities. Which you need to be in hospital to access. During labour. Which makes a HB extremely risky. Your choice. Take the risk.

The cheapest option for the nhs is a straightforward HB. They cannot guarantee this. Women are often FIGHTING for CSs. They’re not recommended lightly.

Control? Really? This is birth. No one can control it really. Why the concern with control?

It's absolutely your decision, and you sound like me, in which case there won't be any forcing you. But for now you need to put their inappropriate language out of your mind, because you clearly shouldn't be basing this on either being pressured or spite. Complain after If it'll help.

If I was in your shoes I wouldn't take the ecv. Turning a breach baby is one thing, but surely if you turn an unstable transverse they may well just turn back. And babies do turn mid Labour, which is bad if you're induced because contractions are less likely to ease off.

If it were me, and baby was breach, I would make a case for going into labour naturally, immediately presenting at hospital, and taking an emcs if in a poor position. Obviously not if you Labour quickly of live far away though. You don't get your home birth, but there's a small chance you get uncomplicated.

But transverse is much more dangerous if you go into labour, so given there's a high chance of that, I'd take the c section.

Potentially you go in for very regular presentation checks, you might get a homebirth if baby turns right, but it won't be uncomplicated as the midwives will be worried about position. And frankly you lose a lot of the homebirth benefits whilst accepting higher risks.

My personal experience was a homebirth against medical advice, BUT baby was optimally positioned and every midwife I saw recommended it based on my circumstances, so really just against protocol.

Try the ECV. I did at 40+2, it didn't work and they offered me a choice of hospital vb or a planned csection. I booked the cs for the Friday (40+5) but was still unsure. As it was, I went into labour the day before cs and they were happy to allow me to try vb. Not 100% without complication but I delivered dd (bum first so not quite the same) after a 2 hour labour! The presentation of the breach is important but skilled midwives can and do deliver safely, albeit in hospital rather than at home. Has to be something you and your consultant are happy with though.

Not at all advocating a transverse attempt at vaginal home birth. I'm not ridiculous.

Just this has come out of blue - not expected at all and struggling to make a decision when usual path for me is that off let it be etc

So when baby was frank breach a month ago I was certain would go for breach vsginal delivery but now it's spun to ceph then to transverse I feel super wobbly about it.

I live an hour from hospital and my last labour was 20 minutes. Ffs.

C section

I suggest trying the ECV based on how you seem to be feeling, because if it works you can go ahead with the vaginal birth anyway which is great, and if it doesn’t work or you change your mind once you arrive for the procedure then ceaserian will still be there on offer to you. Kind of buys you some time aswell. It’s a rubbish decision to have to make, especially in such a short time frame

You may have to go and stay in hospital for a while so not an easy option with 3 other DC at home but if they can confirm unstable lie rather than transverse or breech then maybe you can ask for what I had with my unstable lie at 39+2?

In my case I had to be admitted to hospital when they discovered the problem just before 39 weeks in case my waters broke while the baby was transverse and so there could be a cord prolapse. However, while I was in hospital I was palpated quite regularly and when they found the baby head down one morning they offered to break my waters and start labour with a drip. Not ideal but I felt it was my best option for a vaginal delivery and it did indeed work. Might be worth asking about that as an option if you have got an unstable lie. Best wishes for a smooth birth.

I’ve had homebirths against hospital recommendations (15 fats over due with one and low hb with another) because it was best for baby and me after I’d carefully weighed all risks and benefits. However, without knowing all of yours, based on what you’ve written, I’d go for an evc plus vaginal delivery in hospital if you have a supportive team not pressuring you to do things you don’t want. Otherwise evc and homebirth if your relaxed enough. If your likely to be anxious I’d go C section.

Go for the csection. Why risk anything

Do whatever the safest option for the baby is.

I've only had one baby but he was stubbornly breech and an ECV wasn't successful so I had an ELCS. To begin with I felt a little cheated, but now that he is here I honestly don't give a seconds thought to how he arrived!

Plus, I drove again 4 days after giving birth and had no issues. It's not a 'given' that you'll be laid up for weeks on end. I was absolutely fine.

One of the reasons that they suggest ELCS for breech babies (esp for first time mums) is because so much experience and expertise in delivering breech babies has been lost and lots of units simply don't have staff experienced in it.

I know you have already had babies so your birth canal is probably fine, but for me as
A first time mum, it was a no-brainer decision

Good luck!

I would what’s safest for baby (in other words, an elective c section).

Are you for real? Your willing to risk your babies life for the sake of having the birth you want?

You are being ridiculously selfish here.