ECV or planned c-section?

[Crunchiecravings]

Hi everyone

I had a growth scan yesterday at 38+4 and discovered baby is now breech after being head down for the last 4 weeks. I am gutted ☹️

I have an ECV booked in for tomorrow when I will be 38+6 but I can’t make my mind up whether to go for the ECV knowing the risks and low success rate while also being aware that time is ticking. I have an anterior placenta and my baby is estimated to be 8.5lbs now - not sure if that makes a difference with the risks of an ECV.

Please can anyone help me to decide whether to go for the ECV or straight for a planned c-section?

Thank you.

I thought my dd3 was breech and needed a scan to check. She wasn't but the time before the scan was spent googling. I decided there was no way I'd risk ECV. The cord can be tightened around the neck by the turning. It's also more likely not to work and looks painful.

That was what I decided after my research. I had an anterior placenta as well. She was 8lb 14! Is this your first?

Thank you for sharing your experience. Wow 8lb14!

No it’s my second baby but I didn’t experience this with my first. So you had a normal delivery in the end then because she wasn’t breech? I’m terrified of c-section recovery but equally worried about the ECV ☹️

She wasn't breech. Because of the placenta it was really hard for them to tell. Will they re scan before the ECV? Baby might have turned again

Ah I see. Yes I think they rescan before doing the ECV but baby’s definitely still breech right now because I can feel his head sticking out in the same place as yesterday. I’ve tried the forward leaning inversion from the spinning babies website and cold peas & hot water bottle but he’s not budging!

I’d just go for the c section, given the likelihood of turning at this stage and size must be so low? It’s 50/50 at best I think anyway? I tried ECV at 38 weeks (and moxibustion etc!) and did bugger all (except the ECV made me cry as it’s a bit medieval) but she had been firmly breech for weeks. There’s just no room left!
I had my c section 10 weeks ago and the recovery is tough but you bounce back surprisingly quickly. Have you got support?

Thanks for your advice @Twistering and good to know your recovery is going well. Yes you’re right that it’s 50/50 at best which aren’t great odds.

Yes I have lots of support so I needn’t worry about that. It’s just my fear of c-sections that’s delaying me making a decision but hearing your experience has put my mind more at ease about it.

I had an ELCS at 39+4 for my very big baby. Mine was oblique lie (he was wedged in my right hip). That was 5 weeks ago. They didn't do ECV or offer it, they just scheduled me for ELCS the next day which I was relieved about. Baby is fine and I'm glad we got him out the quickest and safest way for us at the time.

I'm still not quite 100% but having said that, at no point has it been anywhere near as bad as some people say when they're trying to warn against the evils of ELCS. I'm gutted I didn't get the water birth I wanted, but I keep reminding myself childbirth is just a means to an end, and the first day of the rest of my life with an amazing healthy baby.

One big drawback with a ELCS rather than ECV is if you deliver by C-section you can't have an oxytocin drip induction in the future if you're planning on having more kids. But I read something yesterday about how if you don't have any major risk factors you can even have a homebirth in future pregnancies after a C-section these days!

I had an ECV with my DD more or less at the same weeks as you. It was horrible and it looked like a scene out of the exorcist! My gynecologist told me that ECVs can work but the earlier the better.

This baby is potentially breech and I've decided that if he is, I'd rather just book the c section, no point in having an ECV, especially when the first time 9 years ago didn't work.

I personally would never risk having ECV done. The cord can wrap around the babies neck. My DS was breach and I continued with planned c-section! I wasn't going to risk his life but that's just my opinion.

I would go for the c section, too many awful stories after an ECV. I have had 2 home births as I'm scared of hospitals, but I would rather have a c section than an ECV with a chance of home birth.

Hi @WhatTiggersDoBest yes I’m trying to think like you in that whatever way is safest to get him out is the best way. I went to today’s midwife appointment leaning slightly more towards c-section but she was trying to change my mind to have the ECV. I wonder if they are told to say that because it’s cheaper?

I didn’t know that about the oxytocin drip for future pregnancies 😮 thanks for letting me know.

Hi @Rainbowhairdontcare thanks for sharing your experience of your ECV. I can compare my current situation quite closely with yours then if you had your ECV at a similar time to the weeks I am now. It sounds like it was a terrible experience for you ☹️ It is probably unlikely it will work for me as well then and I will have to have a c-section anyway so maybe I should just skip straight to the c-section.

Hi @SeekingAdvice111 and @GummyGoddess it looks like the general consensus is to go for the c-section so I think this is what I’ll do. It’s still terrifying to me but hearing other people’s positive stories and knowing they’d have a c-section again is reassuring.

Not a problem crunchie ! Just do whatever you feel most comfortable with :)

DSis had a failed ECV and ended up thoroughly bruised and uncomfortable. She had an infection after her c-section and I'm pretty sure it was related to all the mucking about with the ECV. I wouldn't do it!
Having said that, still time for bubba to turn - it is possible. I was convinced I was in labour at 39 weeks, but it was baby turning and he didn't arrive for another 3 weeks...

One big drawback with a ELCS rather than ECV is if you deliver by C-section you can't have an oxytocin drip induction in the future if you're planning on having more kids

Depends on the consultants as one of my friends got one in her first attempt at a vbac.

Recovery varies dramatically. I've had two emergency sections and was up pain killer free in a matter of hours.

If you decide to go for the section, they will still scan you before surgery to see if baby has moved.

Yeah it might be harder to get a CS with breech rather than oblique/transverse (mine was perfectly cephalic until three days before I last saw the consultant, then the bugger moved sideways and got stuck, and suddenly I could hardly stand up) as there's some evidence for the safe vaginal delivery of breech babies so maybe they're less willing to go straight to CS? But if the ECV doesn't work you've gone through all that pain and ended with an EMCS anyway.

If you're super attached to a vaginal birth then obviously you might not mind trying ECV but I'm getting the impression you'd prefer a CS. With mine, the consultant warned me of all the risks etc and I had to sign some forms but that was it. A couple of hospital midwives asked me why I was having ELCS, but no-one tried to talk me into anything else.

As far as I know, the oxytocin is only used in inductions, but it can greatly increase the chance of scar/uterine rupture. A lot of the old data about the dangers of VBAC is down to the use of oxytocin.

I hope you get the birth you want!

Would you consider a vaginal breech delivery with a very low threshold for section in labour?

obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.14465

www.nice.org.uk/guidance/ng121/documents/evidence-review-15

@Dinosauratemydaffodils my apologies. I thought there was a blanket ban but I've looked up RCOG guidelines. They say it's VERY risky (but not impossible), and apparently prostaglandin pessaries aren't that safe either. www.rcog.org.uk/globalassets/documents/guidelines/gtg_45.pdf

Don't be too afraid of a section. Recovery can be straightforward. Ask consultant about accelerated recovery, it involves drinking isotonic drinks.
Try and get catheter out and get mobilising as soon as possible.
Peppermint tea prevents trapped wind.
I've had 2 and found it a breeze in comparison to friends having standard delivery.

I had ECV with my DD as she was transverse. This was 15 years ago, and I don't remember being told of any risks associated with the procedure - they made it sound very straightforward.

The actual procedure I didn't find painful, just uncomfortable. And it was successful.

DD was born 4 weeks later (2 weeks late). She was born with the cord wrapped round her neck, and it also had a knot in it. It was only because the midwife was on the ball that she was delivered safely. She was pretty blue, but was fine straight away.

It is only recently I have discovered that this situation probably came about because of the ECV. If I had known, I wouldn't have gone ahead with it.

I had a failed ecv for breech baby - I think it was probably at 38 ish weeks. The procedure was fine, the doctor managed to turn her about 30 degrees but as soon as he removed his hands she just pinged back again so he gave up. Breech babies run in my family so I wasn't surprised she didn't budge. There was frequent scanning/monitoring during the procedure so I wasn't too worried. I'm glad we tried. Had a c-section at 39 week, 8lb 13. It was fine. A lovely experience - I don't really feel sad that she didn't come out of my vagina. The recovery was fine, sore but fine.

Let us know what you decide x

Hi ladies, thank you for all of your advice. I did actually go for the ECV because my midwife said I’d still need to go even if I decided not to have it as the consultant would have to arrange the c-section for me anyway.

The consultant managed to turn baby successfully and we were both monitored for an hour afterwards and his heart rate was normal straight away so hopefully it didn’t cause him any distress. It was very uncomfortable though. Hope the cord isn’t wrapped around his neck ☹️ but keeping a close eye on his movements.

I’ve decided after all of your advice that if he turns back breech I will go for a planned c-section but I just felt in the moment that I wanted to give it a try.

Yay. Well done!

Thank you @seven201!