Breech baby- ECV or c section?

[tova]

I'm currently 37+1 and was classed as having an unstable lie however my last two scans the baby has presented as frank breech each time. I've been booked in for an ECV later in the week however this was explained to me by the Dr and midwives as a very simple procedure and no risks were outlined. I was looking into it further and found an old mumsnet thread where a lot of women who had had an ECV had had complications which they felt were a direct result of the ECV. On this thread there were also posts from women who had decided against an ECV due to 'the risks' involved. I am trying to find more information on the risks of an ECV versus a c section to ensure that I am making a fully informed decision.

This is my second pregnancy, my first was an induced vaginal birth with no complications.

It would be great if anyone could point me in the direction of good information about the pros and cons of each or if anyone would be happy to share their own experience/choice when they had a breech baby.

Hi @tova I recognise your username but can't remember from which thread!

I had this dilemma with baby number 2, and now find myself in the same situation with baby number 3.

I had decided not to have the ECV with baby 2. The risks felt too high and I worried a lot about the baby being in distress (I have suffered several miscarriages). Also, baby can turn back! And from what I remember you are at risk of an EMCS there and then if there's a problem.

I did much research via the Spinning Babies website. I spent a lot of time hanging my upper body over our sofa and the other positions she suggested and the baby turned - I was able to have a natural delivery.

With this baby I'm trying the same techniques again and have decided I won't have an ECV. Interestingly when I told my consultant I wouldn't have the ECV he looked me straight in the eye and said he wouldn't want his wife to have one, which I found very interesting!

I might be on the old thread - I also had an unstable lie, got an ecv (was baby 3 and I was still hoping for a home birth). ECV was quick and easy but did turn back again. And then turned again. And again. Etc. (I also had extra fluid which may have made it easier). I also did lots of spinning babies stuff and in the end she was right way around but I was induced at 40+14 and didn't get my home birth.

I had a breech baby for DC2 after a fairly straight-forward spontaneous labour for DC1. I did go for an ECV - it didn't work but also wasn't more than a bit uncomfortable. It was clear very quickly that the baby was well wedged head down. I did then have an ELCS. Most people on here seem to have great ELCS. For me it was really tough - I lost a lot of blood, reacted badly to the drugs and was too poorly to hold the baby for the first few hours and found recovery difficult. Also, despite my requests, they whisked the baby away to do checks and brought him back fully wrapped up so I couldn't get proper skin-to-skin. I went to to have an induction for DC3 as he was late and found it so, so much better than my ELCS.

My unusually bad experience of the C-section made me very glad I had tried the ECV so that I knew I had done what I could to flip the baby. From what I heard, the risks of an ECV are that it could break the waters which would mean that the baby would have to have been got out then.

I did research into vaginal births for breech babies - it seems like the risks and chances of uncomplicated birth are not too different for breech babies after a vaginal birth compared to normal risks for first babies, but only if the baby is in frank breech position with legs up by their head. It's much more risky if the feet are down or legs crossed. My DC wasn't in a frank breech position so I didn't look more into the risks of things like hip displacement for frank breech babies. I think if DC3 had been in a frank breech position I would have tried for a vaginal birth after my difficult ELCS experience.

https://www.rcog.org.uk/for-the-public/browse-all-patient-information-leaflets/breech-baby-at-the-end-of-pregnancy-patient-information-leaflet/

I'd have the section

That's what I did, in your situation

I would have the section. My experience of an elective section was easy and breezy with a very straightforward recovery.

ECVs can be brutal and traumatic and - worst case scenario - cause massive harm to the baby (even death). Some babies are breech for a reason, like being entangled in their cord, and forcibly manhandling them into another position can be catastrophic.

I went C section for my breech baby (after doing all sorts of spinning babies stuff too). I was suspicious when the midwife said the ECV wouldn't hurt but I could have gas and air if I wanted!! If it's so painless why is that an option?! Also someone in my nct group had an ECV, the baby turned head down but she ended up having a c section after a 4 day labour anyway. That was the decider for me!

I had a nice calm planned c section. The recovery is a pain but manageable. I also didn't have another child at home which is something to consider.

I had an ecv, it didn't work and wasn't very nice at all, very rough and baby wasn't for moving at all.
My section was great, straightforward and easy recovery. I went on to have another elective section for my second baby.
My advice would be go straight to the elective.

Hi OP. My DC3 was breech right up until 37 weeks. I opted for a ECV and I do not regret it one bit. The risks, not overly convening in my opinion, we're explained to me and I felt confident that I'd made the right decision.

I had an ECV at 37 weeks and luckily she was turned successfully and stayed that way. I had no complications and other than being a little sore around my stomach for a day or two, I felt absolutely fine afterwards. I had my homebirth which was very straight forward and baby was absolutely fine.

Personally if ever in that position again I'd make the same choice and go for an ECV.

Mine all go breech late on and I have to wrangle them back head down with a combination of spinning babies exercises and a magic doula lady who comes and does a rebozo session. I have no idea how rebozo works but she's flipped 3 out of my 4. The only one that didn't flip was my first who I backed out of the rebozo session for and had an ecv instead. 🤦🏼‍♀️

There's a new Cochrane review of moxibustion that shows that if you try moxi then you're less likely to have a breech baby. Equally you can have a breech birth. I've had two sections and two vba2cs. There's no way on earth I'd opt for a section.

The aim of flipping a breech is to lift them out of your pelvis and then create space in there for them to turn. If you have a birth ball make sure your hips are higher than your knees, your ankles are wider than your hips and you're doing figures of eight/hula hoop movements in varying directions and speeds. DON'T BOUNCE ON THE BALL!. Spinning babies website is excellent at giving you moves to do to flip baby.

Best of luck for whatever route you decide to choose. I was in two minds whether to have the ECV or not. In the end I just attended the appointment so that I could hear what they had to say about it. They took the time to explain everything in detail to me, the risks of the procedure, pros and cons. Also highlighted the risks of having a c section, and the pros of trying to avoid it if possible. They said if it was too uncomfortable we could just stop the procedure at any time. They also explained how they monitor whether baby is distressed or not.

They gave me space to think about it. After probably 15-20 mins of thinking, I decided to give it a go, especially because I could tell them to stop if it all got too much during the procedure. They tried to manoeuvre and turn baby around with no joy, meaning that they'd have to book me in for a c section delivery. I won't lie, the ECV was uncomfortable and unpleasant, but overall for me it was worth seeing if it'd work. Later that night, I had been sleeping on my side for a few hours when all of a sudden out of nowhere I felt baby free it's own feet from my pelvis and slightly turn around. It felt like a pinging sensation (hard to explain). I couldn't believe it (sort of "too little, too late" though). Baby didn't spin around fully and was later delivered via c section.

Hello! My baby was breach from the 20 week scan onwards, that's just where she stayed. Later on in my pregnancy there were lots of conversations about the EVC but I wasn't at all confident it would work, particularly because she seemed very comfortable where she was. I had a c section (ended up going into labour before it, but all was fine) and really liked knowing what was going to happen. I felt I had an element of control at a very tricky time.

Good luck with whatever you decide!

I had 2 breech babies, 2 C-Sections with no problems at all.
EVC only works about half the time anyway and I didn't think it was worth the risk/pain.

Thanks for all the responses and sharing your experiences. It's such a hard decision to make. I'm reading up more about the risks of the ECV and that's really putting me off, I've heard they can be really painful but I'm not as worried about that, more about whether it could potentially cause any issues for the baby.
However I'm really worried about the recovery period for a cesarean. I have a toddler who is just 20months and very clingy with me, plus two stepchildren who live with us full time and need a lot of attention from my partner so Im worried about how much he'll actually help/look after me and worried that I won't get the rest and time required to properly recover from a c-section. My wee girl has never been away from me overnight as well so the thought of being away from her for a number of nights while I'm in hospital after a c-section is scary for me. These are the biggest reasons why I'd want to avoid a c-section and was open to giving ECV a try but I'm seeing very few positive stories about them working out well for people which makes me nervous.

You don’t have to be away for multiple nights after a section. After a traumatic vaginal birth I nearly lost my mind not being able to sleep on a postnatal ward (four days and three nights of virtually no sleep nearly killed me!) so I asked for a fast discharge post c section. I was home within 26 hours.

Whether your husband is going to pull his weight is a separate issue. But there’s no guarantee that a vaginal birth will be complication-free, so it would be a shame to gun for a vaginal birth just because you’re worried your partner is too useless to run the home without you.

Good luck whatever you decide.

That's good to know that there is the potential to be home sooner than I'd thought.

It's not that he can't run the home without me, but I have a close friend who had a c-section recently who said that she needed her partner to hand her the baby for feeds initially because she couldn't even pick the baby up herself... my concern is that my partner will be too busy entertaining my stepchildren (often away from the home as this happens a lot right now) to be able to do things like that for me when it's needed. I hope I'm wrong but it definitely does make me more nervous for a section.

I only needed to be handed my babies on the first night. Night 2 it was tricky but manageable, but by day 4 I was out shopping and making breakfast for the toddler with baby in the sling -pain free (but dosed up, just to be sure).

Most women only stay in one night, sometimes two. I think on average a woman having a c section stays in hospital half a day longer postnatally. Obviously you aren't going in during labour though, so depending on how long a labour you'd have, you might be home sooner with a section even.

It’s been eight years but I don’t remember not being able to pick up my baby. It might have been a struggle in the first 24 hours after surgery, picking up a baby when lying in bed from one of those bedside cots, but once home I think I was able to do it myself.

@tova I have a toddler who is just 20months and very clingy with me, plus two stepchildren who live with us full time and need a lot of attention from my partner so Im worried about how much he'll actually help/look after me and worried that I won't get the rest and time required to properly recover from a c-section.

His main focus should be caring for his 20 month baby, newborn baby, and DP recovering from childbirth (c section or vaginal). The three of you require the most support as you will all be very dependent on him. His older children (unless they are severely disabled) can entertain themselves.

I've had two sections. First one was an emergency, which went wrong and my bladder was damaged, and I had to have another operation and catheter for 6 weeks. The other was planned, and was a breeze in comparison. I was out of hospital very quickly the next day - as I was desperate to get home to my older child, who I had also never left. Recovery was actually really fine. I was up and about really quickly after having my second, and I was able to lift them myself from the first night. I didn't need any help at all. The hardest part was not being able to freely pick up my oldest child for a while. It's supposed to be 6 weeks I think, but I definitely did it sooner, and it was fine.
I would never worry about an elcs, but wouldn't want an emcs. Good luck!

DC2 was found to be frank breech at a scan at 36 weeks. Like you, I had had an induced vaginal birth with DC1, and was hoping for another vaginal birth. I opted for an ECV. If the ECV had failed, I would have made my peace with an elective, but would sooner have tried for a vaginal birth first. I can't tell you how the ECV went, as he turned in the meantime. I have an educated guess as to when it was, as DC2 did a big movement around that time. But DC2 was one for big movements as a rule, and it felt no different.

Unfortunately DC2, the awkward little sod, then went on to get stuck in labour (back to back + deflexed head), and I wound up with a C-section anyway. Recovery wasn't anywhere near as bad as anticipated, though we did send toddler DC1 off to stay with family for a few days. Other than the time unable to move my legs, I had zero issues lifting baby up. So long as I kept to a schedule of paracetamol and ibuprofen was relatively comfortable. Only needed the regime for a few days, then as needed for about a week more.

We were discharged from hospital the next day, so only stayed the one night. I felt slightly nervous about going home and not having the expert midwives there! But extremely relieved to be going home at the same time and be around my creature comforts.

I found getting in and out of bed a struggle to begin with as our bed is quite low down. Any movement that involved engaging my core muscles just took extra time. I tried my best not to laugh, cough or sneeze too hard for example. However the pain relief I took home with me was more than enough, I took paracetamol and ibuprofen but didn't touch any of the codeine tablets at all. I decided I'd only add codeine to the mix if I was really in need of it - that moment never arose. The pain relief works a treat and makes you feel like you can do anything. You just have to keep ontop of taking the doses at the correct times and keep yourself topped up.

I purchased a litter picking tool to help me do my chores around the house. Saved me from bending down to pick stuff up on those days when I was feeling quite sore.

It would be 100% no way an ECV for me. No way.

I wanted to come back and update here, just in case anyone else who is searching up about ECV's comes across the thread and would find the information helpful...

I almost decided against the ECV based on horror stories I kept reading online, however the hospital statistics of complications occurring didn't seem to fit with this and so I decided to go in for the appointment and decide on the day depending on how I felt from talking to the Dr. When I went in the baby was transverse. The consultant was excellent and really put me at ease so I decided to go ahead with it. I was really nervous about the pain but it was done in seconds and really didn't feel more than mildly uncomfortable.

The ECV worked but because I live so far from the hospital and the baby had been transverse, they wanted to keep me in for a couple of nights to make sure the baby didn't turn back. If the baby turned back then it was suggested to try the ECV again and hold the baby in place while inducing. Whilst I was in the hospital the baby turned to transverse then breech again and then transverse so I was kept in longer. After a few days the baby turned head down again themselves and after staying that way for long enough I was allowed home. The baby is now head down and engaged so it's just a waiting game now...

Oh, and something that the consultant told me that I thought was important was that he said that an ECV should never be overly painful and that when it's being performed the baby should move without too much force or pressure. He said if he feels any resistance at all then he does not carry on as in his opinion this is when damage can be done and there is a reason why the baby is in the position they are.