Possible CS because baby is breech: how should I prepare?

[PhilB]

Hi all. I'm 35 weeks, baby's breech and has been since they started palpating at about 28 weeks. MW says that if it hasn't turned by 36 weeks the chances are it won't (although I know some babies wait until the last minute). Am booked for acupuncture / moxibustion on Friday (thanks for previous tips about booking this) to have a go at turning it, and they'll send me for ECV if it's still breech when I see the MW next week. But possibility of CS now seems quite large (apparently they won't try a vaginal delivery for breech for a first pregnancy).

I have been quite upset about it - it's not what I had in mind when imagining the birth - and feeling that I have failed somehow, or that the baby hates me and is punishing me (daft I know). Rest of pregnancy has been absolutely normal and fine, so I really wasn't prepared for the idea of a CS.

Anyway, time has come to get over the upset and get ready for possible CS - so what should I ask the MW / GP? How should I prepare? What options might I have?

I was breech until 38 weeks so keep your options open would be my best bit of advice. Where I live if he stayed breech they would have given me a section at 39 weeks but also given me a scan just to be sure at that point too.

Bring lots of Arnica for recovery.
Organise 24 hour help for the first two weeks at home so you don't have to lift anything (that includes cooking, lifting other children, carrying groceries, hoovering, etc.)

Do some cooking and freezing before you go to the hospital.

Make a nice CD of music you want them to play in theatre.

Get big ugle knickers that are high enough that they won't cut across the stitches.

And last but not least, do not feel guilty. Having a caesarean in order to bring your baby into this world safely is a perfectly natural thing for a mother to do. You do want your baby delivered safely, right? Of course you do. This is a wise decision. One taken with your baby's welfare in mind. Enjoy not having to go through labour and delivery. And enjoy telling your DH that it is his job to wait on you 24 hours a day for the next two weeks.

Oh, and enjoy going for a wee post delivery without a painful burning sensation.

Exactly what Athene says, I am 13 days post sections and doing well, organise a food delivery before you go in, go out the night before for something to eat with you DH.

Make sure you wax/ shave/ or whatever your lady garden. You do NOT want the Bic razor experience!Not nice.

I ended up with a CS as once in labour they discovered baby was breech and big in spite of midwife telling me he was head down and engaged. I have to say because he was an emergency I had no time to panic or stress over the operation and it was all far better than I imagined. The pain afterwards was perfectly manageable, and I was able to breastfeed fine. Go in with a positive attitude. At the end of it you will have a lovely baby and that is all that matters; not the method of how he arrived in your arms.

also try
spinning babies
and
OFP

Also don't give up hope that baby will turn

I had ECV at 37wks with my first(after acupunture & moxibustion had failed) which worked - only for DD to turn breech again 2 days later...

However she turned head down of her own accord at 39wks on the morning of my pre-op appt for c/s - they didn't believe me until they scanned to check! (I knew as the kicks were in a different place) She was born at 39+4 weighing 8lb8.5oz, so not exactly small either (ended up as an em c/s, but that a whole other story )

Don't blame yourself, it's nothing you've done, in fact there is sometimes a tendency for breeches run in families. (My mum had 2/3 breech)

If a c/s is on the cards think about your c/s "birth plan" - eg screen lowered so you can see baby born, music in theatre etc. It is possible for c/s to still be a very special experience, especially when elective (I've had 2, second one elective after VBAC plans went north at 40+10...very disappointed but still managed to have a "good" c/s - if there is such a thing )

Oh, you will be positively starving after the section. Bring food! (but beware that the anaesthesia might make you sick) So I suggest eating half of it in case you puke it up. Then you can eat the other half later when the drugs wear off.

Food.

Hiya, do not feel guilty or disappointed about having a cs. my ds was breech and failed to turn after ecv so I had a planned cs. It was really fantastic, so calm. DH and I got up really early in the morning and sat up talking, watching the sun come up and generally getting excited. Went to the hospital about 9am.

Was booked in and sitting in the waiting room for a while as there were two emergency cs' ahead of me, so dh and I got all giggly and excited and took loads of photos of each other in our surgical gowns! I then walked in to theatre with dh, had all my lines put in and the spinal block (I was a bit shaky for that, but it was done in about 5 minutes) they then started the cs and ds was born about 5 minutes later.

One thing I really regretted and I would strongly urge you to do (unless you're really squeamish) is have the screen lowered as your baby is being born. I really regretted not seeing ds as he came out. I was really worried I'd see my internal organs and be completely grossed out, but in reality you do have a big bump in the way, and the incision is so low there's no chance of you seeing anything.

I would also insist on having your baby handed to you as soon as they've done whatever they need to do (the baby may need a bit of suctioning to help him/her breath - totally normal for cs babies). My ds was handed to me cleaned up with nappy on and dressed and I never got to hold him naked skin to skin which I now really regret. I think I was so bowled away with the whole experience I completely forgot to ask!

After ds was given to me he never once left my arms, he was latched on in recovery and feeding well, and my milk came in two days later which is pretty good considering people often have a delay in their milk coming in if they have a cs.

I recovered really quickly from the cs, was on my feet the next morning after the catheter was out and had a shower. By day two I had no pain and didn't bother with any pain meds, I was sent home on day 3. I did have two baths a day on the recommendation of my mw and put a few drops of lavender oil and tea tree oil in to help healing. Don't know if it works but it smells lovely. I felt 100% after about a week although I did take it easy for about four weeks. I was driving again after about three weeks.

In terms of preparation, I don't think there's much you really need to do, getting a freezer full of food is a good one but I would have done that anyway with a newborn. Buy some high waisted knickers that'll sit over the top of your scar. Some people suggested taking arnica, but I totally forgot once ds was born to take any more, I did take some before the cs but nothing afterwards and I had no bruising and healed very quickly.

I hope everything goes well, if the baby doesn't turn don't worry about a cs, it's really not as bad as you think. I was very grateful for a couple of extra days in hospital too, I know some hate it, but I was a nervous first time mother and I really appreciated having midwives and health visitors around me all the time so I could bombard them with questions! Good luck!

Hey, great suggestions, thanks. Love the big knickers and eating out. Also the CD suggestion - can't imagine DP being impressed if the baby's born to the sound of an unapproved band! I think it's just the shock of something so different after all the antenatal class preparation for breathing and pushing. But I know rationally that if it's the safer option for the baby then it's the better one. I think they scan before the ECV, and before the CS to check again.

betterhalf - my baby also seems to confuse them - MW has to check position based on where the heartbeat is as can't tell bony bum from head, and GP couldn't tell at all - slathered my tummy in gel trying to find heartbeat and then referred me for scan last week where they confirmed it was breech. Not v. reassuring.

betsy - I have been trying the various turning things, no swimming on my back, watching TV on all fours, sitting on my exercise ball at work. What can I say - it's a stubborn baby! But I think at some point I will have to accept that if it wants to be breech then that's how it wants to be - don't like the idea of trying ECV over and over if it's not happy with it and keeps turning back.

HeadFairy - thanks for your account. It makes me feel much more positive about the prospect of a cs and subsequent recovery. I'll get working on those amendments to the birth plan.

You're welcome. It may not be the ideal way to have a baby but it no way does it have to be a disaster either. I hope it all goes well

the other option you have is to insist on a vaginal delivery. it might go against their guidelines but it is not in anyone's power to make you have a c section. the stats on relative safety of c section vs vaginal birth are quite controversial, apparently. so the choice is yours . . .

immediate skin to skin would be wonderful to try to arrange. if not, would you want dh to hold the baby for you? personally, i'd also take in a mobile and numbers for nct breastfeeding just in case you need them. you're in hosp longer so harder in case you need support with bf

if you do want to go for a vaginal breech then contact www.aims.org.uk for useful info

if you do elect for c.s, then the closer to due date as possibel, is better for baby, and you can request a scan before the op to ensure, as even full term babies can change position

Hi. I talked to the MW and she said they just wouldn't deliver it vaginally at the hospital as it was my first baby. She seemed pretty firm about it and I don't think I feel strongly enough that I want to have it vaginally if it's breech to insist.

Another scan on Friday and then ECV next week if it's still breech, and then we'll talk about CS options if that's not successful. If we can leave it as late as possible then at least I'll feel like the baby had a good long time to decide to turn. It's the idea that they might want to do it weeks early and the baby might have turned in that time that I find a bit depressing.

Hi PhilB

I am in exactly the same situation at 34 weeks, and just wanted to say I know exactly how you are feeling.

I will obviously do whatever is safest for my baby, and if they tell me it has to be a section, then I wont resist. But at the same time I am quite distraught at the thought of a section, after all the work I've done on coping with a normal birth, I feel like I'll be robbed of what I wanted.

My sensible brain knows this is ridiculous, and the only important thing is a healthy baby, but my non-sensible heart is not dealing with it very well.

Anyway, really good luck over the next few weeks, keep us posted. Fingers crossed the little blighters do some somersaults!

I am also in the same situation - 36 weeks and baby is breech. I really wanted a home birth and feel sad that i may have to have a c-section. Like PennyB the sensible part of me just wants a healthy baby, but the emotional side wants the natural birth i wanted to atleast attempt. I will be booked in for an ECV next week - but still hoping baby will turn before then.

HeadFairy - Reading your experience has made me feel one hundred times better!

Hi Phil B,

I just wanted to say don't be too upset...a planned CS is just making sure DC is okay. I had a friend who had to have a planned C-section as DD was breech. When they came to take her out, the umbilical cord was wrapped 3 times around her little neck, so a natural birth would have been impossible. Thankfully her MW and doctor didn't even try to turn the baby.

Most important thing is that you and the baby are safe!

Goodluck,

DD was my first, was breech and was born as such at home with IMs. We thought long and hard before making that decision and I fully recognise that whilst it was the right decision for us that doesn't make it the right decision for anyone else.

Two books that I found very informative were "Breech Birth" by Benna Waites and "Breech Birth: What are my options" by Jane Evans. The Benna Waites book has a chapter on complementary methods used to encourage breech babies to turn. If you want to look more into vaginal birth, googling Mary Cronk is a very good starting point.

If you do want to investigate a vaginal breech birth, make sure you're very clear on what you're talking about - a hands-off, vaginal breech birth (a la Mary Cronk) is a long LONG way from a medicalised vaginal breech delivery, and if all I could have had support for was the latter I'd have been in theatre like a shot! If you want to investigate the vaginal breech birth options within the NHS, it would be worth talking to the Head of Midwifery - breech birth is supposed to be a core midwifery skill, its just a question of how much practice they get at it now CS for breech is so common.

Incidentaly, I'm always intrigued as to why its significant that its a 1st baby. I've never managed to find out how that is supposed to increase the risk - if anyone knows I'd be interested.

Hi all. Went for the scan last Friday and it turns out the baby's turned itself round, head-down. So no need for them to refer me for ECV after all. I have no idea when it happened, but it must have been in the last few weeks since the 34 wk scan. I did go for the moxibustion the week before, but who knows if that's what did it or if it's coincidence.

I do feel relieved, but also pretty apprehensive now - after preparing for a calm, scheduled elective CS I'm now back to the idea of chaos and pain! But I will be taking my big pants and CS birth plan in with me regardless - who knows what will happen or whether the baby will flip round again.

Tangle - I got the impression that they were reluctant to do breech vaginal delivery for a first baby because I was more likely to panic or not be able to get through it in some way, but not sure how I came to that conclusion, it wasn't really spelled out.

PennyB and Lcy - I think it's really hard that all the antenatal stuff focuses so much on vaginal birth, especially when the CS rates are high enough to warrant more about it. It doesn't help you to build a positive idea about having a healthy baby when the emphasis is so much on how that's achieved. Anyway, hope they all turn and stay well wedged there!

Thanks for all your help.

That's really good news, so glad for you. Think this one is still head up, but am going for moxibustion on Friday, so fingers crossed.

Best of luck with the birth, and send out "head-down" vibes to the rest of us!

PB