Breech birth

[Jf]

I need advice. My wife is petrified of a C section and believes Doctors should "try" to deliver our baby girl, one of the twins in her belly, naturally. Problem is, she is transvers, lying right across the cervix.

the docs explained you can't deliver sideways. She wants other opinions.

I need a highly respected "naturalist" type that would agree, this time, with the physicians.

Can you or anybody help me?

I had an undiagnosed breech after 12 hours of labour. I was really into natural. I had a tens but was adamant I wouldn't have any other medcal 'interference'. I had my bath all run & was literally just about to climb in when they discovered baby was breech.

I didn't feel freaked out / upset/scared or anything alse like that at the time. I just moved into practicality mode just get on with what needs doing. I did think it was maybe a bit ironic as I had been so against medical intervention, but had a Caesarian (I did find putting in the epidural a horrible experience - much worse than the contractions and wondered why people actually chose to have it done!).

Afterwards I did look back with some disappointment at not having my "natural' experience, but there's no point for me anyway in getting all steamed up over what you can't have. It wass a shame but there you go. I did it naturally the second time and it was pure hell. A totally different labour. No tapes and baths for me that time.

By the way, you said twins and one is breech - I take it both baies would be delivered by caesarian due to the breech?

My baby was transverse occopito posterior (about as wrong way round as you can get) which wasn't spotted until I had been trying to push her out for over 2 hours (with gas and air only). They explained that they could give me a cesarean, but would like to try to deliver the baby 'naturally'. Well, they succeeded, but only by turning the baby with forceps and then dragging her out with a ventouse. I found the experience completely horrific, esp as I wasn't offered an epidural. Dd was born with huge bruising and very swollen head and I felt very traumatised for months after. We are both completely fine now, but believe me, I would much rather have had a c-section! So, JF, in answer to your plea, yes, it is physically possible to deliver a transverse baby but I really, really wouldn't recommend it.

My god Caznay - that sounds an aboslutely horrific birth.

It was! Even the midwives spoke about it in hushed tones. But time is a great healer (it was 20 months ago) and now I even have fond memories of some bits...only some, mind.

Does anyone know if there's any more likelyhood of having another transverse if you've already had one?

Caznay, I am horrified by your story. I thought I'd had a bad experience but it pales into insignificance compared to yours. I am so glad that you were both OK and that you are even able to find some good parts to look back on now. Which hospital was it that offered you such a brutal option?

Jf, if you contact the National Childbirth Trust on 0870 444 8707 they will probably be able to help you with their Experiences Register or through their antenatal work. Good luck.

I remember laying there and part of my brain just switching off and thinking, this feels exactly as one would imagine if you happened to be having a dining room chair pulled out of you. Also I had very painful bruising under my arms where the midwife and dh had to hold me to stop me being literally pulled off the trolley! I went into what I realise now was severe shock about 24 hours after the birth and found it impossible to hold or feed my daughter. Luckily, the midwives took her away and put her in the nursery for a few hours so I could get some sleep and recover slightly, after that I felt much better.

By the way, this hospital finished second in the Times Good Birth Guide for the south-west of England - mainly due to their low c-section rate.

I'll stop now in case anyone near to delivery is reading this! Unless you are totally opposed to a c-section, in which case I think it should be required reading.

I'm 37 weeks pregnant and have just found out that my baby is breech. Have been given the option of caesarian or trying to turn the baby. Has anyone had this (turning the baby) done - was it successful and did it hurt?

not personally but I had a friend who was offered this and took it, but the baby turned again and she had to have caesarian in the end

Monty, I had a cs for medical reasons. You have to make the decision that is right for you, and I had no options at all, but I had a very positive experience of cs. I had a lovely doctor, nice guy who did the spinal block etc. I was a little nervous, but there was no pain, he was delivered on to me, and my dh and I held him and it was beautiful. The first couple of days are uncomfortable and a bit immobilising (though could pick up ds) but within a week I felt fine and within two I was back to normal, driving and everything. This is just my experience but a cs doesn't have to be a bad thing at all. I'd do it again! Good luck with whatever you choose.

Monty same happened to me at exactly 37 weeks.

My midwife suggested go on all fours, with your bottom pushed up into the air, head near the floor. I did this LOADS, funny position to watch telly in, but it worked for me! Good luck, let us know how you go.

I had a c section for the my eldest ds,now 9 who was breach,the hospital ,Norwich, were fantastic letting me go into labour normally etc but I did end up with a ceaser,it was a great experience ;calm,relaxed, the staff were very supportive and I have very fond memories of the whole thing,the important thing was that we had discussed what would happen if I had a section just as you would for a normal birth and all our wishes were followed right down to the music.
Incidentally I subsequently had two normal deliveries.

Monty, I had a breech baby by elective c-section, excellent experience, would recommend it. I was 'born' breech any my mum definitely does not recommend this. I thought that they didn't turn breech babies, at my hospital they told me that they had stopped doing it years ago. My mums sister had a breech baby that they tried to turn at 38 weeks (in Australia at least 35 years ago so techniques are different I'm sure), but had the very, very unfortunate results of the cord strangling the baby. Not trying to scare you, but have you asked how they do the procedure, how often they do it, what their success rate is etc...

dear Monty,
Thought I would tell you a little of my story. I had an 'undiagnosed' breech. I kept telling everyone from 32w on that it was breech but no-one would believe me. I had an extremely fast labour and ended up with a crash section when I was fully dilated and already pushing the breech out. I am so glad. It turned out that the cord was 3 times around her neck. She would have inevitably died if I had not had the section. This is completely different from your case but I am working up to say that the section involved no trauma on my part whatsoever. I was up and about and back to my very physical job within 2 weeks. 18 months later I had a normal delivery, no analgesia but I did have an episiotomy. 6 weeks later I was still in agony, shocked and bruised, still unable to pee or poo painlessly. In my mind there is no doubt that a CS is less traumatic for the mother, and certainly in my case was the only way for my baby.
Don't be frightened of a CS if one is recommended, my experience of CS was also very positive.
Best wishes for a good experience

Lambchops, this was my experience too. My c/section was heaven compared to a bad tear with ds1.

Just read more of this thread. Caznay, Christ! Poor you. Just to add that even the day after my c/section I felt better than I had after my first, a ventouse delivery.

I had the opposite experience to lambchops. I had an emergency c-section with my first (granted it was after 40 hours of labor) and found that I was incapacitated for weeks. It really took me months to feel that I could do normal things with my body (like lift heavy things and exercise). This time I had a vaginal birth with some nasty tearing and a major blood loss. I found that within a week I was more or less back to normal and altogether the recovery period was far less than with the c-section. However, I am told that an elective c-section is much less traumatic on the body. And if you can't turn the baby you may not have the choice anyway.

Paula, when I was pg with dd 3 yrs ago the midwives were sure she was breech, so at 36 weeks I was sent up to the hospital to discuss the possiblility of turning the baby - with an active 2 y.o. at home I wanted to avoid a cs if at all possible. So in Cambridge 3 yrs ago they were certainly still trying to turn breech babies, although I got the impression that it depended on the consultant - at the Rosie at that time they had a consultant who would try it. I was told that there were some risks of triggering labour prematurely, and that it would hurt (but as I'd already been through labour and childbirth once before I wasn't so worried about that!)

In the end it was all unecessary, they did a quick ultrasound before I went in to see the consultant and dd was very firmly head down - seems that the midwife had been feeling a very muscular little bottom and thinking it was a head .

Monty -It is now recommended by the Royal College of Obstetricians & Gynaecologists that women with uncomplicated breech babies at term should be offered ECV - external cephalic version to avoid C/S if at all possible. It may be performed under ultrasound guidance, often after medication has been given to relax the uterus. The debate about C/S is a major one. You have to be guided by the medical team looking after you. As a midwife I would recommend having this procedure when offered if it means the chance of avoiding an unnecessary section. Good luck with whatever you decide.

Hi Monty

I had ECV to turn my baby, it didn't hurt and my baby stayed head down. The procedure is carried out after an ultrasound scan to check on where the baby, cord and placenta are, you and baby would be monitored before and after for any signs of distress. I didn't have any drugs and the Consultant gently put his hands on baby's and helped her move around, it really was gentle - I think she liked him!!

If you go into labour with a breech baby and baby stays that way they will want to carry out an episiotomy The sad thing is that M/Ws are losing the skill of helping women birth breech babies because so many of them are
born by c/s, and given the choice between birthing a breech baby with a M/W who lacks those skills I believe that a c/s is the safer option. Another alternative would be to hire an Independent Midwife who is skilled at helping breech babies to be born vaginally.

There are risks involved with ECV but these are mainly associate with when the procedure is attempted before 37 wks p/g and when the placenta is anterior (on the back of the womb). The risks other than that do seem to be small, the main one being that you could go into labour and may then need a c/s.

I was not prepared to try and birth my breech baby with an episiotomy and M/Ws unskilled at breech births. The way I saw it was I could have ECV and potentially still have my vaginal birth or I could have ECV and end up with
a c/s which I was heading for anyway - it was pretty clear cut for me.

You could ask to speak to the person who would carry out the ECV - ask them about their success rate - it does vary depending on the skill and experience of the Obstetrician.

HTH
and yes as someone suggested stick your b*m up in the air and encourage baby around too! Look up the information on Optimal Foetal Positioning.

Monty at our maternity units they do ECVs every Wednesday so it is a regular procedure. It is successful in 50% of the times (in our unit) and is done by a consultant.
If it fails they do allow women who they feel could have an uncomplicated birth to go the vaginal route... (I think second times mum for example who have already had a vaginal birth will find it far easier).
I believe they would put you in stirrups at the end as it ensures that your pelvis is wide open for pushing... and (this needs to be checked) they may get you ready for an epidural in case you do need a section... NOT SURE about that.

Personnally I'd try turning with accupuncture. Even consultants in our units recommend it as it can be very successful !

Let us know what you decide and how it went...

Good luck !

I went into labour on my due date, the same day I was booked for a scan to check the position of the baby - the midwives just could not tell! We discovered he was extended breech and were advised to go for a c-section.

However, my consultant was all for my attempting a vaginal delivery on the agreement that they'd perform a c-section if there were problems. As someone committed to having a natural birth I was in heaven!

I was fortunate in having a very rapid labour for a first timer - about 5 hours, and got through it with only a TENS machine (which, because of everything that was happening, didn't get strapped on til I was 5cm dilated). Yes, I had to have an episiotomy, but avoided the forceps and it was a small price to pay - a fantastic team at the Royal Surrey in Guildford ensured I had the birth experience I wanted as much as possible and they all worked beyond their shifts to get the baby out.

It's hard to say if breech is more painful than normal - for me, it didn't feel like 'pain' as such (presumably helped by the fact that, for a breech, the baby was very well positioned and came out bum first) and the worst part was getting his head out. I admit that I did scream at that point, but anyone having a natural birth has to go through the same thing- for some it just happens at the end instead of the beginning! And twelve weeks on I would still do it again!

Natural breech deliveries are becoming much rarer - my attending midwife is head of the unit and had only been present at one before. There is definitely a trend to go for c-sections and avoid potential problems. I think it really does depend upon the hospital and the confidence of the staff - we were incredibly lucky to have the right people around us!

One other thing - a few weeks after he was born, I discovered a lump on one side of my baby's neck - a check with a specialist showed that it was a torn muscle caused by the force of pulling him out at birth. Not a serious injury nor is it permanent - exercise will solve it - but it's worth being aware that this is not uncommon in breech deliveries.

Good luck to anyone faced with breech babies - whatever feels right for you is right for you.

I am 30 weeks pregant with my first baby and my doctor has told me the baby is in a breech position!

Every night I watch tv with my bum in the air trying to make it turn around, can you tell me if its quitw common for babies to lie breech and then turn around?

My baby moves round and pushes out constantly, Im worried they are uncomfortable and thats why they are in breech, does this cause them distress?

I am already scared of giving birth and now im even more nervous. I have read the above emails and the word episiotomy gives me the shivers!!! Do you ever feel the same after this is done?

Mammyshirl, my second baby was breech until nearly 38 weeks, so there is hope for you yet!
Don't get stressed. Go to classes and learn all you can about how to cope with labour.
Good luck with your last trimester.

Spend as much time as you can on all fours. A friend did this and her breech baby turned at about 37 weeks I think. It was, she tells me, rather uncomfortable when he did! I used a large inflatable ball to lean over to watch TV to get DS2 to turn out of a "star gazer" position (can't remember the technical term, it's when they're born face up)

Good luck!