Breech baby - c section or natural delivery?

[BumptasticIn09]

Hi, I am 33 weeks & my baby is breech, I know there is time for him to turn yet but thought I'd do some research incase he refuses. The midwife this morning says he feels like he could be a 'generous size' as it s.
I am seeing my consultant on the 24th anyway to discuss the birth due to complications when ds was born & my severe pnd afterwards, I've already been told I could opt for a c-section if I want..

ECV - anybody had it done, did it work, did it hurt, etc..

Does anyone know how likely it is for a breech baby to be born naturally without forceps or ending in an emergency cs?

Part of me is too scared to try after the trauma of my labour & delivery with ds (4.5), but on the other hand, I don't want to end up in hospital for a week after an elective, & not be able to look after the new baby & my ds properly straight away etc..

Can anybody help me decide what to do if it comes to that? I think I am being expected to tell the consultant my choice on the 24th...

breech vs csection is a mindfield! basically in 2000 a randomised controlled trial was published in the lancet claiming that c-section was the safest option for breech babies. However! that trial has been condemmed as it is heavily flawed and one member of the original team actually spoke out about it in 2005, and the authors themselves have admitted that vaginal brecch birth is not associated with worse perinatal outcomes.
However most hosptials will still advise a c-section as they are scared of vaginal breech! Now itis important if you do go for vaginal breech birth that there is a midwife who is expericened in breech births lookign after you. Also it is best not to have an epidural or any augmentation in breech births as this interferes with the normal mechanisms of labour which are even more important with a breech.
Also the typeof breech presentation you have is important.if it is a footling breech then the safest way to deliver is section.
here is a article about breech birth you may find useful http://www.aims.org.uk/Journal/Vol10No3/handOffbreech.htm

apologies for terrible spelling there also did link wrong. www.aims.org.uk/Journal/Vol10No3/handOffbreech.htm

Thanks ladies, I will look at the link once I have ds in bed

Where I live (Isle Of Man) as long as it's not your 1st birth they encourage, well, support 'natural' delivery as long as the presentation is ok..

I think the decision will be totally mine when it comes down to it, I am just unsure if I am brave enough to try knowing there's a higher chance it'd end with an emergency section.

With a section the only thing that worries me is the recovery time, being able to bf etc.

AGH!! The baby better get his head down before the 24th!

BumptasticIn09

You need to read this.

www.womens-health.co.uk/breech.asp

It explains everything about breech births.

Please visit it might put your mind at ease.

x

Just wanted to tell you that I had a c-section with a breech baby and it was a very positive experience.

It's absolutely your choice of course - and I didn't have an older dc to look after - but it really is not the end of the world.

I think it is also worth bearing in mind that because it has been practice now in this country for several years to perform ceasarean section for breech, many midwives have never delivered a breech, or have no recent experience.

You would ideally need a guarantee of one to one care with a breech experienced midwife imo if you chose to try vaginal delivery.

And most of our elective CS ladies go home on day 3. There may be many factors at play there but it is rare to be an in patient for a week.

Just a small point but I had no difficulty breastfeeding after my caesarian.

also you may want to focus on trying to turn the baby before delivery - acupuncture is really really good for this - application of moxa to the little toe - really works well

Umm, of course you will need a specialist trained in acupuncture to do it for you. SOrry, probably blindingly obvious but didn't want you to think I was suggesting you have a go yourself

I had a footling breech and a c-section with forceps (he was very wedged). It wasn't planned and yet was an excellent experience both at time and recovery afterwards and I didn't feel like I couldn't care for DS nor did I have problems breastfeeding so it may not be a terrible outcome either way!

Thanks ladies, I think I am going to look into anyways of encouraging him to turn, but if nothing works then probably opt for the c-section.
Our maternity unit is only very small, so the chance of getting there in if I go into labour naturally & them not having a midwife on shift or available who can deal with breech is quite high. I don't think I want to take that risk.
I will listen to what they have to say on the 24th when I see the consultant and senior midwife but I think the c-section might be the safest option.
I just need to not be a wimp!!

Rempy, im just wondering are you a healthcare professional? If so why are you so postive about c section mums going home after 3 days? It is major surgery! You need lots of rest although yes it is important to be mobile as well. I had a cs due to ds being breech (privately) and there is no way I was well enough to go home even though I made an excellent recovery. After a week in hospital, I was on top of the world and ready for anything. I dont mean to pick a fight or anything but I get the impression that the NHS have a very flippant attitude to CS, 2 or 3 days in hospital is not enough. OP I dont mean to scare you, it is fine, you will be fine, just have lots of gentle walks in the fresh air, lots of rest, keep up you pain relief and you will be fine. Also had no probs with breastfeeding .

bellasmama - it's ok, you've not scared me, I don't like the thought of a week in hospital, but then who does! Though if it comes to having a cs I can't see myself rushing out, my only real concern with staying in is being away from my ds (4.5), though in the last year he is used to me being in hospital as I was in for 2 weeks in May with a kidney infection, then another week in January when I went into prem labour.
He takes everything in his stride, but when his new baby brother is here I think he may find it harder.. And he'll only be allowed to visit between 2&4, though I think I should have a single room which would be better for him not wandering off or disturbing anyone

Only time will tell I guess!

Bumptastic, If you have a c-section the NHS should put you in your own room and you should get one to one care.

Sometimes they fail to do this but it should be done and you will need to make sure they have a room all ready for you.

"Breech birth
A breech birth occurs when a baby is born bottom first. Your obstetrician and midwife will discuss with you the best and safest way for your breech baby to be born. A caesarean section is recommended and it is likely they will advise this.

You will be offered the option of an external cephalic version. This means the baby is turned into the usual head down position (cephalic) by pressing on the mother?s tummy."

This can be quite uncomfortable but you may wish to speak to other mums who have had it done.

1 in 20 deliveries are 'breech'

I have had an ECV done and honestly it did not hurt one bit! Although it failed for me it is certainly worth a go.

I had an emergency c-section and was more than well enough go home after 2 days however another mother who had another child at home was able to stay much longer to recover.

Chellesgirl where on earth did you get this idea that the NHS will put you in your own room if you have a c-section?

www.wwl.nhs.uk/Library/All_New_PI_Docs/obs_and_gynae/026%20breech_baby_what_are_your_choices.pdf

Please, Please read this Bumptastic before making a decision.

Chellesgril - I am sorry but that is totally and utterly unrealistic to expect your own room and your own midwife if you have a CS.

As an example, the unit I work in has just 4 side rooms. We can easily have 14 women on the ward recovering from a CS and there may be women who need a side room because they need barrier nursing. In terms of staffing, in the day there will be 4 or 5 midwives in total, looking after the whole ward. At night you're lucky if there are two midwives. A side room and a midwife for every mum who's has a CS just aint gonna happen!

what should be provided by the NHS and what is provided in actuality is not always the case. Where I work sounds similar to daisymoo, all c.s mums will get a private room for the first few hours after delivery, with a MW with them for a while, but certainly no guarantee of that continuing for days.

in theory all MWs should be trained to deliver a breech, as undiagnosed breech deliveries do occur.

Im not saying it will happen as I stated.

But the head consultant on my ward - after I was meant to get my own room after having a premie told me that Every mum who has a c-section or premie birth should get thier own room due to the fact they need 1to1 care.

The unit where I will deliver has 6 side rooms, though these are given out for ante-natal problems & mums with babies in special care first, then c-sections, & then'anyone else'
I in no way will expect 1 to 1 care, our hospital sounds like what Daisy Moo has described, not many staff, it has 16 beds in total (I think) 2 4 bed 'wards' 6 singles & 1 2 bed which is where you go for initial checks/referals for monitoring etc.. 4 delivery rooms & 1 pool room.
I think there iare about 800 births a year, though the unit always has something going on, as it deals with everything maternity related from 20 weeks. They have had to stop offering home births due to being 5 full time midwives down on the unit, so everyone is working longer shifts as it is & they can't spare anybody to go elsewhere.
I totally understand all of this, the care is excellent, the unit & all equipment top of the range & the staff are lovely.
I can't see how any hospital can guarantee 1to1 & a private room for any patient..

but what they should get and what they do get are so different . i would love , love , love to see one to one care for all mothers, private rooms, in fact one room for ante , intra and post natal care so you don;t have to transfer all over the place within the unit, and that you would know the MW who was caring for you.

Hi, I had a c-section due to breech baby. Baby turned breech at 35 weeks as head was too big for my pelvis. Had a failed ECV at 36 weeks and c-section at 39.
C-section had complications and certainly wasn't the pain-free, bouncing out of bed experience I had envisaged but I appreciate it was a slightly unusual situation.

It is a really tricky decision to know what to do for the best but whatever you decide, please be comfortable with your choice and don't feel bullied either way. If I am honest, after my experience I would have checked breech labours out more thoroughly but am not convinced I would have made a different choice.

Sorry, hope my incoherent rambling helps, said baby now a huge toddler trying to help type!

Thanks, yes I think that does help I know what you are trying to get across.
DS was 7lb11 but they are already saying this little man is big, I am quite tall at 5ft7-8 but I have a tiny size 6-8 frame, so I think some of the concern is that although I have already birthed a baby so they know I can - though there were interventions.. & as they think this one is larger is it safe for me to try breech. I guess I will see what the next scan shows & listen the their advice..