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...

I ended up having ds by section as he was breech and ECV turned him from frank breech to footling (little beggar was digging his heels in). I didn't try very hard at the ECV, I found it quite uncomfortable and scary, and I was also really ill with a chest infection and didn't want any more fiddling about and went for the section.

To be honest I was so nervous about delivering him vaginally if he was breech in any position because the midwives just didn't instill much confidence in me, they all kept saying there weren't many mw at the hospital who were experienced and if they weren't on shift that day etc etc. I'm sure they were scaremongering to get me to commit to section, however after the ECV there was no choice for me.

My section was very positive, very little pain, up on my feet after 12 hours and healed very quickly with no problems bfing afterwards.

Good luck with turning that baby!

How was your first birth? you mentioned complications. This may have a bearing on how you give birth this time.
most babies will turn but I'd try all that has been suggested so far plus ECV as head down as midwives are more used to babies being born this way.
All midwives have training in manoeuvres to "deliver" breech babies. The skill comes in not Delivering unless progress is not being made. babies can be damaged and get stuck if pulled inappropriately. A breech labour usually progresses well and quickly with no assistance needed for the birth. It either happens naturally or you need a caesarean. there is no place for induction, drips to speed things up, epidurals, labouring on your back with legs on stirrups etc.
it's a hard choice.

DS was back to back, his shoulder got stuck, they already knew he was in distress beforehand, he had opened his bowels, and his heart rate was suffering, so i had had drugs to stop and start my labour, i was in for 3days before i eventually gave birth, they had to cut me too.. Lots of sheets/hands, pushing, pulling etc..
He wasn't delivered in the UK though, I was in Germany at the time, different countries, different ways & all that.. I have been told if I was in the UK I'd have had a c-s..

as i said a breech birth would have no intervention. if it doesn't happen naturally no drugs etc should be tried.
it is common for babies to be back to back in a first labour. shoulders more likely to get stuck if you are induced, have an epidural, give birth on your back or need forceps or ventouse. the drugs used to start or stop labour can cause fetal distress. very unlikely to have problems in subsequent births.
They think the baby is bigger but what do you think. scans can be very inaccurate in guessing size!
more breech problems are caused by small premature babies rather than well grown ones. i know big babies can be born vaginally-breech or head first.
if a baby really is too big it's bottom won't go into your pelvis, labour won't progress and you can be given a caesarean.
i'm not anti-caesarean as i'm grateful for one I needed but recognise it is major surgery which carries potentil risks for mum and baby.

I would personally go for c section, definitely. Just my opinion though. Good luck with your decision

I'm a health care professional, and I can reassure you that following a C-Section it is highly likely that you will go home on day 3 or even if doing well on day 2. Locally, there has even been one done as a day case! This has been standard practice for years (not day case!), and very few women need to stay in longer than that. It is usually only if there are unexpected complications with either baby or mum, and doesn't happen very often. The kind of things that could cause you to have to stay in can happen with a vaginal birth anyway, infections, bleeding, jaundiced baby etc. Complications are much more likely after an emergency C-section, so my general feeling is that if you think you are going to end up with one, do it electively. That way everything is calm, planned and the risks are a lot less.

The issue of midwives and doctors not having experience in vaginal breech birth is not to be taken lightly, and is a real factor. Things can go wrong very quickly and you really need to have someone with the experience to deal with that. There is a difference between knowing what to do so you can cope in an emergency (unexpected breech) and having plenty of experience in doing it so you feel comfortable doing it planned. A big unit might have someone happy to do this, many small ones won't.

You also should not have any sort of induction or augmentation with a breech birth, and you do have to accept a higher risk of things going wrong.

I personally would not have a vaginal breech birth. However that is just me.

"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!"

My local obstetrics run unit sends you home on day 2 or 3 after a C section if no complications are apparent.

where I work c-section isn't a reason to get a side room, mums with babies on nicu, barrier nursing twins is. You do not get your own room for a few hours after the birth you go to a 4 bed recovery ward where the curtains are open so midwives can keep an eye on you. Imagine being in a side room 30 mins after csection having a midwife pop in now and again and you having a PPH but no-one can see you.
cs is so common in my unit you would need a whole ward of rooms to ensure people with cs got a side room.

oh yeah also all our cs women go home day 2 or 3 if all is well.

in my area, there is a midwife run unit and an obstetrics run unit.

CSs are only available at the Obs unit. If you are diagnosed as breech the MW run unit will not take you and the Obs unit routinely does CSs for breach

So, because of this, (and a bit ironically) the only place where the staff are practiced (and therefore competent) in vaginal breech births is the MW run unit where it sometimes happens as a surprise.

If I was diagnosed in advance as breech (and therefore sent to the Obs unit) I personally wouldn't push them for a vaginal birth as the staff are not used to them and that is VERY important IMO. I really dont think that staff's competence and confidence in what they are doing should be underestimated.

i totally agree with finding staff who are competent in breech birth as this has a definate income on birth outcome. if you need to talk to one of the most experienced breech expert midwives phone Mary Cronk. I would not put myself at risk from unesessary surgery unless there was no other option. Surgery is not risk free nor is any birth.
Independent Midwives often have breech birth skills. Breech birth for carefully selected cases is a good option for mother and baby.
Lets hope baby turns before birth.

Ds1 was breech and I opted for a C-section and it was a very positive experience. Totally different from an emergency section.

I had an ECV and it was scary and painful.

However, this is your 2nd baby and everything will be "roomier" so might be easier to turn.

I was also given special exercises ( can't remember them now) to encourage him to turn but he had other ideas.

Not been around but yes, I am an anaesthetist, and as others have said it is pretty standard to go out on day 3 post section.

It is big surgery but mothers are very well motivated to go home after having had a baby. Its not like other surgery where resting in hospital is a pretty attractive option, the dynamic is quite different.

Most women only require intravenous or intramuscular pain relief for the first 24 hours, after that its oral. With no other issues why be in? Foods better at home. Bathroom is your own. Open visiting at home. "Free" telly. Your own bed. No brainer to me.

I found a post natal ward to be the least restful place possible - and I was only there for 12 hours. And I was in a side room...

OP, if you are considering ECV, check who does it locally, and what their individual success rate is. Several of our obstetricians dont offer it now, either because they feel its not worth doing, or they dont do enough to maintain a good enough standard at it/feel confident doing it. Because just like breech vaginal delivery, because so many women have sections for breech the number of ECVs is falling.

Rempy, I guess I do understand where you are coming from, I was very lucky and had my DS in a well known private hospital and was very spoilt. In an ideal world all women would have what I did. I would have found it hard to come home on day 3 but maybe if I had been on a shared ward I would have felt diffrently. OP have you seen your consultant yet?

Hi, no I haven't seen the consultant yet, I have however been at the hospital!!
I've been having infrequent contractions for about 36 hours, I've just got home under strict orders of bedrest for another 48 hours, they hope it will stop on its own, if not back to the hospital & I'll see the consultant earlier than I'm meant to be. (I'm seeing him a week tomorrow)
The baby is still breech atm.
Rempy, I was told the same today re consultants and ECVs. the success rates are only supposed to be about 50% as some aren't possible & some little darlings turn back!! (Though I don't know what the average is)

Any news?

Hope all is well bumptastic.

Still here in bed, contractions keep coming, can get quite painful if I walk around - the postman came & rung the bell when dh was out earlier, then I decided to make tea and toast while I was up and about.
DH is hoping he can get tomorrow off work too to look after ds again.
I feel exhausted which is the ridiculous part. Agh, why can't this pregnancy be straightforward?! Hoping when I see the consultant he'll have a plan of action for me, I really don't know if I can keep going until 39/40 weeks.. I feel so bad saying that