Unstable lie: c-section or not?

[HopHopALady]

I am 38+4 and have been in hospital since 37+1 due to unstable lie. This is my second baby, the first I delivered naturally with no problems at 9lb 10oz. This one was estimated to be over 8lbs at 35 weeks so it likely to be between 10 and 11lbs at birth. They examine me every morning and baby seems to be mostly oblique, sometimes transverse and has twice been head-down but never engaged. The second time he was found to be head-down was this morning and the consultant said if he's still head-down tomorrow, I can go home. Am now confused dot com as previous consultant who discovered first head-down said no such thing. Am booked in for elective c-section at 39+1 (on admission, was given choice of ECV followed by induction at term or elective c-section - didn't fancy the first option, plumped for a bit of concrete planning), which is only 4 days away. Would love to go home as already have 2 year old but I also really want c-section so I can get on with recovery and new expanded family life. Am I mad? Would I be able to insist or would they/could they refuse to do it if baby is head-down, even if not engaged? Don't understand why risk is less if head is down but not engaged as he's still "free" to move about. Thoughts, opinions, experiences, advice, etc, gratefully received.

bump....sorry I can't advise.

I would make a fuss and demand a second opinion if you are now being told something different to what the previous doctor told you.

I had an unstable lie with DD (1st baby) which wasn't spotted although she had been transverse quite a lot and was never engaged. During labour, she turned so she was brow presentation and head up - and I ended up with a section after 2 and a half days worth of induction and then labour. [grr]

With DS, he was also unstable lie. He never engaged either and was always transverse. I had wanted an elective c-section after what had happened with DD and the hospital resisted until the consultant realised about the unstable lie at about 35 weeks, having discussed my previous labour and seen the position DS was in. When DS was delivered by section, they still had to get him out with forceps because he was in such a difficult position.

Your previous pregnancy might suggest it would be ok for you, but I do not think your approach is at all unreasonable. FWIW I recovered really quicky from my second section and it was a far better experience than when my labour went wrong due to an unstable lie at the fully dilated stage.

Good luck.

Thanks strawberrycornetto. Yes, I have to say I am in no way desparate for a natural birth as I have already experienced that. What I really don't want is to end up with an emergency CS and that's what my fear is by letting it run its natural course. He seems so happy to keep on swimming, who knows what position he'll end up in at delivery!

Strawberry cornetto could you tell me more about an unstable lie? My 9lb 6oz DS was born by c-section after he turned transverse 19 hours into labour and an hour or so into the pushing phase and I've never been able to find out why. He too never really engaged and was very mobile in the lead up to labour. Am currently in the process of getting my notes as I've never had anything other than 'sometimes these things just happen' from the oh so helpful health visiting team, but I'm also worrying about pelvic disproportion and other issues wrt future bubs.

I don't know much more than is in my earlier post really Poppet. Both my DCs were transverse for most of the second half of the pregnancies. DD was apparently in the correct place although not engaged when I was induced. Both were small so still had some room to move I guess (37 weekers due to obstetric cholestasis. The only other thing I remember was the consultant with DS telling me that the shape of my pelvis may mean that the babies would be able to move more.

The reason it was relevant was because, before the OC was diagnosed the second time, the hospital was refusing to give me an elective CS if I didn't get OC and went to term. I was very anti because my experience the time before was so bad. They only agreed to it when the consultant concluded I had an unstable lie because he said in that situation, it would not be advisable to try for a vbac.

If you get your notes, you will be able to discuss it with your midwives/doctors next time I guess.

Hi

I have an unstable lie, and have been advised by midwife that i maybe admitted at 37 weeks. This is really worrying me as i now need to find childcare arrangments for my 3 year old, as cant afford hubby to take time off work.
Sounds liek i can go for elective cesearian then at least it cuts it to two weekS!
I would be most grateful if you could uptdate me as this is a April posting so im assuming all is well and baby is here now.

Many thanks

My baby was found to have unstable lie at 40 plus 3 days. Well he was sideways (think it is called transverse).

As I was over my due date they were very keen to CS me. I resisted as I had school run drive to do and felt it wouldn't be practical for me to be without my car for so long afterwards!

I had to be quite insistent that they try an ECV. Well I went home and came back the next day to have the ECV and the baby had turned head down! Hadn't felt a thing - LOL.

So in the end no ECV but they induced me straight away incase he turned again. So had a natural delviery in the end.

bump

Why do you have to stay in if your baby is unstable lie?

I am 34+2 with dc2, hoping to have a vbac (failure to progress last time)
This baby seems to be in a different position every couple of hours. Mostly at the moment the bump is hard and high, but soft under my belly button. The baby is constantly 'wrestling!'

I don't have a lot of confidence in my MW, who i am not due to see til next week.

Sorry for hijack

Sorry for the delay in responding - have only just noticed these latest messages. I was told I had to stay in hospital because of the risk of cord prolapse. If the cord comes first, there is a possibility that the baby's head could come next and compress the cord, cutting off all nutrition and oxygen. Apparently, there is a seven minute window to get the mum to theatre in this eventuality... So I didn't question the reason, I stayed. As a family, we coped OK, DH bringing DD to see me at weekends. Yes, it was sad but it was only a brief interlude in our otherwise "normal" lives so we just got on with it.

They wanted to manually turn the baby at term and then induce me but I'm afraid I pushed for the c-section so I could get out of hospital quicker. I was told they won't do elective c-sections any earlier than 39 weeks anymore so that's what I had. It all went smoothly and now DS is 3 months old and blossoming. I would in no way say that a c-section is an "easy" option - I felt like I'd been hit by a bus! - but at the time, it was the right choice for me and my family and I don't regret it.

I hope that helps sacredg and alicetheinvisible and that this is not too late.

HI there

Thanks for that update. My baby has turned to breech, and im booked in for a ECS on the 12th....and im bricking it!

So how did it go? Hope you're recovering OK and settling down with the new addition.

My unstable lie was still unstable after his due date and I had him at home. The advice to me (in 2002) was to call the community midwife as soon as I though things might be starting and check the lie at the time. Anything but head down and I'd have gone in but luckily he happened to be head down at the right moment! He was spinning several times a day until birth!
I had an ECS and it was fine. He just decided to turn round again after it!
You must do what you think its right when you have all the advice and information you need.

Interesting, homebird8, that they didn't "encourage" (aka force!) you to be admitted with a known unstable lie and that you had your baby at home. I do wonder what would have happened if I'd have been "braver" and stuck it out until the due date, gone for the ECV and seen if he would have been delivered naturally or not...

A friend of mine had her baby at home when that wasn't supposed to have been the plan due to various known risks and complications (he came too soon for her to get to hospital) and I have to admit I'm slightly jealous...

Stupid to dwell though, should just focus on the end product and that we're all OK!

Hope to hear from sacredg and how her experience went.