Breech delivery - need opinions / advice

[ma4pie]

presentation scan yesterday. We are going to try an ECV tomorrow, which I know has a 50% success rate, but I want to have my decision straight in my head incase this doesn't work. Thing is I am totally devastated by the idea of having a c - section and, as such, am concerned that I am being swayed by what I want over what will be safest for bubs.

Personally I would prefer to try for a vaginal breech delivery. I have a big pelvis, high pain threshold and good endurance but this is my first (so pain and endurance not tested for childbirth) and bubs is measuring quite large. She is bum down with legs up by her head. I don't know why I am so anti c - section either. I'm not bothered about having an operation, not squeemish at all so would actually probably want to watch, and I'm not that bothered about not being able to have a 'natural' childbirth - it's not a feeling of failure by any means. I think I'm just concerned about afterwards. I don't want to be separated from the baby soon after she's born, really don't want to be stuck in hospital for a few days and reeaally don't want to be limited for weeks after we get home. I know all of this could happen with a vaginal birth anyway so, deep down, I know I am being irrational.

DH would definitely prefer me to have a c - section. He went through a nightmare birth with his ex and their first child - very premature, emergency c - section, mum and baby nearly died. He's being really supportive of whatever I want to do but I know he's scared of the prospect of a vaginal breech delivery, possible emergency c - section and problems for the bubs or me. I don't know whether I could actually put him through the worry. I've also spoken with his ex (who is extremely supportive too) and she has assured me that a c -section won't be that bad and that she would opt for one given the circumstances.

I think I just need reassurance that a c - section is the safest way to go and, as such, the right decision to make. I do know that I would be absolutely devastated if I opted for a vaginal birth and something went wrong. I guess I just don't want to take the 'easy' option for no other reason than it's the done thing. Sorry if this all seems redundant given that the ECV might work - I just don't want to leave my decision until tomorrow when I will probably be tired, sore and emotional.

Lost top of message! Bubs was suspected breech at last 2 midwife appointments and conformed breech at presentation scan. I am 37 1/2 weeks.

I'm probably the wrong person to answer here as I deperately wanted a c-section and had a terrible phobia of giving birth. So perhaps the opposite feelings that you have.

Anyway, I read so much about c-sections and managed to then eventually have one. I just wanted to re-assure you that they are statistically very safe, especially for the baby.

When I had the c-section, I was not parted from my daughter ever. The whole thing was over with in less than an hour (maybe about 45mins) and the baby was out very quickly after the incision. The most time taken is sewing you back up again.

People seem to have different experiences, but I was out after 3 nights (would have been 2, but I had an unrelated problem that needed checking out). Within a week I felt fine, enough to go on a few mile walk (taking it easy with my husband and daughter in the pram).

I had a friend who was in your shoes and she was gutted she couldn't have a natural birth, she opted for the c-section as her son was very wedged in, but months on she was very glad that she did have it.

DS2 was breech, discovered at 39.4 after umpteen midwife appts saying he was a small baby with head down but not engaged! He was 9lbs...

I was also upset at the thought of a breech birth especially as I had 16m ds1 too, and no family support.

The increased risks to the baby of a breech birth were explained to me by the consultant, and I signed the forms and came in the next day for the op.

It can also be far harder for the mother, as there is less for the mother to push against when the head needs pushing out.

A c section IS a major operation, the NHS would not offer it routinely for breech babies if they did not think it reduced risks to the baby.

Lets hope that the ECV works. My baby was too large to try that without risk of placental abruption.

Thanks for sharing your experiences. No joy with the ECV, doc tried 4 times and actually gave up before I did - though I wasn't sorry, wasn't the nicest thing I've ever experienced! He couldn't get a firm enough grip on bubs and she kept slipping back. We have opted for the c - section and I actually feel ok about it now that the decision has been made. Bonus is that we got some amazing late scans and pics and that madam will be here within 2 weeks! Thanks again.

My DD was breech and the ECV didn't work for her either (she's very stubborn like her mum). I was booked in for a C-Section, but went into labour a few days before. I have a DS who was 2.5 at the time, so was worried that the ELCS would affect my ability to look after him after the birth and I wasn't keen on being in hospital for several days. As it was, my DD decided not to wait and I delivered her by vaginal birth as this was the safest option given how quickly everything progressed. I was so worried but I was in great hands at the hospital and her safety was paramount. She swallowed some fluid during delivery so I didn't get to see her for a couple of hours as she was taken to the Neo-Natal unit, but as soon as I was able I was allowed to see her and she came down to the ward with me after a few hours. I did have to stay in for a few days (as I had been expecting to do with an ELCS) so they could monitor DD. I guess what I'm trying to say is do what is best for baby and you'll cope brilliantly whatever happens. Although I didn't get immediate skin-to-skin post delivery, it never affected my bond with her nor my ability to BF which were my main concerns. Good luck with everythinhg!

I had a breech birth. It was, tbh, pretty easy. My dd was presenting folded in half - legs up against her head. In this position, the bottom is a bit bigger than the head, so no chance of the head getting stuck.

The key thing to a successful breech birth is to use no medical intervention. No sweeps, gel, drips, pain relief. If the labour progresses on its own, then all should be well. If not, then the next best course of action is a c-section.

Google 'Mary Cronk' - a midwife who championed breech births. She gave me the conviction to go for it.

You'll be fine. I had a c-section too, best decision I ever made!

Just to get the other side of the story (I've just come from a meeting with my OB about attempting a breech birth for twins), the decision to deliver most breech presenting babies by c-section was reached after the the 2000 Term Breech Trial which was a massive study of breech births. They found there was a 5% increase in risk of short term newborn problems, i.e. resuscitation, nursery admission, low Apgar score etc. This meant that most health authorities took the decision that sections were best in breech presenting babies.

However, in 2005 there was another study that showed a lot smaller risk of injury, the Premoda study, around 2%. This was because they selected for the best kind of candidates for breech birth: women who had had previous successful VB, babies lower than 3800g at birth and frank breech rather than any other presentation (frank breech is when their legs are by their ears, therefore less room for cord prolapse). I live in Canada and our ruling health body, SOGC, decided to go back on its original decision that all breeches should be c-sections in 2010 and went back to their original advice.

Basically, there is an increased risk to the baby with breech births, but this is exacerbated by having a team who are inexperienced with that kind of delivery. If you've got someone who's made this their specialty you have much much better outcomes, i.e. they wont attempt maneuvers that do compromise the babies health etc. However, because there's been this 10 year gap where lots of people have stopped doing breeches there is a dearth of experience.

What it kind of comes down to is: VB is better for the Mum over all (less chance of blood clots, DVT etc); breech birth has an increased risk of short term newborn problems; breech birth should only be attempted with a 'good' candidate and by an experienced team.

What I would do if i were you is see if the OB and MW's at your hospital have any experience of breech births and then see if they reckon you'd be a good candidate. If the answer is no to both those things, then a section would almost definitely be the best thing to do. If the answer is yes to both, then maybe a VB could be considered...

I hope this helps, sorry it's such an essay - having just been to this breech birth clinic I was full of info so wanted to pass some of it on! Also, check out Mary Cronk's website as she is probably the leading advocate of breech birth in the UK. Here's a famous article of hers

The think about the 2000 Term Breech survey is that the headline didn't tell the whole story.

If a doctor was in charge, it was safer to go with a C-section, rather than accelerating and using forceps, and being in theatre.

If a midwife was in charge, particularly in the case of undiagnosed frank breech where no one was panicking, the risks of vaginal birth were lower than the general risk of C-section.

From the research I did before having my breech baby was an all or nothing approach. Have a completely natural, hands-off (literally) vaginal, or a C-section. Nothing in-between.

Yes, my OB was saying how destructive the 2000 study had been as it missed out so much important information regarding breech births and yet was used as a justification for stopping doing them. She was really quite enraged about it (and she's a doctor - but she is known as the Queen of Breech Birth's here!).

Cool OB! Yay!

Very cool OB. She even pretended to be one of my breech twins and the chair was my cervix. All so she could demonstrate the difference between frank and complete breeches!

Nothing much to add really Ma4Pie, except to say you'll be fine! Dd was an extended breech (feet by ears), so was a planned c-section, delivered 2 weeks before her due date. It was an overwhelmingly positive experience, and dd was never taken out of my sight. I stayed in hospital for 4 nights, and to be honest I was grateful of this, being a first baby! By the time I went home, I felt so well, and was back on my feet in no time. I don't know why people always go on about not being able to lift your own baby after a c-section, I was able to lift her straight away, no problems (she was only 6lb7 though!). In my opinion, the risks to the baby of attempting a vaginal birth were just not worth it. Dd is now nearly 2, and we're expecting dc2 in August, so we'll see how things pan out this time!

Best of luck with it all!

Just wanted to add that my DD was breech so I had an ELCS and it was a lovely 'birth experience' (as far as they can be) - very relaxed and all the hospital staff were amazing. Baby was fine, was never parted from me and I breastfed straight away. I was also out of hospital in under 48 hours (but I made sure I had loads of help from DH at home). I was also breech and my mum had me naturally and had told me it was horrendeous and she would have definitely opted for a section in my situation and wouldn't want to do it again. I was feet 1st though and so was my DD and I know that is a much more compliated delivery than bum first. As everyone else said, if you are going to opt for a VB make sure you have very supportive, experienced midwives assisting. But please don't be scared of a planned section as mine was fine!! Good luck!!