ECV after previous c-section

[alex344]

After a general anaesthetic emergency C-section with my last baby I am keen for a natural birth. However baby 2 is not playing ball and is now breech at 37weeks. I am booked for a turning on Tuesday and was pleased to still be in with a chance. However a nurse friend today said she didn't think ECV after c-section was safe. I'm reading mixed advice on the web. Anyone know the answer or had it done after a c-section? Thank you

Anyone? Thanks

I wouldn't risk an ECV in general. The risks, while small, aren't worth it to me.

I had a cesarean and wouldn't ever have an ECV, especially now.

Where I work an previous lscs is a contraindication for an ecv. Ask the Dr about it before they start. It might be that there's recent evidence saying its not as much as a risk as previously thought.

If I'm honest I wouldn't have an ECV at all, previous section or not. The worst outcome, although minor risk, is too terrible to think about. There are too many sad stories for me.

I had an ECV with DS2 at 37 weeks. He did not grow from that point and was born grey. He has lots of disabilities now, some are genetic and other CP related.
Never an ECV !!!

The NICE guidelines (www.nice.org.uk/guidance/cg62/chapter/1-Guidance#management-of-specific-clinical-conditions) seem to suggest ECV shouldn't routinely be offered to women with a uterine scar. I'd ask to talk to your consultant about the benefits and risks before consenting to this.

Also, one other thing to be aware of is that if ECV is successful, there is still a higher chance of an emergency CS or other intervention in labour. So it might be that you consent to the ECV but end up needing an emergency CS anyway. I'm not sure how significant the increased risk is but again perhaps something to ask your consultant about.

I had an elcs following a failed ecv and was told that I wouldn't be eligible for an ecv in future due to the c section scar - definitely check with the consultant.

Fwiw I wouldn't really recommend the ecv having had one - I was worried about the (very minor) probability of something going wrong for the baby. As it was the baby was fine, but the procedure was pretty unpleasant and unsuccessful, and this was at a hospital with a higher than average success rate. My elcs, on the other hand, was fab

I wouldn't have an ECV at all to be honest, there are small but significant risks, and I've heard they can be terribly unpleasant and painful!

I'd never have one of those.

My experience matched Glomerulus' exactly.

I wouldn't have it if I could go back in time knowing what I do now, and am quite pleased it is off the table as an option this time (not that I'd need one, this baby is thankfully playing ball).

Thank you all so much for your responses. I have paused the ecv for now, but I'm meeting the consultant who does them tomorrow and I'm armed with a list of questions now. I had a very frightening and painful c-section due to a failed epidural, so it is nice for me to read some of you actually enjoyed the experience! Makes me less nervous to go through it again. I will be gutted to miss out on the experience of childbirth if that's what I decide, it feels like a fundamental part of life to experience. But I obviously I want a happy healthy baby more x

My spinal failed too they bunged me full of morphine and carried on awake! It was actually not too traumatic- mainly I think because the surgeon visited me afterwards and gave me a full debrief. For what it's worth, if I have another ill be asking for an elcs.

I wouldnt have an ECV full stop, to be honest. It's almost impossible to distinguish a baby that will turn eventually from one that won't due to good reason (cord tangled/short for example.) I think it's too risky and I personally wouldn't consent.

I had to have a section (vasa and placenta previa) and honestly, I'm over the idea I missed out. I felt like that for a while then I've spoken to so many women with serious damage from forceps, botched deliveries or just regular old birth. Birth is one day - the real experience is everything after.

Good luck whatever you decide. If you go go fir the ECV, ask:

How many the consultant has done, and when
Success rate in turning
Complication rate
Have they ever had a baby born with issues or die after an ECV (after, not as a result of or they can say it wasn't due to that!)

This link was posted here some time ago - a very tragic personal account of an ECV gone wrong. I don't think I could ever consider one given this. I've hear moxibustion (sp?) is effective

justiceforrebeccaflorence.wordpress.com/about/

It is against the NICE guidelines although this didn't stop my [very anti c-section] hospital for insisting that this should be the first course of action rather than repeat section (not outlining to me that it was firstly not recommended and secondly that I could refuse ECV anyway). I didn't want the procedure and ended up transferring hospitals but if you do want it, some hospitals allow/recommend it.

Moxibustion isn't effective alas... It's woo :( ditto acupuncture

I remember that thread, barren :( terribly terribly sad. Poor lady.

And yes, if you want a c section demand it. They are under pressure to reduce numbers which imho has lead to some poor clinica decisions

:) my woo-ometer is usually very strong but I remember reading that there is some evidence (not strong, I should add) that moxibustion can be effective. It goes against most of my instincts about this sort of thing though, but there you are

www.cochrane.org/CD003928/PREG_cephalic-version-by-moxibustion-for-breech-presentation

Zaurak lists some very good questions for the consultant. I would add:

What monitoring is carried out? (Should be half an hour before and after the procedure, with near-continuous monitoring during)

How many attempts are made to turn the baby/ how long is the procedure? (Ideally no more than 3 attempts and no more than around 15 mins).

I did a lot of research prior to the procedure and as far as I can tell, the sad cases where things went catastrophically wrong were where the procedure was carried out incorrectly. Even if it's all by the book, feel free to refuse if you're at all unhappy. Also sorry to hear about your first came experience- of course there are risks with a elcs too but mostly they go very smoothly and IME the time and lack of pressure makes for a really lovely experience.

Good luck however you get on!

cs - not came!

On the moxibustion front, my woo-ometer went into overdrive about it too. However I was desperate to avoid a cs and I'd tried everything else... It didn't work either and I didn't even experience the extra movement from the baby that women report during/after it. It was nice to know there weren't any faults with my meter's wiring however, even if it was an expensive diagnostic test!

OP - just realised that your procedure is today. Hope it went/goes well. If it doesn't work I assume that you've come across the spinning babies website which gives some possible ideas.

t1mum - wow, that is dreadful! Good on you for transferring.

OP, I'm in the same boat as you and from the very start was told by my hospital that I would not be offered an ECV due to my previous c-section. I'm currently 35 weeks and will be scanned again at 38 weeks and booked in for a section at 39 weeks if the baby is still breech.

Just an update. I met with the consultant today, a very lovely man. He had no problem with me canceling the procedure and my long list of questions!

He said that previous cs is not a contradiction to ECV in the UK. If a hospital says they can't do it it may be because they don't have experienced consultant. He has been doing it for 17 years, around 3-5 a week and has never had a complication other than one mother who ended up with high blood pressure after the procedure and was kept in but then had a fine birth.

He said he takes each case individually. In my case my last baby was 3 years ago, a nice long time for the cs scar to heal. I have a large amount of waters, making turning much easier, and baby was somewhere in between a footling breech and transverse position, much easier to turn than a full breech apparently. He limits the time and attempts for previous cs mums and basically if baby doesn't go first time he stops. All of this made me feel real thought had gone into my case individually.

There was no pressure to make a decision today, he said to go home and make the choice I was most comfortable with, and if that was elective cs that was absolutely fine.

Sorry for the long story but I thought it might be useful to anyone that searches in a similar situation. Your suggestions helped me put some in depth questions together so thank you. I would say definitely go for a meeting with the actual consultant that's doing the ECV to gage experience, skill and complication rate and whether you feel they have paid attention to the details of your individual case.

I don't know what I would have decided but I definitely felt more informed. However my tale has a happy ending in that I had a scan before I left in case I did decide to go ahead later in the week and baby had gone head down naturally!! We were delighted.

However thanks to the comments here I am now less nervous about a cs generally and more at peace with it if natural birth doesn't go my way ultimately. Xx

Sounds like you've met with a good consultant there!
Good luck with whatever you decide. For what it's worth, the surgeon told me that it's very rare for a spinal to fail like mine did, and that it'd be unlikely to occurr again.