ECV or Caesaerean?!

[DaisyBee123]

At my last scan appointment with a consultant she told me that my baby was breech. It was also breech last time I went two weeks prior and I'm not sure how long the baby has been in this position for.

I have an appointment in 3 weeks time and if the baby is still breech, I have to decide on whether I want an ECV or C-Section.

Due to my baby measuring slightly on the small side, the consultant also wants me admitted to hospital for 37 weeks and induced.

She warned me that having an ECV is uncomfortable and isn't always successful and in that case I will have to go for a C-Section anyway. On the other hand, it might work and then I could go on to have a normal birth.

Of course in 3 weeks, I have a bit of time where the baby might move naturally, but I'm not so sure as s/he has been like this for weeks! And in which case, if it doesn't move, I want to mentally prepare myself of what I think the best decision is for me.

Originally I felt quite calm about birth, keeping an open mind, but wanting to do most of it at home and go into hospital at the last minute so to speak! And take whatever pain relief/medication I feel I need at the time. I was pretty chilled at the idea of simply going with the flow and listening to my body. So being told I will have to have a date booked in (breached or not), I am finding quite scary due to not particularly wanting this medical intervention (I am a great believer that the baby should come when its ready - within reason). And also I have heard being induced can lead to a more painful and longer labour, so my original plan will be out of the question.

Having thought about all this, I am tempted to side for the C-section. To save putting my body (and mind) through it all - like having an ECV, being induced and then having to go on to have a C-Section anyway if not successful....

But I am also aware it is major surgery so don't want to just opt for it lightly and therefore weighing up my options!

What I do like about having a planned C-Section is that the actual birth I assume is far less painful and lengthy. But the massive downside is the recovery process. I have family that will greatly help, but I am worried about how well it will all heal.

Caught in what is best to do! Wondering what your experiences are of ECV and C-Section. Have you had both a vaginal birth and a C-section - if so which one did you prefer?

Thanks for your help!

I had a ECV and avoided the cesaerean as she stayed put. Ask who will do the ECV and how often they do them - at our hopsital, there is one consultant who does them all (there's a knack to it aparently) so you need the repeated practice. If they say that a range of consultants do them, or they don't do many, go for the cesaerean.

The ECV was fine - avoid google which has tales about horrendous pain for the mothers. You have a muscle relaxant and are tilted so your feet are raised then, in my case, they were going to try rotating baby one way, but stop if she didn't move or moved back, and then try the opposite was, and leave well alone if there was pain or she didn't move. Baby moved on the first attempt.

They don't know why baby is breech - undiagnosed fibroid etc. could mean there's no room for baby to move. You then rest for an hour whilst they monitor baby, and you have to take a labour bag with you in case anything concerns them about baby's stats as you'd get an emergency cesaerean the same day (baby stuck around for another 2.5 weeks for me) if there were any concerns. I'd go for an ECV over major abdominal surgery every time.

Just to warn you, baby will need hip scanning at one month, regardless of what birth you go for, it's a breech position in the womb thing, to check the hip sockets have developed correctly.

Hello! I am pregnant so haven't given birth yet so I'm sure plenty of people will come along with actual experiences which will be helpful to see.

However, I have read a lot about this as my partner's family has a tendency to have breech babies so I'm a bit scared ours will be too!

Regarding breech baby:
You can try lots of things to get the baby to turn. Look up tips on the web and try a few pregnancy books too. The website spinning babies is mean to be very good - has exercises to encourage baby to turn. spinningbabies.com/learn-more/baby-positions/breech/ Walking briskly, prenatal yoga and swimming regularly can all help get the baby in right position. Try placing a hot water bottle on the place you want baby's head to go, and a bag of iced peas where it's head currently is. The baby will seek out the warmth! Not failsafe but worth a shot! Not sure where you are based but you can also try a pregnancy osteopath or chiropractor who are experienced at helping turn babies. I know an ECV sounds scary but if it was me I would try this as a last result - if it works, you can go on to have a vaginal delivery. The 'worst case' of it not working is having a c-section which you would have to do anyway if baby doesn't turn so what is the harm in trying?

Regarding induction:
Highly recommend reading Expecting Better by Emily Oster and/or the Positive Birth Book by Millie Hill. Both speak plainly about induction. Another option is this focussed book called Induction Matters: www.amazon.co.uk/Why-Induction-Matters-Pinter-Martin/dp/1780666004/ref=sr_1_4?keywords=induction+book&tag=mumsnetforu03-21&qid=1581688884&sr=8-4

Often induction is forced on women unnecessarily. It should only be used as a last resort and if baby is doing well, there is no reason to induce before 42 weeks. You are right, induction can lead to a more painful labour. Know your rights. It is YOUR decision, you don't HAVE to do anything, you can refuse induction if you don't want it. If baby is fine, there is every reason to up to 42 weeks. Why do they say you need to be induced if baby is small? Surely a bit more time in womb will help baby size? Also bear in mind often they get the size wrong... women sometimes told their baby is huge and it comes out 7 pounds so completely normal.

Totally agree with everything that @islayBridgid says here. Do your research into why they suggest you be induced and don't be afraid to challenge this if the answers provided don't seem to make sense. Also there are loads of things you can do to try and shift baby to a non-breech position, moxibustion is apparently very successful and there is also reflexology and massage and positions as outlined on the spinning babies website. It is also perfectly possible for you to give birth naturally even if the baby remains in a breech position so don't automatically assume you'll have to have a C section if baby does not turn before then. The birth ed website has a lot of information and positive stories about breech babies you can find here on their hub birth-ed.co.uk/search?q=breech

spinningbabies.com/

Try some of these exercises and see if she decides to move herself :)

@islay, not necessarily the case, sometimes small babies (IUGR) may indicate a placental deficiency, in which case it can be deemed safer to deliver earlier.

I would choose an ecv every time personally.

They do get the size wrong even with frequent scans.
There are basically three outcomes, ecv fairly quick induction, ecv long induction ending in emcs or elcs.
I was overdue had a long augmented labour ending in a emcs. It’s not an option I’ll be taking again.

Ask exactly why they want to induce you and at which points you can opt for a csection. eg can you try an induction but opt out after 48 hours if it’s not progressing rather that 4 or 5 days?

I insisted on an epidural before the drip.

It’s also worth bearing in mind how many children you want as generally it’s 2 csections, 3 max. Although some people do have more. They do give that, and future possible fertility issuesas a reason not to have a csection although I told the doctor that would just be a theoretical point if they didn’t get the current child out!
I’m in no way anti csection I’ll be having one if I have another child.

There's a good podcast too on your options for a breech baby presentation well worth a listen:

Listening to "3. Breech Birth: Your Choices with Guests, Dr Shawn Walker and Emma Spillane" at

www.buzzsprout.com/615412/2108814-3-breech-birth-your-choices-with-guests-dr-shawn-walker-and-emma-spillane

OP, how tall are you and baby's dad? and how big are babies in your family usually? "Small" babies can be completely normal for you or your family. Mine tend to be longer than usual and on the smaller side for weight but I'm tiny and DH is tall so it figures.

If baby being small is signficantly small, I can see why they'd want to induce but I'd want to be seeing data that shows how wide a variation they're looking out. Don't be afraid to say no to induction (it's really grim) and take a supportive person with you if you can, primed to ask the consultant to confirm what they mean

I’d chose a c section every time. I have read too many awful ECV stories. Just a risk I wouldn’t take.

I wouldnt worry about it yet. My baby was breech at 34 weeks but had flipped by 36, and around 80% do turn on their own. You can try things like "spinning babies" exercises but there is little evidence that they work (I didnt bother).

Personally I had planned to have the ECV if offered. People who have had it said it tends to be uncomfortable but not agonising.

Also as others have said you dont have to have an induction just because the doctor wants you to. Discuss the pros and cons, how sure are they that your baby is small, how small are they and why is that a problem? Ultrasounds are very inaccurate at measuring baby sizes - mine was predicted to be 9lb and came out less than 7lb.

We were in the same boat and had an ECV two weeks ago. I was reluctant first after reading (second and third hand) horror stories on Mumsnet but did some research and decided that ECV would carry no more risks than a c-section, and it would give us a chance for natural birth and normal recovery rather than going through major abdominal surgery.

The ECV was amazing, glad we did it - while very uncomfortable, it was not painful. Baby got turned in under two minutes and luckily stayed that way (39 weeks now). We were monitored the whole time and got to see both the wards and the baby on the monitor which was a bonus

Obviously we still may end up with emergency c-section or instrumental intervention but there are no guarantees that a scheduled c-section wouldn’t result in complications.

Spinning babies methods also worth trying and there’s also acupuncture or moxibustion. Good luck

I had a persistent breech pregnancy where DD didn’t respond to an ECV. The ECV wasn’t painful, but every part of my maternal instinct was screaming on high alert all through it and I promised myself I wouldn’t do it again - guess I might feel differently if it had worked!

We also tried moxibustion, which worked in that it made her wriggle around like an octopus but no luck.

I went on to try for a vaginal delivery but ended up with cord prolapse and a crash C-section. My lesson learned was (I felt) to listen to the doctors when they talk statistics. It’s difficult to know how they apply to oneself, but having fallen foul of things a couple of times now I’m a lot less gung-ho than I was!

Following with interest, I’m pretty certain my baby is still breech and has until Monday to flip..

Out of interest, do they really push you into the ECV? Or do you genuinely get the choice between that & section? I know it’s your right to choose but just wondering how the approach it?!

I had a breech baby, was breech from early on and didn't move on own accord. I was offered an appt at hospital to discuss turning, which they'd do there n then if I consented. I didn't consent and they were totally fine with that, it felt like a genuine choice with absolutely no guilt tripping either way.

I knew before I went I would be saying no. Breech runs in my family. One auntie tried the turn, and it was excruciating painful, baby turned back and she had a vaginal birth which went wrong and caused lots of problems. Other auntie had the turn done, baby got stuck sideways and ended in emcs under general.

I had a scheduled c section based on experiences of women on my mums side of family and all went well. I think the women in my family have a twisted pelvis or something similar, hence the problems!

I was offered an ECV with my first, but having read that the success rate is 50%, they tend to have cannula in, prepped for c section if things took a turn for the worst, and also having considered the fact my baby had been transverse then oblique breech right up until this point and maybe for a good reason, I declined. I was offered it twice, once on the morning of my C section. I wasn't made to feel guilty for declining at all, and actually felt positive that I was able to take charge and make decisions on at least part of my birth, as a c section was never in my 'plan'.
Good luck OP. 🍀

Thank you for all your informative responses! At first my maternal instincts was saying no to this ECV as I thought it might be rather distressing and not have a successful outcome. However, just in these few days I am tempted to just try it and put a stop to it if I really don't feel right - I think it is all about having that element of control over your own birth.

I will try some of that Spinning Baby stuff and hopefully the baby can turn on its own!

It's more of the C-Section recovery and after effects that I am anxious of! Perhaps I need to give the ECV a chance...

I will definitely quiz the consultants more before agreeing to any induction. They didn't go into it too much because it all depends where I stand on my next visit! Both the father and I are pretty small and so is the rest of the family really - small to average - and so I'm not particularity worried about the baby's weight as it seems all in proportion with me and the regular scans is showing a growth increase every time - it does make you want to keep the baby in there a bit longer to catch up!

Hi OP, I had an ECV after trying everything to encourage my baby to turn (spinning babies, acupuncture, moxibustion, the works!) My personal preference was to try for a vaginal birth rather than section and I felt very reassured by the fantastic consultant and midwife who would be completing the ECV, particularly as they had performed many successfully - definitively a good question to ask about experience as a pp suggested. Unlike someone else said, I certainly didn't have a cannula or get prepped for a section but was monitored closely throughout and the babies heart rate never changed so he was obviously unphased! I did find it quite painful but I think this was due to the position he was in - it took quite a while and we had to stop and go back the other way after he got stuck - but hypnobirthing really helped and it was great to test its efficacy pre labour! I was induced for other reasons a few weeks later but went on to deliver 'naturally' and was so glad I'd had the ECV.

Hi OP! I was in a similar situation to you, breech baby and decided against the ECV and opted for elective section. Went in at 39+4 for the section and baby had moved! I'd not felt anything at all, in all honesty hadn't really tried the spinning babies tips because he was breech for the majority of my pregnancy. Was offered an induction that day instead and ended up with an EMCS 2 days later!