ECV or elective c section

[Missdrifter]

Hi, I am currently 36 weeks pregnant and baby has been breech throughout pregnancy. I have been offered the ECV procedure to try and turn the baby and have been told this has a 30% success rate. I have sort of agreed to give it a go but I am very concerned about putting the baby at any risk. I have been told the biggest risk is that the baby doesn’t move but I would be interested in hearing others experiences etc. My other option is to go straight for an elected c section. So unsure what to do as both come with risks and I don’t want to have any regrets.

Has anyone been through this recently who doesn’t mind sharing their story? Thanks

Hi! Firstly I'm not going to sit here and tell you what to do as my pregnancy had no issues through out , from friends having breech babies they actually decided not to have the ECV procedure done as they didn't want to risk anything ! I think if I was In your position personally I would elect to have a C section it's the safest way I believe . Now from someone who has had a c section (not by choice) I'll warn you it's not pretty and the after math is pretty awful but atleast with an elected C section you'll know exactly when to expect baby and you'll know that the risks are a lot lower . It's totally your preference your baby and your decision to make as a mother but in my opinion I wouldn't bother with the ECV procedure x

@Mummy120494 thank you so much for your reply. That’s exactly how I was thinking before today’s appointment. I was adamant that I wasn’t going to have the ECV but I almost felt like the midwife and consultant were suggesting the ECV would be worth a try, so I started to believe that I should trust the professionals. But since coming home I am already having doubts. I just want to do whatever is safest for the baby but with this bring my first, I really don’t know what would be best but I think I would feel more comfortable going straight for the c section.

My first baby was breech and I was offered an appointment for the ECV - my husband and I were conflicted over what to do and the night before the procedure (I was told to attend the appointment whether I wanted it done or not - if I didn't then we would book in the section) a good friend reached out to tell me that she had had the same scenario with her daughter....and she had refused the ECV as her friends baby died during it. For me that was enough to refuse it. The hospital would not take no for an answer!!!! We were there for 5 hours! But I stuck to my guns!

Finally the midwives changed shift and I told the 'new' one that it was a gut feeling not to do it and she accepted that. After the c-section they told me I had an abnormally long cord and the baby wouldn't have been able to turn. The decision to not do it was right for me.

For what it's worth, the elective section was a very positive experience for me. It was lovely to walk in with my husband and meet everyone. Very calm atmosphere. I remember being in pain for a couple of days but I was walking up the stairs the next evening without issues. In fact, I was talking to my consultant earlier today and he asked if I had decided re elective section or VBAC for this baby - I said I'm pretty sure I'm swaying towards another section as it was such a positive experience for me!

@niki26 that’s so much for sharing your story. Thats so awful about the baby dying because of it (I certainly wasn’t made aware of any risks that great) That’s interesting that you were told to attend the appointment even if you had changed your mind because that’s what I have been told too, but hearing your story I may just cancel the appointment altogether and book in for a c section. Really pleased you had a good experience with the elected c section, I have only really heard positive stories from those who had planned c sections and i think that’s the route I want to go down x

Personally I would go for the ECV, but it really doesn't matter what I would do...it sounds like you are more comfortable with the c section so I think you should go that route.

I know - my friend said she would never have forgiven herself if I went through with it and something had gone wrong and she hadn't given me that information. Gut instinct counts for a lot I think!

I have gestational diabetes which is why I will be delivering between 37-38 weeks this time - the choice is really going to be induction or elective section. I understand (but don't know for sure!!!) that a lot of inductions end in emergency sections - so I'm minded to avoid that and go straight for elective!

My birth options appointment was cancelled due to coronavirus but my consultant is going to get it reinstated so I can discuss all the risks etc so my mind isn't completely made up yet. At least this girlie is head down so I have a choice!

I was in this exact position OP, as were 2 of my friends due 2 days before me (from my n.c.t group)
They both opted for the ECV, one baby wouldn't turn at all, the other turned then almost immediately turned back and they both ended up having electives anyway.

Their experience, plus the risk of the cord wrapping round baby's neck, was enough for me to decide on the elective c-section, which as a PP said was a great experience for me.

I think (though happy to be corrected) elective is very different from emergency- mine was calm, positive and my healing afterwards was very straightforward- I was (gently) up and about after a couple of days and driving after 3 weeks.

In fact I'm due DS2 in a few months and have decided to go for the elective c-section I have been offered as it was so positive for me the first time round.

Hope it all goes well!

Thank you so much everything! X

*everyone not everything 🤣

I literally almost wrote this same post a month ago. My baby was breech at 36 weeks and I was unsure about the EVC. Look up spinning babies -I did the lying upside down on ironing board with frozen peas up high near babies head and heat down low to encourage babies head there. Anyway 5 days later at scan Before ECV after doing that and other spinning babies exercises on the website the baby turned by himself. 2 weeks later I had an incredible, smooth vaginal birth. Good luck.

Same for me. My little one was breech throughout. I refused ECV, not sure why, just because?! I had a gut feeling C-section was right for me. Section was a breeze and recovery was a breeze. I can only recommended.

Oh, as you've been breech throughout the pregnancy make sure you are referred for a hip scan for your little one. Hip dislocation was not picked up by the doctors in their first tests. It was only because a midwife was so adamant we should get it done that we were referred for a scan and our boy ended up in a Pavlic harness. Had it not been for this midwife he could have ended up needed a whole range of interventions in early childhood.

Thanks @mouse1234567 I have been trying the techniques they suggest on spinning babies and I will continue to try them, so pleased they worked for you.

@Springb0ks that’s a good point regarding the hip scan, I shall certainly push for one regardless if baby turns or not because she has been in position for a long time now. Hope your little one is doing fine now. Did they offer you the c section for the 39th week?

Nooo, lost my message! Basically it was: look at the facts, not people's anecdotal evidence, choose the risks you're willing to take, inform yourself of what the procedure involves and what the risks are (death of the baby was not mentioned to me). There is a 0.5% chance of a crash section being needed, which is why the baby is monitored before, during and after and the procedure and it is only carried out when an operating theatre is available (anecdotally, none of the surgeons I spoke to had ever experienced this happening). I fully understand your desire to hear people's opinions, but do you really want to base such an important decision on what a bunch of people online tell you, rather than the research and medical evidence?

FWIW, I had an ECV. It was uncomfortable and didn't work, so I then had an ELCS. I decided an ECV gave me a chance of a vaginal delivery, which seemed preferable over a section. Unfortunately that wasn't to be. I know of at least two women who did have a successful ECV and then vaginal delivery. I am also acutely aware that statistics aren't the be all and end all, but I'd say on balance they are still preferable over anecdotes. For full disclosure I should probably add that I really don't understand the opposition to the ECV procedure on Mumsnet and other parenting forums. I am also not quite sure where the distrust in the medical profession comes from on this issue. They really, really wouldn't be recommending a procedure that they felt was unsafe/ not the safest option (that's not to say they won't push a particular cause, but they won't lie to you). No obstetrician wants a baby to be harmed or killed. And if you're more cynical: maternity care receives the largest share of law suits, so they'd advise you to take the safest option just to avoid that, if nothing else!

I don't think there is any evidence that postural techniques (like Spinning Babies) actually work, quite aside from the fact that they're pretty daunting to attempt at full term pregnancy

We were automatically referred for a hip scan because DS was breech (albeit only for the last two weeks of pregnancy), this should be standard practice!

@letmegetthisrightasawoman really appreciate your message. I have been trying to look at the facts but I just wanted to hear other people’s experiences because it is such a big decision and I find it helpful, but I completely understand and agree with what you are saying. For some reason the ECV just doesn’t feel right for me but I’d much rather have a normal birth if possible so it is a tricky situation. Best case is that baby moves on its own.

I had a ECV at forty weeks. It was the most painful thing I have been through ever and it didn't work.

The doctors tried for thirty mins to turn baby. I was ill for two days afterwards. I ended up with a brutal EMCS.

If I had the choice again I would go ELCS.

I didn't know the baby was breech until 40 weeks but that's another story.

It took me a long long time to recover from my EMCS.

That's my experience I won't tell you want to do it's just information so you can make a choice

Little one is just fine now. I had a section at 38 weeks as had low pappA and IVF pregnancy which means slightly higher risk of placenta failure past a certain point. Sounds like a lot but was all very easy!

@Missdrifter I'm glad it came across right, I was worried I was being curt. Would it be possible for you to discuss your concerns with an obstetrician (again) before you decide? Can you articulate why it doesn't feel right? Of course there is nothing stopping you from just declining an ECV and going straight for an elective section of that's what you want! Sounds like you're not sure it is though. Have you been advised of the chances of your baby turning spontaneously? DS was very cheeky and was head down weeks 30-36, then transverse and then breech at 37 weeks. I was not impressed there was no way he was going anywhere during the ECV. I'm quite shocked at a PP's experience of it - it certainly wasn't pleasant and I did cry (involuntarily, it was a physical reaction, not emotional), but it only lasted 5 minutes (they stopped without me asking) and I had some bruising on my bump, but I didn't have any other side effects or need a recovery. Because DS was being delivered slightly before 39 weeks I had to have steroids, now those were a bastarding pain in the bum!!! Avoid at any cost

DC1 was breech and we did try an ECV. I didn't find it painful, just a little uncomfortable and very odd when they gave the muscle relaxing injections and you could see the outline of the baby! They scanned before and after the procedure and again after an hour I think. They had a theatre ready to go in case of foetal distress. Ultimately it didn't work for me (baby overshot and then whooshed back to breech) but I don't regret it - I did really want to avoid a CS as I had to have it under general anaesthetic. Good luck whatever you decide!

I had an ECV which failed then ELCS. I didn’t enjoy the ECV at all. It was extremely uncomfortable. And my ELCS was calm and relatively unstressful although not completely uncomplicated as the standard anaesthetic procedure didn’t work so I had to have multiple spinal needles and eventually an epidural which was very slow. I would agree with previous posters that you need to base your decision on evidence and facts not other people’s anecdotes. Complications from ECV are incredibly rare which is why they offer it as an alternative to definite ELCS which also has complications. Although mine failed I certainly don’t regret trying

Thank you so much to everyone. It’s great to see that most have had really positive planned sections.
@Letmegetthisrightasawoman I do suffer with bad anxiety and I think that’s the main reason why the ECV procedure doesn’t feel right with me because of the not knowing and slim success rate and if anything goes wrong then it’s me who’s made that decision (I am fully aware that’s the same if I opt for a c section too - which is why I wish there wasn’t a decision to be made and that baby would turn on its own) Looking at my notes too I can see that the baby is right at the top of the chart and head is measuring very large. Also baby has been in this position throughout the pregnancy (and have been told it’s less likely to work on these babies). I suppose I am also worried that even if baby does move will I then just become anxious about baby turning back etc. I am going to talk it through with my midwife today. I know that everything comes with risks and I just want to get it right for my baby. Thanks all your help.

Had a very straightforward ELCS 12 weeks ago with decent recovery, having turned down an ECV. When doing my research and comparing statistics I initially ‘forgot’ that ECV doesn’t deliver your baby, whereas CS does. So in the end I based my decision on comparing ELCS risks with ECV risks combined with vaginal delivery risks. I felt that risking ECV pain/complications to potentially endure a difficult labour which could end in EMCS wasn’t for me.
Cochrane have a few ECV reviews which may be worth reading. Your gut feeling will always influence your interpretation of the evidence though.

www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000083.pub3/full