Vaginal breech delivery

[CockatielcalledSega]

Plenty of time for my baby to turn but just interested in experiences in case they remain breech nearer term. Obviously if a c section is strongly recommended we will go with medical guidance but I think our trust do/have done breech deliveries (baby is frank breech at the moment at 31 weeks)

Has anyone delivered in this way or know of anyone who has?

My DD was undiagnosed breech. I was 5cm dilated when when they figured it out. I delivered her. I'm not going to lie, it was a terribly scary experience but I didnt want a section.
When I got to 10cm they made me fight the urge to push for an hour so that she was further down the birth canal. She was also back to back and he head got stuck under my pubic bone. I had to have an episiotomy and forceps. The room was filled with 14 doctors/ midwives etc rather than just the 1 that I had imagined, just in case they were needed. DD needed 2 rescue breaths but was healthy and is 6 next week!
DS was also breech but I turned him by lying on my ironing board leant on the couch with my feet in the air and a bag of frozen peas on my bump.
Good luck to you either way

Thank you for telling me about it. Doing some reading and so far the risks do seem higher with vaginal birth and I guess I wouldn't know until labour if anyone there is experienced, so I think I would go with c section, but will discuss it with midwife

Do you mind if I ask how it compared pain wise?

The term breech trial in the early 2000s showed that c-section was the safest way to delivery breech babies.

Since then LSCS has been the standard recommendation in the NHS although I notice that the advice seems to have softened - however the fact that so few vaginal breech deliveries have taken place means that staff experience of this has really dwindled.

My concern would be the level of expertise anyone looking after you would have in vaginal breech delivery as it is done so rarely.

If you were my friend I'd advise you for your babies sake to seriously consider a section (which does carry slightly increased risks for you). My friends have a predisposition to having maternal request LSCS anyway so they may approach this from a different place to you. Most of us have done obstetric anaesthesia and seen way to much shit go wrong and it really affects your personal decision making.

www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/breech-baby-patient-information-leaflet.pdf

DOI: anaesthetist who hasn't been on a labour ward for 6 years.

My DS who is 5 months was breech and they didn't pick it up until I went in to hospital to be induced.

I felt the risks of trying to deliver him breech were to much and opted for them to turn him which they managed to do successfully. Unfortunately even after being on the drip for 12 hrs I failed to dilate and needed a section anyway. I'm glad I tried though as I know I did everything to facilitate a natural birth.

He is my 4th baby and I just didn't want to take the risks with a breech natural birth.

Good luck I hope baby turns for you, I would say that DS being turned wasn't horrific as I had heard it would be and I breathed through it so I would recommend trying that first.

Does sound like a planned section is the best advice, thank you

Not so concerned about personal risks but recovery is a big factor due to my DC1 being due major surgery shortly thereafter too, plus very limited help after birth, which was why I'm hoping for vaginal birth but of course recovery from that isn't always straightforward either even with a head down baby!

@fatisnotafeeling cross posted, thank you, that's encouraging to know ECV isn't always terrible!

Congratulations on your DS!

Happy to share my experience if you pm me
Vaginal breech
Delivered vaginally in hospital

DS2 was breach for a bit. I talked to the midwife, and was clear I wasnt going to attempt ECV. She was actually really encouraging of attempting a vaginal birth. He did flip about 35 weeks, so it wasnt attempted.

A friend delivered an undiagnosed breach baby as her first. He had some hip issues, but they are all fine now.

Delivered vaginally in hospital with consultant in attendance and epidural in place in case things went wrong and CS required. In 1999 before the research mentioned above was published. All went progressed well, baby born not breathing, serious brain damage and lifelong catastrophic disabilities.
I wouldn’t recommend it.

The doctor explained it to me like this: We can try for a vaginal birth but if it goes wrong it could be disastrous for the baby. For example, oxygen deprivation leading to severe mental disability. Or we could do a c section which is much more risky for the mother but the baby will be safe. So I chose the c section. It didn’t go well. I have constant pain and I need repeat surgery to fix my stomach. But my baby is safe and healthy, and I’d make the same choice again.

Ds was undiagnosed vaginal breech birth. I was fully dilated when I got to hospital. Was v straightforward, no tears/sutures and perfect healthy baby. I realise we were very lucky.

My sister was breach. The midwife stayed on shift two hours extra to observe the delivery as she hadn't had opportunity to see a breech delivery before. This would be my concern. If the team on haven't had relevant experience in delivering breech babies they may not be fully able to cope with it or spot early warning signs.
I would recommend seeing someone who helps turn babies(don't know the proper term). A good friend had an emergency c-section with her first so went to see someone who helped her baby to align properly and had a successful vbac. Sorry I can't remember the proper names of these people.

Doula here! Whilst breech is just a version of normal, the majority of staff here won't have much experience of vaginal breech births, hence you will find yourself steered towards a Caesarean. However, that doesn't mean baby won't turn beforehand, or that you can't try a vaginal birth if that's what you want. I highly suggest checking out the Spinning Babies website, which has loads of advice on how to get baby into the best position for birth.

My ds2 was breach delivery, I was induced but the baby’s position was not picked up, by the time they realised it was too late. Plus me insisting I did not want to have a c-section (as didn’t like the idea of not feeling my legs and longer recovery etc)
A couple of other midwives came in to watch as they hadn’t witnessed one before. I had to try to refrain from pushing while they unwrapped his legs, then his arms.

I accept I was lucky but on reflection it was actually fine, I just tried to relax as best I could and let my body and the midwives guide me through it. It was fine.

My son thinks it’s great he came out bum first!

Good luck whatever you decide do try not to worry too much, your body knows what to do xx

I had a very different experience - I had a lovely, calm, vaginal breech birth on just gas and air. I was booked for a csection but my body got there first and my labour was too quick for them to do an emcs. I woke up and went to hospital as soon as we had someone to look after our other child, less than an hour after my first contraction, and she was already halfway down the birth canal. The consultant was paged, and he was so calm and so cool about it all that I just absolutely relaxed and I swear that and having no epidural etc helped. It was bizarre, my body just knew what to do (unlike my first birth which involved syntocinon, an epidural and a substantial tear!). I would actually go so far as to say I enjoyed the birth.

DD was breech. Consultant and head midwife were happy for me to try delivering, but as none of the staff in the big London teaching hospital had attended a vaginal breech birth, they did not fill me with confidence. Csection was fine. Was home in 48hours and totally mobile. Recovery may be slightly longer on average, but I was in hospital for less time than half of my antenatal group who had difficult vaginal births.

There was a buzz on the ward about my breech delivery too. So many midwives coming to tell me how brave I was etc afterwards. My midwife encouraged vaginally delivery as she had done one before. My DD is born in September and was the first that year.
My DS thundered his way out in less than an hour so I cant really comment on pain.
I had pethidine and gas and Air for both.
I didnt want a section with either as my then partner was useless and I wouldn't have had any assistance whilst recovering 🙄

My cousin was born vaginally breech and has life long hip problems from it. Not to mention the horrendous time my aunt had birthing her.
Personally I'd chose the csection as it's less likely to result in serious injury to parent or child.

I wouldn’t even try it. For me the risk to the baby is far too much to even consider.

I have had 2 breech babies, and 2 amazing c sections that I wouldn't change for the world (1 traumatic vaginal birth in between them). I was offered a vaginal breech birth with my first that I declined. I would bet that you would be steered towards emergency c section if there was any sign of problems during a breech vaginal birth, personally I wanted to avoid that.

Just a note on the hip problems that other posters have mentioned, my first daughter who was breech was born with hip dysplasia due to being in a breech position while she was developing in the womb. It wasnt related to her birth. My other breech baby has healthy hips.

@opinionatedfreak the term breech trial has been widely discredited. It has led to a stupid % of c sections world wide, even in crazy situations where a vaginal birth would have been preferable.
I really think the trial has caused more harm than good.
Now the deskilling of staff is leading to them pushing c sections, when a vaginal breech birth is just a different kind of normal.
The researchers themselves admitted that they were wrong on suggesting that vaginal breech birth could impact morbidity in later life.
I can just see the headlines that hit the tabloids about breech birth when the trial came out.

@CockatielcalledSega if your baby is breech and doesn’t turn / the ECV doesn’t work. It is worth discussing with your consultant. Vaginal breech birth of the baby if it is in an optimal breech position is very doable.
Weigh up your options and make an informed decision.
All the best with the rest of your pregnancy!

@BeMorePacific I know that the term breech trial wasn’t great scientifically.

However it’s impact is definitely there - a serious lack of expertise for vaginal breech delivery.

Hence my recommendation above - not because of the trial results. But because of the staffing safety.

I tried for a vaginal breech birth with DC1 - talked with head midwife at the hospital who was happy to support it. Unfortunately I ended up with a crash CS due to cord prolapse. It was very frightening tbh and having once ‘fallen foul’ of the statistics my attitude to risk is now very different.

I went on to have a lovely VBAC For DC2 and, after a semi-elective CS for DC3 still believe that a vaginal birth is a much nicer experience - I just wouldn’t go against medical advice in order to have one.

OP, unless you have a v small baby and a v roomy pelvis, I wouldn’t even consider a breech delivery. It is not “another form of normal” as some PPs claim - it is a malpresentation with a higher risk of complications. The baby’s head is bigger and harder than its bottom, and the breech may deliver but leave the head impacted and the baby short of oxygen, as the cord is compressed by the head.
The reason why modern obstetric staff have so little experience with vaginal breech delivery is that they quite rightly advise a section instead, and most mothers take that advice, rather than gamble on brain damage for their baby.
At 31 weeks there is still, as you say, plenty of time for baby to turn. There is also the option of an external cephalic version - turning the baby manually before labour - but in my experience, if the baby is easily turned, it will often turn itself straight back again!