Breech vaginal birth

[mama8925]

Talk to me about your breech birth.
Where we live about 5% of vaginal births are breech (as opposed to 0.05% in england as the rest are c section), this little one keeps flipping so preparing for the possibility (dc1 also was but was successful in ecv, however didn't flip around as much as this dc is)
Was is any more difficuly physcially? I didnt find my regular birth all that bad. Any other added complications that were specific to breech birth? Would love to know your experiences
Many thanks!

Mine was breach up until a few days before. Flipped head down and I had two vaginal deliveries.

had my babies been breach when the time came…. I’d have gone straight to c section no question . Upon the advice of my
retires midwife mother

If you mean you're in a different country, OP, so am I, and my baby keeps flipping.

Had an appointment with the resident "breech specialist" consultant in the hospital who was very relaxed about the whole thing. He said since I've given birth once already, he would be fine with going for a breech vaginal birth if the baby doesn't flip head down.

He said ideal scenario baby is head down or we do an ECV and then normal vaginal birth.
Next best for me but a little riskier for the baby would be a breech birth.
Riskier still for both me and the baby would be a C-section.

He really put my mind at ease. Baby currently head down but who knows what it will do in the coming weeks!

I have no desire at all to have a section. Absolute last resort for me!

This is it exactly @Uphighseesky
My midwife when I first asked (due to dc1 being breech and having had a successful ecv, how common ecv was in this country) she was more than confident about delivering breech as its much more common here than jumping straight to a c section, which comes with its own complications and risks and would also be my least favourite option!
I've got a few appointments in the upcoming weeks to check on things and prep for all options
But like you, feeling pretty comfortable with the idea of breech vaginal delivery as the midwives here are much more a)confident and b)experienced. Even in my small town hospital!

My two were breech and I had sections for both

Not with the risk IMHO

feeling pretty comfortable with the idea of breech vaginal delivery as the midwives here are much more a)confident and b)experienced. Even in my small town hospital!

and what makes you say that?

Perhaps because they are more experienced with breech births and not so quick to jump to booking a section? That's my experience too.

My first presented breech and I had successful ECV.

My second also presented breech and ECV was left until later and wasn’t successful. This was a few months before an influential Canadian steady was published indicating significantly elevated risks for breech vaginal delivery.

I had a trial of labour with the obstetrician and two midwives in attendance. Labour progressed well, late second stage monitoring contact was lost for a short period and we now know there was cord compression for a critical period. She was born not breathing and initial resuscitation was unsuccessful. After 2 weeks in NICU followed by 14 weeks in SCBU then a baby ward she survived but with profound physical and cognitive disabilities. She is tube fed and non verbal amongst the rest of it.

Mine was face first and back to back, but not breach. I'm not uk and the midwives spent hours spinning him so that he could come naturally. We have far fewer c-sections here than in the UK and I'd trust the midwives. From mumsnet it sounds like the midwives in the uk only show up at the last minute and don't have time to try alternatives.

My dad was a breech vaginal home birth. The midwife must have had nerves of steel!!

In the UK most breeches are born surgically, which means doctors and midwives have absolutely no practical knowledge of delivery breech babies, further increasing the risk.

In the large inner city hospital where I trained, any vaginal breeches would be attended by a select few team that were trained in countries such as Eritrea, Malaysia and Uganda, as they had so much experience of breech birth that we did not have.

If going for a vaginal birth, make sure your midwife has experience.

Did you have vaginal?

was back to back excruciating?

My DD was in breech position. I have a family friend who at the time was one of the most experienced midwives in our region and worked in a specialist high risk unit where all the potentially problematic births are sent to. She had extensive experience of (unplanned) breech deliveries and in addition to her role and seniority at that time she had also worked and taught in other countries. I really did not want a c section. Friend advised me in no uncertain terms that I should not voluntarily opt for breech delivery, the risks were so high even in a modern, well-resourced hospital. I was booked for ECC but in the event DD turned by herself the morning it was supposed to take place. Don't risk it.

14h at home (that was the plan), then water bath at the midwife unit. The wouldn't let me have G&A because the staff are only allowed to be exposed to it for 4h and they knew it was going to be a long one and that I'd need it later. I don't remember much of this bit, I was so miserable. After 18h I chose an epidural which was wonderful. Still mobile so I could still move under the midwives' guidance to turn the baby, who eventually cooperated. Born without intervention with 30 mins pushing on hands and knees after 24h! I was lucky to have a brilliant team and a very experienced ex-midwife doula.

ETA I think in the UK I'd have ended up with forceps or c-section. Some disadvantages of our system though, they threw me out 6h after birth even though it was the middle of the night, which does mean that everyone gets a private room.

I had my 3rd vaginally and he was undiagnosed breech. The only difference was the people who came and watched because it was so rare

Bloody hell… I’d have taken a c section over that!

less risk if you have had previous successful vaginal births than a first time attempted delivery.
the head is the issue, the presenting part of bums or legs are soft tissue and the cervix doesn't have to be fully dilated for the body to start to pass through. the shoulders are next, sometimes wide but can be wiggled to one at a time or break/broken naturally to make the width narrower. then comes the head, which hasn't molded (to peanut shape) is wide round and can be difficult to near impossible to deliver resulting in brain damage and a c/s attempt to get the baby out.
mom's who have good pelvises and past successful deliveries (the bigger the better) have better chances but it's a chance.

Both of mine were breech. I had a pelvic x-ray when pregnant with my first to ensure that I could deliver vaginally (I’m not particularly big and they needed to be sure that my pelvis could accommodate baby’s head). Baby was delivered butt first by a registrar, I had an epidural in case a c-section was needed. Baby was folded up with feet up around the ears!
Baby no2 was also breech but was a “footling” delivery, ie feet first and forceps were needed. Both were delivered by the same registrar to a room full of students and goodness knows who else! This was the 90s, I don’t know if I would be allowed to have a vaginal delivery these days.

I should preface this that lots of measurements would be taken if baby is breech before labour to make sure a breech delivery is "suitable" regarding pelvis size and baby head size and positioning if they are even breech (as I said, baby moves all over the place)
And having prior small babies and no problem deliveries midwife was very encouraging if baby is breech
But just wanted to see others experiences with actual breech delivery, not just other people's midwives saying to have a c section (as they are not my midwife with their personal experiences in a hospital that delivers breech babies)
Sorry to hear you had such trouble and unfortunate issues with delivery and your daughter @LightDrizzle, these sorts of things are definitely the kind of things I've always heard with regards to breech so it's always on my mind, but it's nice to hear that people have also had "no problem" breech deliveries too.

Lovely to read talk of experienced midwives and OBs who can support breech delivery if that is the maternal wish and the risks are assessed. (I would love to know where you all live..)

It is worth doing biomechanical movements to support a flexible pelvis and create as much space as possible.. which will either help baby move or give her enough room on the way out. .. spinning babies is the best known but there are many other experienced midwives and doulas who can advise.

Having midwives and OBs who have seen vaginal breech deliveries and are knowledgeable about the biomechanics is great.

It was actually ok. Only 6h were properly miserable. With the epidural I could sleep and eat and I needed almost 0 recovery time afterwards. The midwives did put in my notes that they'd expect a completely trouble free and easy home birth next time, if the baby cooperates!

I'm in NL. It's very different to the UK. Hospital births are only if there are medical issues or you want serious pain killers. You're under a team of community midwifes who stay with you all the way through starting at home, then they hand over to the hospital midwives if something starts to go wrong. It sounds so much less stressful than the UK. 20 years ago infant mortality was higher than it should have been so there's been a lot of attention, but it thankfully hasn't turned into very high rates of c-section and we have very low maternal mortality. My midwives at least had done loads of CPD about spinning babies. When I raised something I'd read on pubmed after the birth, the midwife asked for the ref and said she'd raise it at the staff meeting. I was really impressed!

@Paaseitjes ... of course you are!! The name gives it away - plus of course, the description of your experiences!! It is interesting that the narrative is that 20 years ago, the infant mortality rate was high, but it was, and remains lower than the UK despite, or perhaps because of the much higher rates of home births.

My last was a footling breech. Like yours is now, she was spinning. As she was an unstable lie and presenting as a footling breech on a scan they made me stay in hospital in case of cord prolapse if I went into spontaneous labour ( was wanting virginal birth ) The plan was to turn and induce … however she had other plans and I went into spontaneous labour. She was still footling breech. Plan changed to emergency c section, but by the time I was getting prepped in theatre I was fully dialated. Consultant scanned and cord was fine so she came out as a footling breech virginally. C section stopped literally seconds from GA being given

I’ve had two very straightforward 2 vaginal births and 1 c section.

And on the basis of what you describe, I’d have been begging for a c section. That sounds medieval.

Yes, my vaginal births were more “satisfying” I suppose but I recovered so quickly with a c section. All things being equal… I’d choose a vaginal over c section based on my experiences BUT only marginally.

Hi, I had a vaginal breech delivery in the UK.
My baby was small which I think helped. I went into labour early and was in established labour when I got to the hospital. The consultant had previously advised c section when I'd been at my check ups but on the day everything was happening fast and I said would it be ok if I tried for a vaginal delivery as I was really scared about a c section. She said yes but did look a bit worried.
In the end there were lots of doctors and staff in the room probably to gain experience.

My DS was delivered breech. He’d been breech all through pregnancy and there was talk of c section of the manual turning. I hated the thought of the manual turning and was going to opt for CS. He turned himself in time for my last midwife appt then flipped again in labour.
The first the midwife knew of it was him pooing into her hand. He came out bottom first, then each leg, then finally his head. There was a consultant in the room who just happened to be on shift and the midwives told me afterward it was the first breech delivery they’d seen.
this was all unmedicated too, not through choice but because it was too fast!

Had a small tear but recovery was much easier than with DD who was spinal block and forceps!