Breech birth - would you be up for it?

[littleEDfamily]

In my mind attempting a natural delivery with a baby you knew was in a breech presentation was for sado-masochists only, but I hear there are people who are brave enough to give it a go.

I am curious to hear any tales from women who have attempted (and succeeded) to birth a baby naturally from a breech position and also whether others feel like me that they just wouldn't have the guts to try it.

[ljs]

A friend of mine was hoping for a water birth at home and was in the throws of labour when the midwife noticed that the baby was breech...( this had not been picked up beforehand). She was rushed to hospital in great pain and she had to deliver the baby and did so with the help of an episiotomy and forceps...... I know that she said she wouldn't wish it upon anyone.... !! I'm not sure what hospital procedure is for breech/ natural births ??

After having two children my self one with episiotomy/forceps and one with no pain relief I would think it would be a NO NO for me..... OUCH !!!!

[The Nappy Lady]

Despite two brill home births breech the thought of a natural breech birth has always terrified me, don't think I'd ever be brave enough, I think (though don't know enough to be sure) that the risks are greater for mother and baby, which if true would swing it for me.

M

[alieh]

I was - in theory - up for it. I did loads of research, spoke with senior OB at Kings (Dr. Penna), had very supportive midwives (The Lanes) who drafted in midwifery colleagues with natural breech experience to be on call for me.

I agreed with Dr. Penna that I would go 10 days overdue, but that if labour hadn't started spontaneously by then we would do a section.

Anticlimatic end to the story....went 10 days overdue and had a section.

[Ruth_Baldock]

I personally couldn't but my

mum naturally birthed two breech babies, one at home! Brave woman, very brave.

[littleEDfamily]

My midwife said that if the breech presentation is 'good' (ie they are bottom first, but with no dangling legs, and I think facing the right way), in consultation with the relevant specialists (who may be midwives, consultants or whomever has the most experience with that type of scenario - apparently in other countries breech is not necessarily regarded as a major complication, so esp at Kings there are specialists who are quite confident with it) you may have the option of trying it.

I wince just at the thought of it.

[littleEDfamily]

aleih - our posts crossed! What exactly did they say to you about the risks - what was it about your situation that made them supportive about giving it a go (assuming not too overdue)? Was it your first?

[alieh]

Yes, after all my research the conclusion seemed to be that if baby was bum first, labour started spontaneously, and progressed well, there was no reason the birth couldn't be natural. The best book I read was Breech Birth by Benna Waites which summarised all of the research out there (good and bad) in a very matter of fact way.

[alieh]

If you are thinking about this, I would be very happy to lend you the book and also share the birth plan that we very carefully drafted which covered all kinds of things like whether we wanted continuous monitoring of baby's heartbeat while labouring, etc. Honestly, I wasted so much time on the internet reading both inspiring and scary stories that I got in such a muddle. This book was a welcome relief because it summarised all of the facts - it is written by a doctor who had to decide about her own breech birth.

Yes, it was my first baby.

The key factors in a successful natural breech birth seemed to be:

-Butt first presentation (forget the technical terms, but where they're in folded pike position)

-Labour starts spontaneously (they won't induce if baby is breech)

-Labour progresses well

-VERY KEY - midwives and/or doctors with experience in breech delivery

Even though I ended up with a section, I am so glad that I did all of this planning for a natural birth and that I went overdue hoping to go into labour. It meant that when I did have my section, I felt like I had done everything I could to avoid it (if I had had the section at week 38 or 39 like doctors would have liked, I would have always wondered whether he might have turned if I had waited longer). This is just my own personal reflection based on how I felt, not a comment on what would be right for every woman.

I also did all of the other things to get baby to turn (acupuncture, moxibustion herb thing, yoga, swimming, propping bum up for hours on end, etc.) and even had two attempts at ECV at Kings. This bubs was not budging! A stubborn 17 month old he is now too!

[alieh]

BTW, I would be very happy to discuss in person if it would help. I found this time incredibly stressful and it ruined the last 6 weeks of my pregnancy.

[Fuschia]

If twin II had been breech I would have gone for it, Kings were quite happy with that.. in the event, she was head first.

[GinaG3]

I would deliver breech if it was safe to do so and my baby or myself at the time weren't at risk (I would want professionals that had experience in breech though, even if they just sit in and observe). I can imagine it to be very painful and I would hate to have any interference in a natural labour, but needs must. Delivering first time round naturally was hard enough, but i'm rather brave when it comes to labour I suppose.

[new mother]

what about safety for the baby?

I don't know the statistics but I imagine worse owing to risks with the cord?

[GinaG3]

The statistic for breech births are worse. Breech birth is infact deemed natural and babies can be delivered in such positions. Cord prolapse in full term head down babies stands at around 0.4 - 0.5%, this statistic remains the same for frank (hips up) breech births and then rises to nearly 5% for complete breech and a rather astonishing 15% for babies born in the feet first breech position. I believe for reason's to do with hospital safety and the safety of patients in a lot of case's it is much safer and easier to do c-sections as opposed to taking the risk attached to breech births.

Even aware of the information I would still try my hardest to deliver naturally, if I knew my baby was safe.

[Fuschia]

http://www.rcog.org.uk/womens-health/clinical-guidance/breech-baby-end-pregnancy

[Belle]

Did people find that their midwives normally were c hecking position then from a certain point? Mine never did and I remember starting NCT classes at around 32 weeks I guess (maybe later actually) and everyone else had been told what position their baby was in and am sure at one point were even discussing how engaged they were or weren't, but I hadn't. I remember my NCT teacher told me to check with m/w who just shrugged and said there's no point till much later. He was early at just under 37 weeks so never really got to that stage.

[cg]

My son was breech and i was told by Dr Penna at Kings that there was a 1 in 17 chance that he would be seriously injured if i had a natural birth - that swung it for me and i had a c-section a couple of days before due date.

[Mellors]

I'm afraid that the only person I know who had a natural breech birth with her first son now has a 3 year old who is quite severly diabled as a result (oxygen starvation to due cord prolapse or some such).

There is no way I would take the risk, and I know she spends every day of her life wishing she had made a different choice.

Thats just one story though, and I am sure there are loads more positive ones!

[Fuschia]

The actual increased risk is small, I believe, as long as the positioning is good, it's not an induction and the staff caring for you are experienced in breech births. I think if you find yourself where your baby is breech, you need to do a lotof research, and speak to those caring for you to get different opinions. Obviously a CS brings with it its own risks, mostly for the mother. All you can do is weigh up all the issues taking into account your own specific circumstances.

I really felt with our twins that a planned CS would have been a bad choice for us, unless absolutely necessary... I hate hospitals so being an inpatient would have been hard, being away from DS1 would have bene hard for him, it would have been very hard to establish bf, and as DP doesn't drive, that would have been a problem in the recovery period too.

I know other twin mums who have felt absolutely the opposite and chose a CS from early on. There isn't really a right or a wrong, often.... just many factors to consider. As long as any choice is informed. Unfortunately there is no guarantee things won't go wrong. I have heard of twins dying in hospital after a full managed medicalised birth, and women who needed a hysterectomy after complications from a ceasarian.

[nunheadmum]

My first was breech from about 32 weeks on - wouldn't move despite everything. I looked at loads online trying to decide whether to go for a natural birth or a c-section. I was under Dr Ross at Kings.

What swung it for me was when she said that once the cord is outside the mother, they have 7 minutes to get the baby out before there is potential for problems as the cord stops working. 7 minutes just didn't seem that much time to me (probably influenced too by my sister in law who's son had an unusually large head which wasn't picked up and caused her major problems). The c-section seemed to carry fewer risks for the baby - though I admit my research on that wasn't in depth. In the end we felt that we couldn't take a risk which was based on my own preference to try for a natural birth - I'd never live with myself if something had gone wrong and I'd always wonder what if....?

We were also told that of the c-sections they do for breech, 1 in 15 has an obvious problem which would mean that natural labour would have ended up in a section anyway.

I can't vouch for the validity of the info we were given but it's what influenced our decision.

Having had my first by a lovely planned c-section and my second by an awful natural delivery, of the two, I think I would rather repeat the first. In response to Fuschia's comments above - I had a spinal so my daughter was delivered onto me and immediately breastfed, I was off painkillers by the end of the day and recovered from the section far quicker than I did from the natural delivery. Every birth can be so different depending on you, the baby, the staff you encounter - it really is hard as there is no right or wrong answer.

[littleEDfamily]

Luckily, I've now been told our baby is head down, but given the fact that I was a breech baby (delivered by C section), I have always had the 'what would I do?' question in the back of my mind. For me, the deciding factor is that I think you need to be confident in your ability to birth a baby naturally to give you and it the best chance of a good birth, and for me, knowing we would be at a considerable disadvantage would mean I wouldn't have the right mindset, and it would be c section all the way!

[alieh]

The interesting thing is that the risks to baby are higher for a normal vaginal birth than a c-section - in other words, if baby's safety was the only concern, c-sections would be "safest" for baby in every instance. But risks to mother are much greater with a section, and of course they're not going to do sections for every birth. But I just thought it was interesting that people kept telling me that the risks of a vaginal breech birth were higher than a section, when stastistically that is true for every birth.

I just hope I don't have to worry about this when the next bubs comes along!

[new mother]

Nb that stats for sections include emergency sections where either the mother or baby is already in trouble.

Planned section are a COMPLETELY different kettle of fish.

Biggest risk is bp drop in mother which the most junior anaesthetist should be looking for in advance.

Subsequent hysterectomy occasionally occurs but is likely to be from panicked emergency scenarios. (In a planned section, if drs and expert witnesses were honest, medical negligence would be the cause.)

[Fuschia]

nunheadmum Wrote:

-------------------------------------------------------

>

>

> Having had my first by a lovely planned c-section

> and my second by an awful natural delivery, of the

> two, I think I would rather repeat the first. In

> response to Fuschia's comments above - I had a

> spinal so my daughter was delivered onto me and

> immediately breastfed

I did have a plan in place in my mind for if we DID need a planned CS (if Twin I turned breech) and was also prepared for the worst case (which for us could have been an emergency CS for twin II under GA as an epidural might not have been possible, as I was on bloodthinners) But a planned CS can certainly be a peaceful and happy birth...

You can't overplan every scenario but it made me feel happier knowing we would do our best to make it work for us howver it turned out, and if something was medically necessary, then so be it...

[linzkg]

Hi there, have a read of my thread as my baby was also breech and I was very strongly considering a natural breech birth but I found everyone on the forum very supporting and helpful with their opinions so it may be of some use to you: http://www.eastdulwichforum.co.uk/forum/read.php?25,268504,page=1

My midwives from Brierley were supportive but there's always doubt. I tried everything to get him to turn as I felt strongly about a natural birth and eventually had a successful ECV done by an incredible doctor at Kings.

I feel very strongly now though .. I wouldn't dare consider it .. my son was born the "right side down" eventually BUT if I'd gone the natural route with him being breech I'm pretty confident (and so are the midwives) that he wouldn't be here now.

We had a dreadful and traumatic time and he was stillborn (the only reason he's with us today other then a small miracle is that the midwives reacted super fast and the ambulance got here in 2 minutes!) He ended up being 10.7 - and can I just say at my post date scan at 41 weeks I was massive and said to the idiot Dr Mike Marsh that I was concerned it was going to be a big baby he told me not to flatter myself and that there was nothing to suggest he would be a big baby - point being that if he was still breech and I'd gone it natural .. don't even want to think about it!!

I am still battling now and my son's almost 1 with SPD and had MRI scans on my lumbar and hips. I was in hospital for a week expecting a blood transfusion etc.

Just consider all the possibilities and outcomes. I'm really sorry if I've offended you by my post and put a negative spin on things but feel its important to share both good and bad experiences.

I'm a relatively slender build and people do just laugh when I tell them his weight - it was completely unexpected and the topic of weight and size just never came into our decision on a natural breech birth.

All the best though