Any comments on VB vs CS for breech baby?

[numa]

HI - this may be a bit premature, but at 36 weeks my bubs is still breech and resisting moxibustion and inversions to help him/her move!

My OB said she is willing to do a VB if asked... I was with my sister when she gave birth to her first baby breech. It was a very long and exhausting labour and then she needed oxytocin and an episiotomy. I talked to her about whether she would have made the same choice, and she said she wasn't sure (even though she is very pro natural birth and had her second bub at home). She said she felt quite traumatised by the birth experience for some time afterward.

We whave decided with OB to try manual turning (ECV) at 37.5 week visit if needed. Bub is in an odd position - one leg straight up and the other down.

If that doesn't work we will need to make a decision at some point. My first thought was that I would try VB, but ultimately I want to do what is most safe for bub. I also am concerned with attempting a VB and then having to go for an emergency CS. I figure a planned CS would be less traumatic for everyone....

I really want a natural birth more than anything, no drugs etc. I have been preparing using the Pink Kit and going to weekly independant prenatal/birth education classes.

But then this bub is so precious I wouldn't forgive myself if something happenned to him/her during birth - and I know with breech there is more chance of cord prolapse and other risks to the baby.

Just wondering if anyone has thoughts on this?

BTW - I'm 37 and this is my first baby...

[Trillian]

Personally, if I were you and I had an ob that was willing to do it, then I would go for it. Breech births aren't automatically more difficult than birthing a baby in a head down position, they are just another variation of normal. Do be aware though that your position during the birth is crucial to successfully birthing a breech baby, so you need to make sure that during your labour you are doing all you can to help yourself and your baby. If you go to www.spinningbabies.com there is a wealth of info there to help you. Also do you have an other support apart from your DH like a Doula? If you do you will benefit immensely from having one and her coaching you into the best positions. Also check out youtube for breech births as well to see that it can be done and also how it is done kwim? there is an independent midwife's website too that has a vaginal breech homebirth on it, I'll find the link for you.

ETA - here it is, Homebirth: Midwife Mutiny in South Australia

[bugalug]

hi there

My first bub was breech, and we decided to have a c section. I wasnt very keen on the idea of an ECV, due to the risks for bub and myself, and a breech vaginal delivery sounded risky aswell. We were pretty much advised to have a c section delivery as soon as we knew out little boy was breech.

I just naturally thought i would have a vaginal birth, but when i founf out i had to have a c section it was a bit weird at first but because it was for the safest arrival of our little man we didnt think twice.

I had a no problems BF after the op - you often hear that its hard due to a sore belly but i fed normally in a normal BF position. Yes bubs is taken away, but this happens anyway doesnt it? My hubby was with bubs when he was taken away to be weighed etc and i was stitched up. Dont get me wrong, they hand bub to you as soon as they cut the cord and clean them up, we have great pics of us with bubs.

I had a pretty good recovery, the first nite is hard when you haev to rely on the midwife to get bubs up for a feed and change nappy etc. But i was up and walking the following morning and had my c section late afternoon.

At the end of the day its up to you & whats best for ur bub and youself - thought i would let you know a little about my experience with a caeasar deleivery. If you want to know more just let me know, i;m more than happy to share.

[Pandora]

... Yes bubs is taken away, but this happens anyway doesnt it?

Nope it doesnt always happen. With DS they did all the cord cutting, cleaning etc with him on my belly afterward. At and some hospitals they dont take them away after CS either.

If your OB is confident enough to do a VB surely she must think the babies positioning is OK, or else she will want the position to be a certain way for her to do it - did she say anything specific?

[numa]

Thanks ladies for your posts!

Trillion thanks for the links, very interesting and useful

Bugalug for your story - was glad to hear you were fine with BF afterwards

Jellybean for your birth story - was your bub a breech too?

Purplemamma you have given me hope mine will still turn - do you have any links to stats? Everything I read didn't sound good for vaginal breech, so I would love to read something that indicates VB is safer than CS for breech.

Ellibam - good point about going into labour first and the benefits of the hormones, I hadn't thought of that..My sister won't be there but my Mum and DH will. Mum was also at her breech birth - mum is very instinctive and has very positive feelings about her own births, she'll be calm and reassuring.

Mantaray, thanks for the link, what an amazing guy hey!

Rayray, I must say I'm not totally sure where my OB is coming from. She discussed the study regarding safety of breech birth but then said the validity of it is questionable because most of the participating hospitals were in South America. She said she'll do a VB for breech if asked by parents because of risk of being sued if something goes wrong. I always get the impression she thinks I'm worrying far too much about things (probably true, but hey I'm a beginner!) and she seems very unfazed about everything.

I'm sure she is very skilled - she is the head of Maternal Fetal medical unit at Monash Medical Centre and used to be the president of RANZCOG - she would have seen it all and then some! I guess in the next appointment I'll go through all possible options and pros and cons for each with her.

Also at the hospital prenatal workshop the nurse said that the automatic CS for breech policy at Monash is changing, and they are starting to do more breech vaginal births again.

If anyone knows of any studies with statistics, other than the South American one, I'd love to read it!

[Trillian]

Kelly would probably have some more stats about that. If your ob is confident about you being sucessful despite all the info she has, I would still give it a good shot - I think you have a great support network in your Mum because she's BTDT with a breech baby of her own and knows that it can be done. But if baby is still high and can't engage because of the leg postitioning then that does bring in cord prolapse into the situation and that is a problem in itself. How far past dates is your ob willing to let you go? You might just need that little bit extra time to allow baby to turn too. Also, have you tried any acupuncture or Bowen Therapy to help baby to turn? Often babies can get 'stuck' because our stomach muscles are too tight so they tend to hold everything in better than someone on a subsequent pg. I really hope that bubs does turn around for you so you have a little less pressure and worry on your shoulders about it but I know that what ever you decide to do will be right for you.

[JellyBean]

Thanks for those links Trillian - they are great.

If it were me, Numa, I personally would have to give the vaginal delivery a go, and then if it didn't work out in the end- then so be it. It may seem easier just to opt for a c/section and save dissapointment later- but truthfully, I think you would always wonder 'what if..?' - know what I mean?

I had a labour which spanned 4 days (I was determined to have my baby at home in water without drugs), but on the last day (at only 3cms dialated) I was too exhausted so opted to go to hospital to speed things up and ended up with an epidural, episiotomy, etc. I was disappointed that I didn't get the birth I had hoped for, but my saving grace was that I ended up with a vaginal delivery in the end. Looking back, it was the only aspect of the whole labour process that I was really happy with.
I know not everyone feels this way about vaginal delivery, but I just think that, no matter what your views on birth are- nothing should stop you from attempting to acheive the ideal. Just don't consider it a birth 'plan' - more of a birth preference. If you do not get your first preference- you can re-assess and take it from there.

[Pretty Butterfly]

My bub has recently turned, luckily, but she was a perfect frank breach before that.

And I was going for a VB. If you check the stats, (I did, lots!) A VB with a good positioned breach is still safer than a c-section.... not sure with one leg up and one down though...

There are lots of positions that are great for a breach birth, Trill has given you some great links...
Good luck with your decision babe, and bub just may turn yet!!!!

[Ellibam]

i would try for the VB. esp if your ob is willing(so very few that are).
you will be in hospital so at any sign of a problem you will be c/sed straight away.
also going in to labour first is better for bubs then going straight for a c/s all the hormones help with bubs and your body in the aftermath of birth(either way)
there are some great books on delivering breech babies to so getting in to the idea of a slightly harder labour might help.
would you have your sister there with you?? i think she would be a great source of knowledge for you when you are in labour.

[MantaRay]

Have you seen this thread: https://www.bellybelly.com.au/forums...w-bisits.html?