Natural breech birth?

[~*Niadalla*~]

I was contemplating a breech birth with DD. She was presenting breech at 36 weeks. I was going to try every thing humanly possible to turn her. I had asked my OB if I could deliver vaginally. He said, if any other Ob or attending was on, then there was no way in hell I would be allowed. If he happened to be on at hte time I went into labour, he would have allowed me (seeming as I had already VB'd a reasonable sized baby, so he had the confidence that my body could do it). He said had I been a first time Mum, there would be no way he would have 'allowed' it. ( Iwas a public patient in a public hospital)
I thought about it for quite a while, and in the end decided that if we couldn't turn DD, that we'd probably lean towards a cs but that I would refuse that before I went into labour in case DD turned.
I was lucky that I didn't have to worry about it as DD turned at 37 weeks.

Good luck! All I can say is reasearch research research!
There's still alot of time left for your little one to turn.

[Early Kids]

Thank you for sharing your story Sally, how sad for your friends but equally how wonderful their child survived against the odds. However it may interest you to know that those care providers who support breech birth usually do not usually support it in preterm infants, as their head is so much bigger than their bum, making the risk of injury or death much much higher. A preterm baby who was expected to survive would usually (even with pro breech obstetrician) be delivered by caesarean.

In this case the VB was probably supported to maximise your friends chance of using her uterus again, which is a common practice when a baby dies in utero or is not expected to survive long term. A caesarean at 24 weeks is more complicated that a full term one, as the uterus is so much smaller, and makes a future pregnancy much riskier.

I realise this, I was just pointing out that things can and do go wrong (especially with breech birth) and it is best to do full research before making a decision. My friend didn't have the option of doing research and relied solely on her care providers opinion, which we all know is somewhat biased!

[onthefly]

All the best Persephone - hopefully you can get your bubby to turn.
In WA, as far as I'm aware, it's virtually impossible to have a VB with a breech presentation if you're a first-time mum as your pelvis is 'untried'. I suspect the real reason is that so few OBs (or middies for that matter) have experience in managing the delivery.

[Traveller]

I realise this, I was just pointing out that things can and do go wrong (especially with breech birth) and it is best to do full research before making a decision. My friend didn't have the option of doing research and relied solely on her care providers opinion, which we all know is somewhat biased!

I appreciate that, however for the sake of balance on this discussion I wanted to point out that preterm breech birth and full term breech births are two completely different things with regards to risk. This was more so that anyone who didn't have your experience with preterm birth would understand the quandry your friend and her care providers were in. Regardless of how her baby was born there were huge risks. Not a nice place to be at all.

[Alan]

Most hospitals unfortunately will not consider a breech birth and I very much doubt if a birth centre would consider one.
I attended a breech homebirth last year. See thread below.
https://www.bellybelly.com.au/forums...homebirth.html

[*Infinity*]

Hi Persephone,

My son was born by emergency c-section, he was an undiagnosed breech presentation - he was head down my whole pregnancy and flipped in his last week. We didn't know until I arrived at the Birth Centre (in a major public hossy) in well established labour (8cms dilated) and my midwife did a vaginal examination. So it was all fairly rushed.

It would be fair to say that most public and private hospitals in Australia will recommend a c-section for breech presentation. Based on the risks associated with breech vaginal birth and the fact that is has been largely unpractised for so many years that not a lot of practitioners are experienced enough to support a breech birth comfortably.

For us, we had a short time to discuss our options & make a decision and it was fairly clear which way the hospital was trying to point me. And based on the info we had at the time we chose c-section (no less devastating for me, but a choice we own). FWIW based on the info & research I've done I believe that planned vaginal breech birth is safe - the key is confidence of the birthing mother & her support and the experience of your care providers. The type of breech presentation also plays a role. I found Henci Goer's book "THe Thinking Womans Guide to Better Birth" really helpful.

The thing that annoys me the most is that care providers will tell you all the risks about breech birth, but seem to conveniently omit the risks associated with a c-section. Like a lot of things in life, its about balancing the risk and really its your choice.

Its highly likely bubs will turn, I think its only a very small percentage that remain breech, so I'm sending your baby lots of "head down" vibes!

Good luck

[skeetaboat]

I don't understand why the change in delivery procedures for breech babies.

I believe it was the international 'Term Breech Trial' in 2000 that really sealed the deal. It reported better outcomes (mortality and major morbidity) for neonates in women randomly assigned to CS than those randomly assigned to VB. Some methodology in the TBT has been widely criticised since (including, from memory, the use of practitioners untrained in VB breech deliveries in some countries, and use of induction in many cases!), owever by the time criticisms came out, clinical practice almost accross the board had changed. Meanwhile, practitioner skills in managing the breech VBs has been lost.

But that doesn't mean it can't be done! There are still a few practitioners around with breech birth skills, and older practitioners are likely to have breech birth experience too. "Hands off the breech" is the golden rule. And hold off pushing until your body is doing it involuntarily to ensure you're fully dialated.

[CharlieBrownGirl]

Thank you skeetaboat, that makes a lot of sense. How frustrating that practices have been adopted based on the study without peer review and evulation.

[Bumperstump Cummerbund]

DH was a natural footling breech birth - I'm not sure the midwives even realised until his feet started coming out first! But MIL says he was her fastest labour.

He was her 4th baby, maybe that makes a difference?

[Persephone1]

You Ladies (and Alan) are such legends. Thank you for all your wisdom, frank and interesting discussion and support. I'm not quite 29 weeks, so not really worried about his position at the moment, but it raised my curiosity and I'm glad I asked the question now.

I'm a bit sad that breech tends to = c-section, but if I do end up with a breech bub at least I'll try and be prepared enough to know what decision to make at the time. And I'll be doing what I can to turn him if that's the case.

Thanks again,
Seph

[starangelk]

Hi Seph - just wondering if your baby turned or is still in the breech position? I am almost 35 weeks and had an Ob appt today and my little one is still head up - so just thought I would check in and see if your baby had turned and if yes, did you do anything to assist this? Xx

[Freya]

I had Ds3 at a birth centre. I had no previous birth complications. I had brought up this exact query with my midwife around 34wks because I dont feel breech should neccesarily mean csection.

She told me that birth centres cannot legally birth breech babies BUT that they cant force you into a csection so if I wanted to vaginal birth I should and could at the hospital. She made it clear the OBs would try and talk me out of it and get cranky at having to attend the labour (another legality) but that they would let me do it. It was my plan if he was breech but he wasnt. He was born through Townsville Hospital who are teeny bit more progressive than most hospitals so that may be why I had a choice.

[Fleur]

Just reading this with interest as I have a friend due in a few weeks & at this stage her bub is breech.

What exactly are the risks for breech birth? I know cord prolapse has been mentioned...what else? Does anyone have any stats? (even a rough idea would be of interest).

[chocolatecatty]

Such an interesting thread. I've been wondering the same thing as this is my last bubba (probably) and I'm sillily thinking something might go wrong (unfounded reasoning). I'm booked into the Angliss FBC and I imagine they wont assist a breech birth (but will still ask them next appt).

My question is - if you're going through a public hosp and have no private insurance but have a breech bub can you ring someone from the list Kelly made up (wow, can't believe how lucky Vic is to have so many obs willing to deliver breech, awesome) and see if they'll assist? Pardon my ignorance!! Will they come at short notice? And what on earth would it cost you?

[Persephone1]

Hi,

Sorry, I lost the thread. Baby is still breech, although they're saying he's actually still transverse. His head bobs up under my ribs sometimes but at other times he's lying across my belly. If he doesn't shift, my GP says it'll likely be a c-section, which is making me need to re-visit this question of whether I'll be supported to deliver vaginally. Certainly I won't stay at the Birth Centre, but I might look into finding an Ob who will support me - only we're going public, so I don't know if that will affect us. Augh, so many questions!

I'll come back and post when I know more. In the meantime, please send me your "turn upside down" vibes!

[Oorki Galoorki]

transverse has to be a a csec. there is no physical way you can het a child out that way
breech is different.
please read this Breech Birth | Homebirth: Midwife Mutiny in South Australia
it will give you lots of information about breech
get on to the spinning babies www now get bub moving while it still can easily. see a chiro/physio accupunturist.. its best to get your body in to alignment so baby will simply go into the rigth position.

[Snacks]

Hope your bub turns for you soon, Persephone

My question is - if you're going through a public hosp and have no private insurance but have a breech bub can you ring someone from the list Kelly made up (wow, can't believe how lucky Vic is to have so many obs willing to deliver breech, awesome) and see if they'll assist? Pardon my ignorance!! Will they come at short notice? And what on earth would it cost you?

Congrats on the pregnancy, Cat!
In a public hospital (at least in Sydney - I think it is nationally...) you can choose your own private surgeon, however you have to pay their fee. I would think this would vary greatly between practitioners. My guess is you'd be up for at least a grand for attending a VB or performing a c/s.

[Pandora]

Depending on the type of breech position there are a couple of private obs in melb who you might get to support you but you'd have to go private