vaginal breech birth & changing OB's

[MeredithD]

Have also posted this in platinum chat hoping for any responses/advice.
I am now 31.5w pg and bubs still happily head up. I know, I know, I know everyone will say still plenty of time to turn but I just have this gut feeling and a need to be prepared for all outcomes - including baby remaining breech.
I have been to spinning babies site, have read all the old wives tales,am having acupuncture, have been using moxa sticks, doing the plevic tilts etc etc so if none of that works then will have to accept how baby wants to be.
My OB has made it quite clear that she will defnitely NOT support a vaginal breech birth and thus my only option with her would be a c-section. I am really not keen to head down this path and would not feel at all comfortable consenting without exploring other options. To me, a c-section should be a last resort if there is no other safe way for baby to exit! My OB did agree to refer me to Lionel Steinberg -the "vag" man in Melbourne aapparently and probably the only OB who would support a first birth, vaginal breech. I have heard very good things about him and a midwife friend of mine said she would certainly trust his opinion and skill with a difficult birth.
I have two real questions
1. Has anyone attempted or had experience with a vaginal breech delivery?
2. Has anyone changed OB's so late in the pregnancy. I am not that worried about "offending" my current OB but just wondering how it would work cost wise and feeling comfortable with someone new so close to birth

I have still not made up my mind what choice I would make if faced with breech baby in a few weeks - I want to do what's right for baby but also for me. My DH is worried about the vaginal option but then he has only heard the hospital antenatal class standpoint on the subject. I have done quite a lot of reading and get the impression that a vaginal breech birth could certainly be very successful if handled by someone experienced. Does it seem sad/odd to anyone else that our choices have become so limited by modern medicine? Yet, they are quite happy to allow, even reccomend interventions such as induction, epidurals etc which have the potential to lead to complications, forceps,vacuum, emergency c-sections!
Sorry for the long-winded post, just feeling bit confused at present - any thoughts would be greatly appreciated..

[bon]

I have never been in this position so I can't comment on whether or not a vaginal breech birth is a good/bad thing. But I do think that you should definitely see the other OB if you can, and see what he has to say - he will be able to give you all the facts and info that you need to make a decision about this. I don't feel that all breech births should necessarily be by c/s, but that is a personal opinion not based on any facts! At least your current OB has been upfront with you and let you know that she will not do a vaginal breech, so you can investigate your other options.

And, yes, there is a good chance that bubba will turn for you!

[chocolatecatty]

Hiya Meridith,
Have you read 'New Active Birth' by Janet Balaskas? It says 'provided the first stage goes well adn a supported standing squat is used, most breech births are uncomplicated....if you discover your baby is breech by 35 weeks, stop squatting and try walking an hour a day to encourage bubs to turn'.
She also says 'lots of babies are lying breech 6 weeks before birth and then turn spontaneously, so don't do anything until 5 weeks beforehand (ie: 35 weeks).

I realise this last peice of advice would be hard to follow but she knows her stuff...

All the best

[BellyBelly]

I've replied to you in the Professional Support Panel but also if you go to the RCOG website you will see a statement they have prepared about vaginal breech birth even being favourable in some instances! So print it out or have a read. As the others have said though, baby often turns just before birth...

[Michelle71]

Meredith - go for an appointment with the other doctor for a different point of view. That should answer most of the questions regarding the birth from their point of view.

As for moving that stubbourn bubba (see ... it stuck and it has a mind of its own ) when do you finish work?? There is some belief that those of us who work on our feet have more difficulty with bubbies turning and also with posterior positions due to pelvic positions and gravity. If you are off soon it will give you the opportunity to do some of the things from spinning babies to allow more room for the baby to turn on its own.

As well as acupuncture, chiropractic manipulation from someone who specialises in pregnant woem can also be useful for ensuring good pelvic alignment to allow the baby to turn without *obstructions* getting in the way.

Most importantly, look after yourself. There is not much longer to go until that much wanted bundle arrives to change your world forever.

[David Vernon]

G'day Meredith,

I find it interesting the language that Obs use. Why does your Ob not say "Sorry, but I don't have enough experience to help you birth your baby vaginally... even though you are paying for my expertise..."

Obstetricians have become so fearful of vaginal delivery that the only way they seem to know how to manage breech birth is via a C/S. It wasn't so long ago that obstetricians happily helped the mother birth breech babies vaginally and now they suddenly seemed to have forgotten. Pardon my cynicism but really it seems to simply be that a C/S can be done in 20 minutes whilst a full labour may take many many hours... Some obstetricians will quote research evidence for their refusal (the now discredited term breech trial) but most others simply refused to support the woman in her desire to birth the way she wishes.

Perhaps you should try an IPM. Most of the Melbourne IPMs are experienced in breech birth.

An excellent source of information about breech birth can be found in Maggie Banks book "Breech Birth - Woman Wise".

All the best and I am sure that your bub will turn and make all this worry unnecessary. And as for your DH - get him to read some books. Whilst a breech birth is not as straight forward as a head first birth, a caesarean section is not without risks and he needs to be aware of these too, so he can support you in YOUR decision.

Best wishes,

David

[*Efjay*]

My brother was breech during labour & turned just before they werer getting mum ready to have an epi & c/section. So like you said you know there is plenty of time to turn. Even if you go into labour in the breech position. You could still turn!

[MeredithD]

Thankyou all for replying - Its great hearing some positive stories -probably need DH to read these!
I took advice from Kelly and rang Lionel's office yesterday. He rang me last night which was great.
I was very happy with him. Yes, he is arrogant but then a lot of "good" Dr's are. He was very positive about vaginal breech birth - says he has success rate of 75-80% which is pretty good considering cephalic success 90%.
He was quite strict about having to fullfil "Lionel's Rules" (almost giggled at this point!)
Baby has to be frank, below 4kgs etc etc as assessed by u/s at 36-7 weeks
Must have spontaneous labour - fabulous as I don't want an induction!
NO epidural - fabulous - I don't want one!
Will have an episiotomy - eek but better than a c-section
labour must progress at reasonable rate - fair enough
Must change to St Vincents - mmm, bit of a pain as we are booked at frreemasons but he says he can get me in and I would accept the change if need be.

So, all in all, I feel more relaxed now. I don't actually have to make the change to his care until 36w if baby still breech so the pressure has kind of been lifted. If baby turns - great! If not, I know I can still attempt the birthing of my choice and if I still end up with C-section, I will know that I tried everything and there is no other option.

Choc - yes, I have Active Birth and am inspired by the positive spin on breech deliveries. I am doing all the exercises. As for waiting until 35w - I get conflicting advice on this one. Both my OB and acupuncturist would prefer to see bubs turn sooner than later as I am quite small so space will become an issue.

David - You are spot on!! I am very cynical re all the "medical" advice I am hearing too - and being a vet, i work in a very "modern medicine" frame of mind. However, I do believe with both animals and people that nature is far more complex and "knowing" than we realise. MOst births, breech or cephalic, WILL progress fine without intervention! Why is there such a need to "control" everything?
Lionel defnitely seems to have this frame of mind (although within "safe" limits) and did bring up the subject of some OB's being "lazy" when it came to birth. Obviously a scheduled c-section is much easier to work around than a natural birth at 3am!!
He even gets women who actually want a c-section breech birth but their own OBs just won't let them go into spontaneous labour first - they are booked in for 38weeks!! This just seems outrageous to me. There is no danger in going into labour with a breech and generally plenty of time to organise a c-section right then - I guess its just a pain when it happens in the middle of the night!

[chocolatecatty]

Ah, that's such good news Meridith! Smiles all around

[Trish]

Meridith that all sounds fantastic. Atleast you are informed. My 3rd son was a breech bub, we tried to have a EC done but it didn't work, I begged the Dr's to let me go or at least try to vaginally delvier him but I was told that no Dr's at the hosp would do it. When I was opened up for my c section the OB said to me "oh, you could've delivered this bub" Der, wrong time to tell me that, I tiold him to close me back up then and I would. Next time around I had a homebirth

I question my midwife if they do deliver breech bubs at home and she said yes that most hb midwives were happy to, and that generally they preferred the women to labour and birth in water as this supports bubs body and there is no need for too much intervention.

Don't fall for the scare tactics you will be given, sure there are some bad stories out there, but how many fanastic, positive breech births happen too. Of course they only like to tell you of the bad ones.