Breech HBAC? Is it safe??? - Page 2

[rebeccalynn]

dd2 was a c/s at 41w6d because she was persistently footling breach. We really believe that her position was because the placenta was very low lying and there was not ideal room down by the cervix for her bottom or head to settle into. We did everything possible to turn her or get her engaged and she just would not do it. My mw is experienced with frank breech and I would have homebirthed with her if dd had been bottom down, but neither of us was comfortable with footling breech because of the much higher chance of prolapsed cord. She is caring for me this pregnancy also and says that she would be okay with a frank breech vbac.

I would just suggest to just keep on trying everything that you can until that baby turns. Adjust your lifestyle to promote optimum baby position. I plan to stay off of the sofa and anything that reclines me or makes me slouch the last 8-10 weeks of pregnancy. Hope that baby turns for you very soon and stays head down!

[applejuice]

Originally Posted by JFTB1177

What is a sacral lie?

The position in which the Sacrum (butt) presents first.

There is also the Occiput (head) presentation, the Mentum (chin) and the SCapular presentation (shoulder). There are variations on all of these, as the sacral lie can also be a foot presenting instead; an occiput presentation can also be a brow presentation.


All are variations. The only mentum presentation I know of personally was in a woman whose baby had Prader-Willie Syndrome.

[JFTB1177]

Originally Posted by applejuice

The position in which the sacrum (butt) presents first.

Ah, thanks Applejuice! Mine is mostly transverse though (???)

[JFTB1177]

Originally Posted by applejuice

All are variations. The only mentum presentation I know of personally was in a woman whose baby had Prader-Willie Syndrome.

Great... one more thing I need to worry myself about Would this be something detected on an u/s? I had one at 20w and a 3D at 33w and nothing abnormal was seen???

[applejuice]

The lie would be seen on a scan; how the baby is lying in the womb, what the presenting part is and the relationship of the axis of the baby's body to the mother, that is anterior, posterior or transverse.

You need to ask what the presenting part of the baby is and what the doctor means by a the baby being transverse. The head could be facing your hipbone and that would be a LOT or ROT left occiput transverse or right....depending on which hip the baby is facing. Ask your doctor since s/he is the one who is the best to interpret it and advise you.

And relax...knowledge is power in childbirth.

[JFTB1177]

Originally Posted by applejuice

The lie would be seen on a scan; how the baby is lying in the womb, what the presenting part is and the relationship of the axis of the baby's body to the mother, that is anterior, posterior or transverse.

You need to ask what the presenting part of the baby is and what the doctor means by a the baby being transverse. The head could be facing your hipbone and that would be a LOT or ROT left occiput transverse or right....depending on which hip the baby is facing. Ask your doctor since s/he is the one who is the best to interpret it and advise you.

And relax...knowledge is power in childbirth.

Thanks... I guess I was asking more about the syndrome... that would have been noticed if I have had multiple u/s's, right? Gosh I just worry about everything!!!

[applejuice]

http://www.nlm.nih.gov/medlineplus/e...cle/002060.htm

Maybe this will help explain more.

[JFTB1177]

Originally Posted by applejuice

http://www.nlm.nih.gov/medlineplus/e...cle/002060.htm

Maybe this will help explain more.

Thanks... I got your private message and tried to send you one back but it said you don't except private messages? Is there somewhere else I could send it to you, or should I just post it here?

[JackieM]

Baby is not only head-down, but LOA! I am praising God and crying happy tears. It's definitely a strange kind of LOA lie, and I can't help but wonder if all the palpations have been wrong the last 6 weeks and he's been LOA all along ... Position was confirmed by ultrasound. I'm not a fan of any ultrasound, but I NEEDED confirmation of not only his presentation, but his body position as well.

His head is just about engaged, his shoulders are between my hips, and his upper back is rounded against my left side. But, since I'm so short-waisted (hardly any length between my hips and rib cage) and this kid is measuring long, the majority of his back is actually lying horizontally under my ribcage, with his bum nestled over by my right hip. His legs are wadded up underneath him, mostly on my right side. So, by palpation, he feels either transverse or breech (no one seems to be able to tell this kid's head from his butt). So relieved and happy to charge full-steam ahead with homebirth plans! Ordering my birth pool (the sevylor) today!

[JFTB1177]

Originally Posted by JackieM

Baby is not only head-down, but LOA! I am praising God and crying happy tears. It's definitely a strange kind of LOA lie, and I can't help but wonder if all the palpations have been wrong the last 6 weeks and he's been LOA all along ... Position was confirmed by ultrasound. I'm not a fan of any ultrasound, but I NEEDED confirmation of not only his presentation, but his body position as well.

His head is just about engaged, his shoulders are between my hips, and his upper back is rounded against my left side. But, since I'm so short-waisted (hardly any length between my hips and rib cage) and this kid is measuring long, the majority of his back is actually lying horizontally under my ribcage, with his bum nestled over by my right hip. His legs are wadded up underneath him, mostly on my right side. So, by palpation, he feels either transverse or breech (no one seems to be able to tell this kid's head from his butt). So relieved and happy to charge full-steam ahead with homebirth plans! Ordering my birth pool (the sevylor) today!

Yea!!!! That's great news!!! Hopefully I'll get the same news too soon! I may get an u/s this coming week, so send some "good position" vibes this way!

[JFTB1177]

I had my home visit yesterday with my MW's birth assistant, and later my doula came as well. Both did a belly check and are pretty sure they felt my baby's wobbly head down low! Still I am going for an u/s this week to make sure... still feel arms and legs all over the place... wish me luck and please send some head-down vibes!

[Robinna]

Originally Posted by JackieM

I'm 32 weeks right now, and from what I understand, transverse can actually be trickier to turn than breech. That's because most transverse babies need to tuck their chin, roll UP to breech, then roll DOWN through another transverse lie and finally to vertex. A baby may be able to simply rotate the 1/4 turn down to vertex if baby is laying with its back toward the sky and its face toward the ground, but that's not usually the case, from what I understand from talking with both my homebirth midwife and my hospital CNMs ... Very few babies will "back flip" to vertex, so it really depends on how the transverse baby is lying. There's not a lot of research that I've been able to find on transverse lie. I know there's no way a trasnverse baby can be born vaginally unless he/she flips to breech or vertex, so that's probably why.

I just can't believe I'm going through this again with baby #2. I've finally come to the conclusion that yes, there may be something with my body that makes me incapable of carrying a term vertex baby, but that does not automatically mean that I can not BIRTH a breech baby. Make sense? So I carry breech; that doesn't mean I can't birth breech. Maybe it's just the way my body needs to do it ...

jackie - having one breech increases your odds of having another (OK, it doesn't really increase your odds, your odds are the same as they always were, it's just that those of us who carry breeches are the ones who tend to carry breeches). It is also thought that breeches run in families, although it may just be that it's the breech-carrying mamas who have occasion to ask their relatives about whether there's a history (breech is so common that most families are likely to have at least one within living memory).

to the OP - I haven't read all the responses yet so forgive me if I'm repeating what somebody else said or if you've updated again - but vbac and breech do not compound risks, they have nothing to do with each other and don't present new risks in combination. This of course has not actually been studied (insert rolling eyes here). Although all else being equal, I personally would be more comfortable birthing a breech in hospital (with a MW or a progressive OB), I would do it at home before consenting to surgery again. I would feel pretty comfortable birthing a breech at home with a MW who would encourage me to be upright. and if I do ever birth again, it will probably be at home regardless of presentation as I tend to have precipitous births.

If you're looking for evidence based info regarding breech please visit my website - it might help you feel more at peace with whatever decision you come to.

xo

[JackieM]

Robin, yep, knew that a previous breech increased my chances of breech again, especially since there was no obvious reason for his frank presentation. Also, my husband was breech.

OP, hope your babe is head-down! Like I said, I'm not a fan of ultrasounds, but I think in this case, it's completely fine, to both assure your care providers of babe's position as well as give you peace of mind. Good luck!

[3tammuz]

Yeah- hope baby IS heads down. Yahoo. Stay down baby!!!

[JFTB1177]

Thanks guys! So I had my u/s yesterday and baby was head down :! His/her back/spine was on my left side, butt under my ribs on the left side, feet dangling down by the head poking out on my right side.

Now we'll just have to see if baby stays this way!!!!

[JackieM]

Yay! This late in the game, odds are she'll stay head-down! And yay for let-side positioning, too!

[mellowyellowmama]

Didn't read all responses, but saw that your baby is head down! :

To answer your original question though, yes it is safe and baby would work her/himself into a favorable head down or breech position for birth (even in labor) in most cases!

[JFTB1177]

Originally Posted by JackieM

Yay! This late in the game, odds are she'll stay head-down! And yay for let-side positioning, too!

Thanks Jackie- had another appt today, still head-down but now POSTERIOR! Oh well, as long as baby is head down I won't complain! How are you feeling???

[JackieM]

Doing great. Had a prenatal today and baby was head-down and head was LOA although his body is somewhat transverse. He's a little stinker, but he seems to be long and I'm very short-waisted, so he's situated so he fits, even though it takes about 10 minutes of palpations to figure out what he's doing ...

There are lots of ways to spin a posterior baby! Sometimes just hands-and-knees works, but Spinning Babies has lots of information on other positions. You're so close, good luck!

[JFTB1177]

Thanks Mellowyellow!!!

Jackie, yea on that LOA baby!!! Yeah my doula has told me to do lots of hands and knees... at my previous appt baby was head down but had body on my left, and MW's birth assistant thinks that I have a lot of room so baby's butt and body are kinda floating around...

When are you due? My due date is on the 18th but we all know how that goes