Frank breech at 36w, and scared out of my mind about the c-section option. Please, help me.

[lellian]

Oh ladies, am I conflicted, confused, and hopeful all at the same time. This post may get a bit long winded, but I need your expertise.

This is my first baby. We are 36w3d. The baby has been frank breech for our entire pregnancy. We are seeing a midwifery group in MA that is associated with a hospital. . more "medwife" than midwife, but it is the best option available to us for a natural birth. The midwife told me last week that we have until week 37 to flip the baby or be moved to the hospital for care. They are shipping us out because we are a liability due to the baby's position.

I have tried EVERYTHING for several weeks now. Please don't suggest spinningbabies, I've lived on that site. I've practiced all the tricks, ideas, suggestions. I've spent hundreds of dollars and 4 sessions with a wonderful acupuncturist, and the baby will move, bounce, TRY to get into position, he/orshe doesn't seem to be able to do it. I've seen a chiropractor up to 4x a week for the Webster Technique, but no success. I walk, I rest on my left side, I even joined a gym yesterday so I could use their pool. I have tried EVERYTHING excpect external version, which the midwife has suggested for next week.

So here is where I could really use some help, clear thinking, and advise as I am so close to this I'm losing all perspective on "just" having a healthy baby however that happens.

1) I have an anterior placenta. The acupuncturist believes this is hampering the baby from getting into postition. She told me that she has worked with me more than any client, and is surprised the baby hasn't flipped. There must be a reason. Could this be the reason?

2) With the position of the anterior plancenta I wonder if external version becomes even MORE risky for the baby? We are not sold on the external version. It isn't on our list of things to try, but I wake up wondering what if this ONE thing, this one thing could help the baby flip vs. the baby is in a frank breech position FOR A REASON.

3) C-section: my worst nightmare, but I'm done sobbing about it. Do we wait until I go into labor and show up for a section? OR do we face it NOW and start working on a birth plan to make this a cesarean birth and not just a cesarean experience? What do we include? How can I make a scheduled (or not) cesarean birth experience as peaceful, stress free, loving, welcoming as possible?

Thank you for listening. Conflicted, scared, and so in love with my baby I just want to do the right things. I am afraid and hopeful. I have no experience with being a mommy, but there is a mama bear in me wanting to protect my baby.

Our estimated due date is Dec 24th, our little Christmas present.

I failed to mention, we have a doula who will be with us. What becomes her role if the cesarean birth in my only option?

Home birth is not an option for us as we don't have the money available to pay a midwife who will attend a breech birth. The one in our area is $3000 not including lab work she'd want done in advance, or the birthing pool we'd like to use.

Huge love to you all for reading my post.

lelle

UPDATE: AT 37 WEEKS OUR BABY WAS STILL VERY COMFORTABLE IN A FRANK BREECH PRESENTATION. WE STARTED REACHING OUT FOR OBGYN REFERRALS IN THE BOSTON AREA. WE SPENT A WEEK CALLING PRACTICES, BEING TOLD NO, BEING TOLD YES, BUT. . .BEING TOLD EVERYTHING EXCEPT YES, YOU CAN GO INTO LABOR SPONTANEOULSY BEFORE A SECTION. MIND YOU, WE WEREN'T INTERESTED IN A SECTION SO MUCH AS WE WERE TRYING TO BUY TIME FOR THE BABY TO FLIP. WE MUST HAVE TALKED TO 12 OBGYN, AND FINALLY FOUND ONE THAT THURSDAY THAT I CONNECTED WITH IMMEDIATELY. SHE TOOK THE TIME TO LISTEN TO ME, TO HEAR THAT WE WEREN'T INTERESTED IN FORCING THE BABY TO FLIP, BUT WE WOULD BE INTERESTED IN HEARING HER METHOD FOR ECV. BELIEVE IT OR NOT, THEY ALL HAVE DIFFERENT METHODS. SAME IDEA, DIFFERENT HANDS ON TECHNIQUES. WE MET WITH THE MIDWIFE WHO WORKS WITH THE OB ON THURSDAY AFTERNOON, AND WERE LUCKY ENOUGH TO MEET THE DR THAT NIGHT. THE DR TOLD US SHE'D CALL US ON SUNDAY, THE NEXT DAY SHE WAS ON CALL AT THE HOSPITAL, FOR US TO COME IN AND TRY ECV.

WE'VE DONE OUR RESEARCH. IT WAS THE LAST THING WE WANTED TO DO. HOWEVER, I FELT VERY, VERY SAFE IN THIS DR'S HANDS, LITERALLY. AFTER TALKING TO SO MANY WE KNEW IF WE WERE GOING TO TRY ECV, IT HAD TO BE WITH THIS DR.

SHE CALLED US ON SUNDAY AND WE MET HER AT NOON. AFTER BEING CHECKED IN, AND MONITORED FOR AN HOUR, ALONG WITH TWO ULTRASOUNDS, SHE, HER CNM, AND ANOTHER NURSE STARTED THE PROCESS. THE PROCESS IS THE PROCESS, BUT THE HANDS ON TECHNIQUE IS WHAT MADE DR WROBLE STAND OUT. SHE WAS AS GENTLE AS YOU CAN BE AND MOVE AN ALMOST 7 POUND BABY. SHE SAID SHE WOULD ONLY TRY TWICE. THE FIRST TIME, I NEARLY PASSED OUT WITHIN 60 SECONDS. I RESTED ON MY SIDE WITH A COLD, WET TOWEL ON MY HEAD. ONCE THE ROOM STOPPED SPINNING, WE TRIED IT AGAIN, AND THE BABY FLIPPED WITHIN 2 MINUTES TO HEAD DOWN.

BREATHING THROUGH IT IS THE KEY. HAVING A DR THAT WILL LISTEN TO YOUR CONCERNS, VOICE YOUR CONCERNS BACK TO YOU, AND TELL YOU EVERY STEP OF THE WAY WHAT SHE IS DOING, HOW THE BABY'S HEART RATE LOOKS, AND TELL YOU TO HANG ON FOR 2 MORE SECONDS BECAUSE THE HEAD IN ALMOST DOWN IS PRICELESS.

I AM WEARING A TIGHT BELLY BAND AROUND MY WAIST 24 HOURS, ONLY TAKING IT OFF WHEN SHOWERING. THE BABY HAS A LOT OF AMNIOTIC FLUID AND WAS MOVING ALL AROUND EVEN WHEN SHE WAS TRYING TO FLIP HIM/ORHER. THAT WORKED IN MY FAVOR. ALSO, MY ANTERIOR PLACENTA HAD MOVED OUT OF THE WAY, AND UP SOME SO THERE WAS MORE ROOM TO MANIPULATE WITH THE BABY.

LESSON: ECV WAS OUR LAST CHOICE, BUT A DESIRE FOR A NATURAL BIRTH FOR OUR BABY OUTWEIGHED EVERYTHING. WE HAD TO DO THIS AND TAKE IT OFF OUR LIST. WE CAN SAY WE TRIED 9 THINGS, AND THIS WAS THE 10TH. I WOULD STILL HAVE TRIED EVERYTHING WE DID BEFORE ECV. IT JUST TOOK ECV TO ENCOURAGE, HELP, MOVE OUR LO.

IF I CAN HELP YOU OR EXPLAIN MORE PLEASE PM ME.

[ctdoula]

Hugs Hugs & Hugs!!

Sometimes babies *are* in a certain position for a reason, even if we don't know what it is. It sounds like you've tried nearly everything. I don't think trying version is such a bad idea. If it doesn't work then you'll have your answer and not be spending time thinking "what if...".

A cesarean really doesn't have to be a terrible experience! Many people have wonderful birth experiences that way. I think attitude going into it really can make a difference. If you come to peace and know that this is your birth and make every effort to make it as joyful and peaceful as possible it will be. It won't be perfect, but realistically in life NOTHING is! Your doula can do a lot to support you, help you not to be anxious before surgery, take pictures, support breastfeeding, etc.

Tell your doctor in advance you'll be having a doula and insist she be allowed into the OR. Most hosptials have a policy of 1 support person only, but they'll break it if you push. Make sure lots of pictures are taken and ask for a mirror or the curtain to be lowered so you can see the birth! Babies are not routinely seperated from their mothers in most hospitals, unless baby has to go to NICU, they usually stay w/you, nurse in PACU, etc.

As for when to do it, current rec's are after 39 weeks or beginning of labor. W/baby in that position they may be concerned w/the cord if water breaks, but have lots of discussions w/the OB.

[EviesMom]

I was in your position 5 1/2 years ago! I was still iffy on the version, but went ahead and scheduled it, and a few days before the version, I went into labor. Labored at home for a little while, knowing that they would do a c as soon as I got there, and eventually called the doctor, went in, had a c-section.

I would get a birth plan in order covering a c-section. I would ask the doula to shift her services to things like going with the baby to the nursery while you're stitched up; or holding your hand while your dh goes with the baby. They took her to the nursery for about 30 min while I was stitched up and then brought her back when I was in recovery. She can advocate for them bringing you the baby as soon as possible after birth. She can advocate for rooming in. She can help you start breastfeeding, and depending on her skills, help the baby eat if breastfeeding is problematic; or arrange for an LC for you. (DD had no bottles, and nursed fine, but my milk took so long to come in that having someone who could advise on an sns/cup/dropper feeding would have been nice.

If you do a version, maybe set up a fun night doing one of your labor projects you had planned, or seeing friends at home, or painting a belly cast, something to mark the upcoming birth.

I've never felt that DDs birth was a bad one, and I think c when you know it's likely coming is less traumatic than one that you go into labor expecting natural birth.

You can do it!

[AlexisT]

If you have an OB who is experienced with versions, I would really seriously consider trying it. If s/he thinks a version is a bad idea, s/he won't do it, and you've lost nothing by asking. If the placenta is an issue, the version just won't be done. Generally, a version is done carefully and under close supervision and monitoring. It may

If a version isn't an option, or doesn't work, then there are stickies about CS birth plans. Having been through an unplanned CS, I can say it would have been much easier had I been able to plan it a little better and get myself used to the idea.

[Litcrit]

Wouldn't they allow you to at least TRY having the baby vaginally at the hospital? Frank breech shouldn't be so scary to them, right?

[nikirj]

A doctor experienced in version would be able to pretty quickly tell if the position of the placenta will be a problem. "Anterior" is a pretty big space, if it is anterior and somewhat fundal, it's more likely the OB will not want to do a version. Versions are usually successful, and that could put you right back into the low-risk category. If you go for an eval and it can't be done, nothing lost but a little time, right?

[fruitfulmomma]

Wouldn't they allow you to at least TRY having the baby vaginally at the hospital? Frank breech shouldn't be so scary to them, right?

Doubtful. Most American doctors are no longer trained to help birth breech babies vaginally. It is pretty much an automatic c-section around here, unless you find a really good practitioner. My husband was a frank breech and was born vaginally, but that was 35 years ago, and my mil basically went into the hospital pushing. Now it is too much of a "risk" because of malpractice issues.

Anyway, I would speak to an experienced doctor about the version and see what they have to say. And I would be prepared to plan for a scheduled c-section so that it does not become an emergency if they are unable to turn him. Unless you want to fight for a vaginal breech birth, which is totally an option for you and I believe that breech birth can be safe, but as I said above I am not sure it is very likely you'll find an OB that agrees with that.

This article may be helpful for you http://www.guardian.co.uk/society/20...icineandhealth

[ctworkingmom]

schedule the section!

Hi!
Just saw your post and I'm so sorry! I don't know much about the breech problems, but I had an awful labor ending in a c-section. I can honestly tell you that after hours and hours of pushing combined with rolling labor pains, the last thing I wanted to hear was "Let's get the forceps!" I ended up having a c-section and recovering from both pushing and the section. If I could have planned it ahead of time I would have scheduled the c-section. I know lots of women who have suffered through the same scenario, but this is a very personal choice! Good luck to you-

[sosurreal09]

oh hun im so sorry your going through this. i was in tears reading it. idk if this will help but if you get on all fours and arch your back repeatedly (like a cat) its suppose to help baby get in the right position...no matter what happens just remember there is a reason for it and the most important thing is your baby. good luck and try to stay positive! *hugs*

[Bluegoat]

I don't know about the version. But it could be there is a reason the baby can't move to a better position.

I agree with the pps that you should have a section plan. That being said, there seem to be some advantages to allowing labour to begin naturally and then going for the section. Doctors and hospitals don't like it because it is less convienient, but it means your body and hormonal processes will be doing more of the "normal" things.

[Fujiko]

C-sections don't have to be horrible. I had one with my dd (after laboring/pushing); it wasn't something I ever thought I'd go through, so I didn't get to mentally plan for it or anything. Nevertheless, I must have been at a mother/baby friendly hospital (originally planning for a HB so I never checked out the hospital), because they had great policies in place. DD was never separated from me or DH, automatic rooming-in, no recovery room (I recovered in my original room), breastfeeding support up the wazoo, etc etc. I'd be looking into what your hospital policies are and preparing for the possibility of dealing with them.

This is, of course, if your version doesn't work out.

I can't remember who said this quote, but I love it: "Life is 10% what happens to you and 90% how you react to it." This is not to say as long as we put on a smile, everything is okay. But attitude can go a long way in shaping our experiences. I didn't let the fact that I lost my homebirth, then I lost my vaginal birth, carry over into my becoming a mother. As soon as I held her for the first time, everything that had happened in the days and weeks prior melted away into oblivion, and we started afresh. (Of course, I was very fortunate that even given the circumstances, the medical professionals were respectful and kind, and I had great support from my lay midwives and family, and I'm sure that had a lot to do with it.)

If I were to do anything differently, I would have talked to the anesthesiologist when I was admitted (even though I was adamantly opposed to pain medication during labor) about what goes on during a c-section, because when he came to talk to me after I consented to the c-section I was really out of it trying to deal with crazy strong pitocin-induced contractions. I barely remember he was there. I'm not sure what it was, but they gave me some kind of drug when I went in the OR and got my spinal that made me really sleepy and my face itch. It was really a downer when I was trying to bond with DD after she was born. Also, I would have asked to be able to see her being born, or at least for DH to take pics or video of that moment so I could see it later. (Side note: I was cooking dinner the other night when the subject of DD's birth came up with DH. I had always thought that when the doc asked him to "stand up and look" that DD was just born, but I guess DH got to see her *being* born. I'm not an emotional person even when pregnant, but this revelation made me BAWL. I was just so glad one of us got to see her being born. End side note.) Also, I'd specifically request getting a double-suture closure if you are at all interested in having a VBAC with subsequent pregnancies.

All this to say, c-section should be a last-resort sort of a thing, but that doesn't mean they automatically devalue or diminish your birth, that while they are often decried on this forum (and usually for good reason), that doesn't mean they have to depower you as a person or make you weak, incapable, or inferior as a woman.

[erin_brycesmom]

Hugs mama, I'm sorry that nothing has worked to encourage baby into a vertex position. I wish you peace with the birth and that it goes well no matter what route. I wish I knew something to help but I couldn't read and not respond.

[paranoidprego]

Oh, how i know what you are going through! My baby was frank breech throughout the whole pregnancy. he was actually in the pike position (feet up next to his face) which made it impossible for him to flip (we know now). we di EVERYTHING under the sun, including the external version, which was unsuccessful. i then switched to another OB who was experienced in breech vaginal deliveries - i met with him and asked him if he would let me try to deliver this baby and i let him know that i will take his advice no matter what if he wanted to do the c-section. i just felt that because he had done breech deliveries, he would know if i was capable of doing it. there was a bunch of criteria that my baby and i had to pass which one of them was that i had a previous vaginal delivery.
if i were in your place, i would get the consult for the external version (they will not do it if they think it can't work). in the meantime, i would make out your c-section birth plan to allow you to feel more in control of your birth experience. and then i would have a sit-down heart to heart with your OB and really try to convey to him/her what your expectations WERE for this birth and what they ARE now; and how important to you it is to have as natural a birth experience as possible. then ask him/her what they are willing to do to make this happen for you.
so many women just take what the OB says as gospel truth; they don't ask the questions, they do not feel like they have a say. doctors are probably used to this and get used to having their way. but if you are nice about it and ask for their help in making this a positive experience, maybe they will really try to help you have that.
i have so much i could say on this subject. hugs to you. what really helped me was when i realized that all i wanted was a healthy baby in my arms - i didn't care how he came into the world.
good luck, momma! you will do fantastic!

[LadyUnaOfStormhold]

Obviously I do not know you, and I'm not your care provider.

But from your post, I have to say, I truly believe that your baby isn't moving for a good reason. Because of everything you've tried, -stuff that in most situations, truly works- I really believe that your baby can't turn. Mayhap, even shouldn't turn?

The c-section is such a tough thing. On the one hand, it's a terrible thing to have with your first baby. It affects all of your future births. However OTOH, having your first baby, via vaginal breech can be ridiculously risky. I wish I had a magic solution for you.



ETA: I was thinking about you, as I was flipping my laundry over (aren't you flattered? ), and just had to come turn the puter back on...

I would go for the surgery.

Here's my thing:
As I stated, I believe your baby is breech for a very good reason. We may never know what it is, but I really believe that is just how it is.

Now, if you look at a lot of anecdotal evidence, often when a baby just wouldn't/coudn't turn, it also couldn't/shouldn't be born. Many instances of tightly wound cords for example, that would not only disallow a baby from flipping, but posed a terrible risk for descent and birth. So on and so forth (I don't want to blather on, you're woan in her third trimester. ).

Honestly, in your shoes, right now I would be believing that my baby couldn't turn, and I would be concerned that there was a very good reason for that, and that it could likely be tied to the ability to be born.

I would go for the surgery. And I don't say that lightly. But it's so true, that a healthy baby in the end is what matters most. It really is.

[ithappened]

I would go for the surgery. And I don't say that lightly. But it's so true, that a healthy baby in the end is what matters most. It really is.

[lellian]

Oh Ladies, thank you for your hugs, support, love from all over the world. It means more than I can say, and if I could hug each one of you, I would. Hugs, hugs, hugs.

We have an ultrasound scheduled for tomorrow morning. This was a last minute call by the midwife to assure herself that we have opted out of her care, and will be transfered to the hospital to schedule a c-section. We've had 3 ultrasounds now, and the baby has scored an 8/8 on what they are looking for in regards to a healthy baby and environment. However, tomorrow I'm going in with a more detailed list of questions for the technician. 1) Can they see if the cord is wrapped around the baby, or if the cord isn't long enough? Does that show up on the ultrasound? Anyone know? 2) Is my uterus the problem? I guess I'm asking for a reason when there may way be no "good" reason that I know of but the baby knows differently.

ECV: The acupuncturist I've been seeing, a very kind, wise, mindful woman, believes that the baby is on it's path, it's journey for life has already begun, and where it is now is where it's supposed to be. She doesn't recommend ECV as she thinks the process is forcing the baby into something the baby can't do and be healthy in the womb. On the other hand, the midwife we see suggested the OB at the hospital who has "years of experience flipping babies." She said the process is perfectly safe, and monitored the entire time, and if the baby goes into distress we stop. I'm not sure what we will or won't do with this option. We have to tell her by Tuesday's appointment so it can be scheduled.

C-section: I know a well thought out planned cesarean birth is the way to go, if the baby doesn't flip. Here is where I'm hung up on the section, and would love all your thoughts: do we schedule it in advance of labor beginning or wait until labor starts? The reason I ask: I read it is extremely important to talk to the spinal anestheseologist in advance, and to know who the OB likes to works with, who does the best "work" if you will. That the side affects of a bad job could haunt one for years. Also, the OB and discussion of the birth plan. . .if we wait and go into labor, there is a possibility that whatever doctor we meet with won't be working. So. . .to schedule one, or hold out to get the benefits of laboring hormones? I'm determined that if we have a c-section we are going to have the best birth experience we can so thank you for your advice and suggestions. I guess I'm still trying to wrap my head around scheduling a c-section when the baby could, maybe, might, possibily flip at any time.

I pray that I'm not being selfish, and I pray that I'm wise enough to know what to do and more so what not to do. I've never known this kind of love and only want what is best for the baby. . .but we are so connected it is sometimes hard to tell where my desires end, and where the baby's begin.

Thank you for reading this, and helping me work through it all.

[lellian]

I forgot to mention again that the baby is "due" Dec 24th. If we wait and go into labor and the baby actually comes on s/he due date. ..what doctor might or might not be on duty? I don't know how this works, does anyone?

[EviesMom]

You might want to schedule it for fairly late and if baby comes early, you get labor benefits instead of chosen dr ones. Anecdotally, both my grandmother's breech experiences (vaginal birth 2 breech, 2 vertex), my mother's breeches (3 late-turning breeches-in labor or days before), mine (breech in labor at 37 weeks exactly; vertex home birth labor at 39 weeks and 5 days), and my homebirth midwife's experience... longstanding breech babies seem to come via earlier labor. I like to think of it as nature knowing they will need to be a bit smaller to fit well.

I did NO choosing of an anesthesiologist, and had no problems recovering. You might want to talk to the OB practice, find out how many there are (mine had 2), make sure you're okay with all of them. If so, ask them about anesthesia.

I would also think about having a boppy or pillows bc nursing can be rough on the c-section wound and the boppy really helps; having an LC lined up/a small cup to feed the baby if needed bc milk can come in slower.

Another thought is to make arrangements to have fewer visitors for the first day after when they're unhooking the drip morphine, and you're getting the air out of your abdomen from the surgery (lots of farting). The day of surgery was honestly easier to see people, and the 2nd day, but that day of surgery we had lots of people who "gave us space", and then they came the day after when I felt like I was breaking wind constantly, needed to move despite it being painful, versus the c-section day I was still in bed.

[lovin'leo]

Since first babies average over 41 weeks in utero, I'd either wait for labor or schedule for 41 weeks. Also remember that babies often flip during labor, although that sounds less likely in your case. Babies who choose their own birthdays are, in general, much healthier than ones taken early. I'd also look into finding a doctor who has experience w/vaginal breech, just to get an opinion on it.

[pampered_mom]

Originally Posted by Bluegoat

I agree with the pps that you should have a section plan. That being said, there seem to be some advantages to allowing labour to begin naturally and then going for the section. Doctors and hospitals don't like it because it is less convienient, but it means your body and hormonal processes will be doing more of the "normal" things.

After having a c/s with ds prior to labor (and in advance of his due date), tbh if I had to do it over again I'd have waited. Due dates are estimates (take a look at the rising number of preterm babies and c/s or inductions). Labor hormones are beneficial to babe (as is being born when ready) so I'd be hesitant to schedule a c/s without it.