38 Weeks & Still Flipping Vertex to Breech to Vertex to Breech

[growgrowgrow]

My baby has been flipping back and forth since 20 weeks.  I thought she would stay head down when we found her that way at 34 weeks, but just before 36 weeks she was breech again.  I started doing the usual flip-the-breech-baby methods at that point.  Webster Technique, cold pack at baby's head and warm compress at crotch, flashlight down low, husband talking to baby down low... hypnobirthing scripts, hanging out on all fours, moxibustion.  At 37 weeks she was vertex, then flipped back to breech... yesterday she was vertex but today she flipped again.

I am continuing to do moxibustion, etc etc etc, but I'm wondering if I should be concerned that she is flipping this late in the game?  Today I'm 38 weeks. 

Also, what do I need to know if she is still breech when I go into labor? 

I am planning a hospital birth with an OB.  My doctor's practice does do vaginal breech deliveries, but from what I understand, an epidural is required as is delivering in the OR.  I understand that babies can flip even during labor, but I would prefer to avoid the epidural.  They do perform ECV.  Wondering if this would be an option during labor, prior to an epidural... I don't know, I guess I'm just looking for insight, for reassurance, for BTDT stories.  I like to think through all possible scenarios.  Ideally baby would flip before I go into labor and I'd be able to have a natural hospital birth, most of the laboring done at home.  Guess I'm also just wondering if she has a good reason for wanting to be breech, if that's something I should consider, and what it might be / how to tell?

I did put in a call to my OB's office this afternoon after I realized she was breech, to talk through some of this, but no one called back before end of day despite the receptionist saying they would.

Thanks in advance for your kind words!

[Jaimee]

I have heard that generally babies will not flip if there is a mechanical reason that they cannot be vertex (cord compression, etc.), so I'm not sure if I would worry too much about a reason that the baby is continuing to flip.  Maybe there is a little extra fluid, more room for movement than usual? 

I have heard that external version is quite painful and they like to give you the epi prior to doing it because of this.  Something to keep in mind when making decisions.  If it were me, I would just keep doing what you're doing and as labor becomes more imminent, I would step up the moxibustion.  Are you doing it yourself?  It can be done in early labor as well.   I wonder if that in combo with your water breaking will secure baby's position.    That could be something to consider as well... having AROM once in labor and baby is vertex.  While I'm not a proponent for intervention, AROM seems less of an intervention than what could happen in the OR with an epi.

Good luck!!

[kltroy]

So this is what's called an "unstable lie".  I'm not an expert, but I believe the general procedure would be to either (1) keep an eye on you and, when you're at term and good with it, induce once you know the baby is vertex.  The other possibility is to do a version if baby is breech and you're in early labor.  Since baby flips so easily, a version should work well.  Yes, vaginal breech is possible, but the head is a lot more effective at dilating the cervix than a butt, and the birth will probably be easier if baby is vertex.  Might as well shoot for that first.

ETA: I had a version with my first baby.  It wasn't any worse than labor (actually, it was quite a bit less intense than most of labor, when you really get down to it). Really, not that bad.  A few deep breaths to relax you and it's over.  They do give you something to try and relax the uterus, but no epi or other pain meds.  So don't be scared of the version - if you can *do* labor, you can *do* a version.

[dlm194]

One of the nurses I was talking to when i went in for a version was telling me that one doctor sometimes put abdominal binders on women after an ECV to try to keep the babies from flipping again if he thought they might flip back. 

[Monkey Keeper]

I dealt with this with my last baby, with the added complication that I was a VBAC. Honestly, I would just do nothing other than encourage baby to go head down. If your OB delivers vaginal breech, then there really is no compelling reason to schedule version, particularly since your baby has plenty of room to go back head up anyway. I would just decline the epidural. I do, however, like the suggestion of belly binding and may try that the next time. As for the ECV, I would not have had any sort of medication, save perhaps some terbutaline to calm the uterus.

If you are not comfortable with the uncertainty, another option (besides the good ones kltroy outlined) is to have the ECV on/after your EDD and induce immediately.

The biggest concern IME/O is spontaneous rupture of membranes with a baby who is unengaged due to the possibility of cord prolapse. Beyond that, I would wait. Baby will either be breech or not when the time comes.

(I know I sound very blase about this, but I put myself through and emotional wringer for a month to get to this point. I had to let go and be okay with whatever outcome, and then he turned and stayed.)

[growgrowgrow]

thanks so much to all who replied  - wanted to update that my daughter was vertex at 39 weeks and stayed that way.  she was born via beautiful natural hospital birth on june 18th.  she had a very short cord so the OB was quite surprised she was able to flip around so much!  in any case all is well.  :-)

[kltroy]

Congratulations!  I'm so glad your daughter cooperated!