Anyone done a vaginal breech?

[NH mom]

I'm 38 weeks with baby #5 and it won't stay head down.  I'm currently wearing an abdominal binder and trying things from spinning babies.  I'm going to try chiro care next week when my new insurance starts, but it looks like a real possibility of a breech baby and therefore I'm being "directed" to have a c-section.  Two of my other kids were 8/12 at birth and this one doesn't feel as big.  I was told I "could" deliver a breech vaginally if the on-call dr were willing to do it  (I see the midwives).  So, has anyone every done a vaginal breech and how did it go?

[olive&pimiento]

I'm sure will will get some replies in many directions, from planned C/S to UC breech deliveries.  Since only you can decide what risks you are okay with, I just thought I would give you some studies in the area 

1) Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial  Dr Mary E. Hannah, et al.  This is the Term Breech Trial (TBT) study

2) Is planned vaginal delivery fo rbreech presentation at term still and option? Results of an observational prospective survey in France and Belgium  Francois Goffinet, MD, PhD   This is the PREMODAS study.

Good luck with your birth!

[Litcrit]

A friend of mine had a vaginal breech birth without too many complications. The baby had a broken collar bone which healed on its ow a few days afterwards.
 

[nudnik]

If the broken collarbone scares you, a friend of mine had an "emergency" c-section for a breech... and broken collarbone anyhow.

[JudiAU]

Vaginal breech needs a truly experienced care giver. I'd plan it if I had the caregiver in place and I knew they were trained and experienced in the procedure. And I would also accept that depending on positioning I might labor and end up with a c-section.

The issue isn't so much if the doctor on call will do them. The issue is whether they have the skills to do them. Few if any recently trained doctors have the skills/experience/training. The two people who do them locally are older and work with a midwife who did her training in the third world and then worked on reservations on the U.S. I wouldn't accept the random ob who was willing to do "risky deliveries."

BTW- I was breech for awhile with my second. Chiro did flip me with a combo of Webster and ligment adjustements.

[shapiro-strano]

I have been at several vaginal breech births as a doula. The OB I have seen do them is older, well trained, and speaks/educates on vaginal breech. He has great success. I do agree with the other poster who mentioned having a well trained and confidant care provider. 

That being said, any labor is better than no labor and research supports this. Even with a cesarean, waiting until labor begins on its own is better for both you and your baby. Your milk supply will come in much better for example. 

I wish you the best of births!

[artekah]

Originally Posted by JudiAU 

The issue isn't so much if the doctor on call will do them. The issue is whether they have the skills to do them. Few if any recently trained doctors have the skills/experience/training.

Yeah that. My first baby was a breech home birth. I had not one but two midwives both experienced with breech birth, one of them *very* experienced. Most of it is knowing what NOT to do. I would not trust most hospital OBs these days with a breech birth, although experienced doctors are out there! So my advice is just to know your provider very well, and don't be afraid to find a new one so you are sure to have the best.

Remember that breech is a variation of normal. You should get the baby to turn if you can, but if the baby doesn't turn, I would (and did!) do everything in my power to shoot for a vaginal birth, and only do a c section as a true last resort. A breech c section is just as risky as a breech vaginal birth, only with the drawbacks of major surgery. The thing that makes breech vaginal birth *more* risky than a c section is when you have people who don't know what they're doing mis-managing things. I have no doubt that a c section is "safer" when your care provider only knows how to do c sections.

My son's birth was wonderful. The labor was fast and straightforward. Everything went smoothly, he was lined up perfectly even though he was upside down, he was perfectly fine in every way. I pushed him out while squatting on a birthing stool--upright is good for breeches.

The important thing is you want to make sure you're fully dilated before you start pushing, even if you feel the urge to push--which I never did, btw. Pushing was more work for me with my breech baby than with my vertex baby--with my 2nd, who was head-down, I finally got to see what everyone was talking about when they say "your body just starts pushing." With my breech baby I had to bear down as hard as I could for 30 minutes to push him out (my 2nd baby, it was 15 minutes and my body did all the work for me.)

But in retrospect it was a very easy birth! Birth is so subjective, but that's my story.

[fayebond]

I hope you can find another provider who isn't depending on chance to get you a normal birth, if only as a Plan B.  I had planned to do a breech birth for my first, and when I got to the hospital, the nurse on call insisted I needed a CS (depsite my Ob's assurance that I did not).  She told everyone I needed it, from the other nurses to the OB on call, until they all were telling me it was the only way.  I don't think they all even knew why, just that she said so so it must be so.  They also said my Ob couldn't be reached and bunches of other lies trying to get me to agree, tehy were so scared I would give birth before they could get me in that room.  It matters who you get, and it matters who is the first person to see you and what they think of you.  I showed up in a bathrobe with a crummy tshirt and no pants having gone into transition in the car, my hair was down, and generally I looked like a crazy lady and not the usual, college degree, artsy, organized person that I am, so I think that mattered too.  

With the right care provider, its no big deal, but when they panic you need to either leave and go to someone else or go with what they know.  Some OBs panic at the last minute and give you an epistitomy al the way to you know where, which would be way worse than a CS, so please don't think you will be able to "talk" them into anything.  Find a plan B, that'd be my advice, so when you get there you can deicde if you like the people on call or not.  Plan C would be UC for me, but I'm reading up on the subject and have supplies gathering for that as we speak, so its not like I'd be in a bus stop all confused about what to do (in which case I would never try to do it alone without a clue).

[paranoidprego]

My second child was breech. My OB tried everything, including external version without success. He told me to schedule a CS. I ended up switching OB's at 38 weeks to an doctor who was known to have done vaginal breech deliveries. i met with him first and he grilled me about why, etc. he told me he had certain criteria that i had to meet in order for him to consider doing it: baby under 8 pounds, that this wasn't my first baby, a certain position of the baby's head and that the baby is frank breech.  my baby met all the requirements. he told me i couldn't go over 41 weeks and if i didn't deliver by then, i would have a CS. i ended up taking castor oil the Saturday before i turned 41 weeks. it started things moving a little. doctor said he would just break my water. got to hospital, broker my water, baby out in one hour. it was a very medical delivery as far as having an IV, being on my back, pitocin to deliver placenta, but it was worth it. I knew this doctor was very skilled in deliveries, had the lowest CS rate and was very skilled in forceps. i trusted that he would know if this wasn't possible and he would give me the CS. it all went well. i would not have done it if he wasn't skilled in delivering breech. 

good luck to you whatever happens. hopefully, that baby will turn the right side down at the last moment and you won't have to worry about it:)

[stellamia]

Any update OP? My baby is breech as well and my MW doesn't deliver breech babies. I hope things went well for you. 

[NH mom]

Update:  Okay, so I went into labor and the baby was head down (and had been for a few days).  I arrived at the hospital and found I was fully dilated and fully effaced... and with a breech baby.  The on-call dr. had a fair amount of experience in breech and had even done one that morning and was willing to do mine.  Until we found the baby was a footling breech. 

After some discussion (all while still having serious contractions) my husband and I agreed a c-section was the best option.  I was prepped and given an epidural and taken to the OR.  The midwife suggested to the dr that they try a version in the OR, and the dr agreed to give it a shot, once the epidural had taken effect. 

On the way to the OR the baby slid to a transverse, shocking the dr.  They did the version and one dr. held the baby in position while the other broke my water.  Once they verified the head was down and no cord was in the way, the dr's left and the midwife took over again.  20 mins later I was holding my beautiful baby girl!

From the time of our arrival at the hospital to birth was about an hour and a half.

[fayebond]

NH mom, that is so amazing and wonderful to hear!  I'm impressed by your OB team's attention to detail, and your really sweet delivery time!  Good for you!

[olive&pimiento]

Wow, that is an amazing birth story!  Congratulations on your little one!
 

[amlikam]

Wow! thank you for sharing (I know this is an old thread, but I found it this morning.)