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Did I have any other options?

post #1 of 73
Thread Starter 
I had a C-section with my 21 month old dd. It was scheduled because she was breech and the cord was wrapped around her neck. I wanted so badly to have a natural birth, but I had no choice, so I thought. Looking back it seems that way but did I have any other options? Breech with a cord wrapped around her neck? On top of that, after the surgery, my incision split open and I had a much longer recovery where I had to pack/ re-pack and clean the huge wound daily for weeks after the result of which is a huge deep thick scar. My previous doctor would not do a VBAC and said that they would cut out the old scar out and give me a new "pretty" one. I just changed doctors and the new one said the same thing, especially because I had so many complications and there's so much scar tissue. So, basically I am going to have a C with the new baby (due in August). My question though is, did I HAVE to have a C with my dd? I read so much on here about people who get C-sections and they are so vilified- especially when they're scheduled, but it seems there really was no other option for me. What would you have done?
post #2 of 73
I would have done the same as you. It's unfortunate--people used to be able to vaginally birth babies like your dd (I was breach with the cord wrapped multiple times around my neck and born vaginally--but that was in Colombia in the early 70s.) However, these days in the US almost no one does these kinds of deliveries, and it is very important to have an experienced, knowledgeable provider, since it obviously is a more dangerous situation. So, unfortunately, you really have no choice. I really hope you don't feel vilified here by what happened. Natural birth is a nice goal but it is not the best choice in all situations and I would hope that everyone here can recognize that.
post #3 of 73
I agree with PP -- I would have agreed to the C the first time too

YES, that birth could have been natural -- but i fear that you would have been in MORE danger trying to do it that way as provider now-days just don't have the knowledge, training, or expereince to do so ---- so that lack of skill would have put you in more danger with a vaginal birth than a bad C..........sorry it sucks, but i think it is turth.

If I was you -- I would be agreeing to the 2nd C to "clean up the old one" and also not to risk a VBAC when there doesnt' sound like any providers would be willing to try ti --- again, teh VBAC is most likly maybe safer than another C -- butttttt, again, if you don't have an expereince provider to deal with all the scar tissue and so on -- then the narual becomes more dangerous for lack of a good support..............again it sucks, but i fear it is true.

so -- yes i think you HAD to have the first C

and FWIW -- I support and agree with teh 2nd C.

Aimee
post #4 of 73
Yes, you needed your c-section. For all the reasons mentioned above. I am sorry you are being railroaded into another one, but there was just nothing you could have done differently the first time around. In all things, you make the best decision you can with the information you have available to you at the time, and so I tell even the women who were scared/pressured into a truly unnecessary surgery not to beat themselves up over it.

But a breech baby...almost no one does them vaginally anymore, and frankly even with a very skilled, experienced provider I would not have wanted to risk a cord-around-the-neck scenario. Nuchal cord isn't a terribly unusual complication, and usually not dangerous in & of itself, but paired with a breech (was she footling, perchance?), it's jus too much of a risk for me.
post #5 of 73
Thread Starter 
Thanks for your responses! I had been really thinking about it lately and it's good to know for sure that I really had no other choice- not that that in itself is a good thing but good to know!

post #6 of 73
i think we all do well to remember that c-sections are not in and of themselves evil (no intevention IS) -- they can and do save lives......

teh miduse and abuse of any intervention is the problem.

OP -- be confidnet

A
post #7 of 73
Did you attempt the Webster technique before agreeing to the c-section? If you did not then I would not be able to say that the c-section was necessary. I hope you don't mind my honest opinion. Cord around the neck are not a contraindiction for Webster and Webster is highly successful. My breech baby flipped twice with Webster and ended up with a double nuchal and I had him vaginally. I believe he probably got the nuchal cords each time he flipped. So if there was one nuchal cord and she flipped head down and remained she would either unloop the current nuchal cord or end up with a double which usually causes no complications (or of course she could have also just kept the one nuchal cord and not gained another).

~Erin
post #8 of 73
Quote:
Originally Posted by Aimee21972 View Post
so -- yes i think you HAD to have the first C

and FWIW -- I support and agree with teh 2nd C.
:
post #9 of 73
Did you do everything you could to try and move her? The Webster (like erin-brycesmom suggested), chiro, accupuncture, spinningbabies, cold packs, swimming, a version? If you did and she didn't move, then yes it probably was necessary. Also, I believe first time moms get railroaded more frequently than others, so try not to stress about that. We are led to believe that docs know EVERYTHING and we know NOTHING, it's just ingrained in us, especially women.

As far as the second section, I'd find a midwife and have a HBAC. Or I'd keep looking for providers until you can find someone willing to support a VBAC.

If you x-post this in Birth Professionals, you can get some midwives opinions about whether you are a good candidate for a HBAC.

I had a feet-first breech vaginally.
post #10 of 73
Quote:
My question though is, did I HAVE to have a C with my dd? I read so much on here about people who get C-sections and they are so vilified- especially when they're scheduled, but it seems there really was no other option for me. What would you have done?
Did you HAVE to? It's impossible for me to say. I would have made the same choice. I consider myself a strong advocate for normal birth. I'm planning my second homebirth in June...but there are scenarios for which I would schedule a c-section.

What I don't understand is why having complications from your cesarean birth indicate that you should have another one.

That sounds like fuzzy logic to me.

Typically, moms who had cesarean births b/c their babies were breech are excellent candidates for vbac. Since you cared for your wound yourself, I am assuming your belly skin incision is what didn't heal properly? Your uterus wasn't the issue?

Are you familiar with ICAN?
post #11 of 73
Well, one option would have been to wait and see if the baby would turn naturally (babies sometimes turn even in labor.) A scheduled section means not allowing that possibility. As others have said, another choice would be to try to turn the baby prenatally, although sometimes babies are breech for good reason and manually turning them increases risk, especially if the cord is around the neck.

Babies can be and are born breech with the cord around the neck, but I don't know the degree of increased risk solely because of that. I've looked and looked and can't find anything about it. Can somebody explain to me why a cord around the neck is inherently more risky in a breech than vertex birth? (I'm not saying it's not, it's just not obvious to me.)

As other have said, there is no way I'd attempt a breech birth with most practitioners. Few have been trained to attend breech, and many who have been trained have a particular hands-on approach that I think can cause more harm than it's meant to prevent.
post #12 of 73
I wanted to note that most practioners will not do ECV(versions) if there is a clear indication that the cord is wrapped around the baby's neck or appears to be short. Most babies are breech for a reason. I truly believe this and so to answer your question I think your first csection was necessary. I wish I would have made the choice to have a csection than try a version that endangerd me and my baby and landed us in the OR with an emergency situation.
post #13 of 73
My last baby was breech up until a few hours before labor began, and she was born with a nuchal cord. She had been breech for most of my pregnancy, and then about a week before she was due my water broke. I thought she turned head down at that point, because things felt so different in there, but I couldn't be sure.

Sure enough, she was born head first, with the cord around her neck....at home, as a UC. She was 13 pounds.

You do not say in your post when you knew she was breech, but as in my case, babies can and do turn before and during labor. I am glad she turned, but I was prepared to birth her breech at home, UC. So, for me I would not have considered a c section for a breech with a nuchal cord.
post #14 of 73
As a pp mentioned, I've not read anything about increased risk with cord around neck in breech. If it was a frank breech I would have attempted a vaginal delivery with a hands-off provider at home.

-Angela
post #15 of 73
Just speaking for myself, I would have driven to Summertown, TN., gone to the Farm, and consulted with Ina Mae first. My homebirth midwife did do breeches.

I was thankfully never in that position, however, that was my plan should things have been different.
post #16 of 73
Quote:
Originally Posted by fourlittlebirds View Post
Babies can be and are born breech with the cord around the neck, but I don't know the degree of increased risk solely because of that. I've looked and looked and can't find anything about it. Can somebody explain to me why a cord around the neck is inherently more risky in a breech than vertex birth? (I'm not saying it's not, it's just not obvious to me.)
.
This is just my guess but if the baby comes head first and there's a cord around the neck it seems from what I've read it's fairly easy for them to reach up there and move the cord. By them I mean midwives, it seems OB's are more likely to rush into a c-section with a cord wrapped around the neck no matter how the baby is positioned. With a breech baby it might be more difficult to reach that far? And don't breech babies take longer to push out and have a higher chance of getting stuck once the shoulders come out? All of that could mean the cord is left around the neck longer than it would be if the baby was head down, at least that's what I would assume.

I really don't know either way if a c-section could have been avoided in this case or not. If it were me I would have to do A LOT of research before making a decision, What's done is done though. What I'm wondering now is, is a c-section really neccesary for your current pg? I'm not saying it isn't, I just figure that if I was in your shoes I would try to focus on the present. I had an induction with my first and regret being bullied into it by my dr, but what's done is done, all I can do is think about what I would do differently this time and be thankful I have a chance to do it again
post #17 of 73
I think there are always other options. Obviously there were in my case since I chose not to have surgery even though my babe was breech up until the final hours before labor.

Every woman must do what she feels is right.
post #18 of 73
Quote:
Most babies are breech for a reason.
Just your opinion, not really factual. But, I happen to agree with you on that part of your opinion. IMO most breech babies are breech because of things like mother's poor positioning (sitting in recliners, laying back on the couch, poor posture, etc). I do not think that most breech babies are breech because they somehow needed to be. Thankfully we have a wonderful non invasive risk free solution - Webster .

~Erin
post #19 of 73
Quote:
Originally Posted by fourlittlebirds View Post
Babies can be and are born breech with the cord around the neck, but I don't know the degree of increased risk solely because of that. I've looked and looked and can't find anything about it. Can somebody explain to me why a cord around the neck is inherently more risky in a breech than vertex birth? (I'm not saying it's not, it's just not obvious to me.)
If you picture the baby descending breech, and see the cord around the neck....

The cord is attached to the placenta, which means the cord would be going UP to the placenta, PAST the head....

The cord can get pinched between the head and the pubic bone as the head is passing through the pelvis.



FWIW....I do NOT agree there are always other options. I do agree that most babies are breech for a reason, but that attempting to turn them with non-forceful means is safe. I do agree that most breech babies can be born vaginally. I do agree that I would look for a midwife experienced with HBACs instead of the repeat c/s. (Asking a surgeon what they think you should do about surgery and you're going to get a surgery answer....to have it or not.)


Interestingly there is a correlation b/w nuchal cords of 3+times and genetic problems in the baby.
post #20 of 73
Quote:
Originally Posted by erin_brycesmom View Post
Just your opinion, not really factual.
Erin, why do you feel that is not factual?
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