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VBAC breech  

post #1 of 10
Thread Starter 
I have another breech baby here... my midwife says it could be the way my uterus is shaped causing my babies to prefer that position. Interestingly, I was also a breech baby and the reason my own mother had all cesareans (she didn't even know about VBAC).

Anyway, I am wondering how many of you midwives would be willing to deliver a VBAC breech out of hospital?

Background info:

I am healthy in every way and have had an excellent pregnancy, my daughter was 8pounds1oz. at 41 weeks. Absolutely perfect.

I had an external version at 37 weeks with her, but ended up with a c-section due to a hasty on call dr and my lack of knowledge. I had dilated to 9cm but didn't progress any more within the hour timeframe he had given me at which point he said that I swelled to 8cm... and a cesarean was necessary. I went into labor on my own but was given pitocin at 7cm (for his convenience)...

...I know there is plenty of time for the baby to turn, which would be great... but I am not interested in doing another version. Personally, I would just like to push him out butt-first if that's what he wants...

Thanks for your input.
post #2 of 10
Have you investigated the webster technique that is performed by chiropractors?helps to turn the babe. also to find an ob that will discuss a vag breech call your local labor and delivery hosp and talk to the nurses. who else would know who would do what. good luck!
post #3 of 10
Find a chiropractor who knows Webster's technique. www.icpa4kids.org has a doctors list that should help you.

It's got an 80%+ effectiveness rate, and it's non invasive and safe!

Your babies position could just as easily (if not more likely) be due to your pelvis position, since your uterus is a rather soft muscular bag, which has attachments to said pelvis, and its shape is often due to what the pelvis is doing.

HTH!
post #4 of 10
bcrn and I posted at the same time!
post #5 of 10
I know somebody who had a primary c/s because her baby was breech, and went on to have her second baby at home with a lay midwife- and her 2nd baby was also breech.

Unfortunately, that particular midwife is no longer practicing.
post #6 of 10
I have heard that breech does tend to run in families. Depending on various things, I would theoretically be willing to assist a vbac breech, and know other mws who would, too.
post #7 of 10
There is also homeopathic Pulsatilla, moxa on the outside of the little toe, slant board, visualization, rebozo work, energy work, etc. for turning babies. Talk to the baby and give it mental pictures of how it will be easier if it comes head down. Body work to relax the abdominal and pelvic area could help too. Lots of options to try!
post #8 of 10
Not a birth professional here, but have you checked out the ICAN list? I know someone on there has had a breech VBAC, and I think it was at home. She did everything to try to turn the baby, and the baby just wanted to be breech. I think she had an unusually shaped uterus as well (a mullerian abnormality; bicornate I think??) I would contact the ICAN list for more information.
post #9 of 10
Thread Starter 
Thank You for all your replies. I have a prenatal appt tonight with the midwife. Interestingly, my backup OB has absolutely no problem delivering a VBAC breech... he even joked that the baby will just poop on him, no biggie, all his breeches do! I have also heard from the nurses at that hospital that he is the best and he has done many breech deliveries even for other doctors who aren't comfortable with the idea. This is very reassuring, and as much as I like this doc I still don't want to birth in the hospital if it can possibly be avoided. I have found a Webster certified chiro and I will fork over the cash to give it a try as well as the slant board and other techniques... more of which my midwife will discuss with me tonight.

-Iris
post #10 of 10
I'm very interested to know where you live and who your doctor is. He sounds verycool! I know one such doctor here and he has tons of breech experience. Sadly, it's a dying breed of docs out there.

But there are certainly lay midwives and CPMs that will do VBAC breeches if you meet their criteria. So if something fails with the current MW/Doc in hospital then reach out to your area homebirth midwives.

If you PM me your location, I'd be glad to give you local resources to turn breech and deliver breech if you are near me - MD/VA/DC area.

To turn breech...a document I share with my breech students:

Ways to Turn a Breech Baby

There are many ways to try to encourage a breech baby to turn. The following is a list of non-invasive, non-painful, benign suggestions. It does not hurt to try - not trying and winding up with a Cesarean Section will hurt!

1. Knee to Chest Position
In one study of 71 breech babies, 65 turned when their mother adopted the knee-chest position. To do this, kneel with your hips flexed at slightly more than 90 degrees (but do not let your thigh press against your abdomen) and try to keep your head, shoulders, and upper chest flat on your mattress. Maintain the position for 15 minutes every two waking hours for five consecutive days. By positioning your body so your head is lower, gravity encourages the baby's head to "float" toward your fundus, flex her chin onto her chest and start to turn under. As pressure builds on the back of the back of the baby's head, she gradually rotates first into transverse, then all the way to vertex.

2. Breech Tilts
Do when you have an empty stomach and times when the baby is active. Concentrate on the baby, avoid tensing the body (especially the abdomen). Lie on your back with your hips elevated 12" (use pillows) and your hips and knees flexed. Gently roll through 180 degrees from side to side for 15 minutes and repeat this maneuver three times a day.

3. Pelvic Rocking
To do pelvic rocking get down on your hands and knees and gently tilt your pelvis as you arch your back, then return your back to a flat position and relax your pelvis. Do thirty to forty of these 3 times every day.

4. Ironing Board
Elevate the pelvis by laying on a board or ironing board that has been propped up onto the edge of a couch - MAKE SURE IT IS STABLE! This position should be assumed for 8 to 10 minutes daily. This position has been shown to be as successful as an external version in some studies.

5. Massage with External Stimulation
Give the mom a full rocking massage - it relaxes the whole body and is essential for the mom to feel the space for the baby to turn. Then, place pillows under her knees, tilt her slightly with a rolled up towel on the right side. Touch the baby (mom's belly, talk to the baby and rotate hands in the direction that they want to go). Have total faith and it will turn.

6. Cat Stretch with Light & Music Stimulation
First, get in a "cat-stretch" position: on all fours, head lower than rear end. You can use pillows to kneel on. Take a flashlight, turn it on, and put the light against your lower abdomen directly the skin - the lower, the better. At the same time, use a walkman or portable CD player's headset against the lowest part of your belly, with music turned on (but not blasting-loud). The fetus will hear the music and see the light, both encouraging him/her to turn toward it, i.e., your pelvis. Try for 30-45 minutes. You may need to do deep breathing - the baby will be MOVING!
7. Moxibustion
A form of acupuncture which is currently the subject of a research study to see if it could help turn breech babies. Some therapists claim an 80% success rate, but before trying it, seek advice from a qualified acupuncturist

8. Webster's Technique
A technique used by specially trained and certified chiropractors to align the pelvis to let the baby turn.

9. Visualization
A way to enlist your mental powers to help turn the baby. Combine visualization with other exercises. You can silently picture what you want to happen. Say to yourself, or have your partner say the following or something similar: "As I lie here in a tilt, I take long breaths and relax my body. Your head presses toward my chest. The pressure of your head makes you wiggle. Come on baby! Come around. Move your head, move your body to take the pressure off. Turn around, tuck your chin and come toward my cervix. My cervix and vagina are your opening to the world. Come close, so you will be all ready to come out when the time is right and Ill be ready to welcome you. Turn around...turn around. I'm relaxing my body to give you more room to turn around, to get ready to be born."

10. External Cephalic Version (ECV)
MUST BE DONE BY A DOCTOR OR MIDWIFE!!! Should not be done on women who are rhesus negative, have experienced bleeding already, or whose placenta is situated low in the uterus. Risks associated with ECV including the possibility of causing distress to the baby and a chance of bleeding or premature rupture of the membranes. Baby is turned externally with strong guided pressure, which can be very painful. Success rates are about 65% in studies.

11. Change Doctors!
Your next best option is to search for a doctor in your area who has experience delivering vaginal breech babies. The doctor would assess the size of your baby and your pelvic size and then make a decision concerning allowing the baby to be born vaginally.
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