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New Here--Looking for Internal Version/Breech Extraction Stories

post #1 of 26
Thread Starter 
Hi,

I'm 37 weeks tomorrow with b/g twins and hoping for a VBAC sometime in the next few weeks. The one thing that's worrying me a little bit is that Twin B (the boy) is still breech, and at this point, I doubt he's going to turn before delivery.

Now my doctor is totally fine with doing a internal version or a breech extraction if he doesn't turn once his sister gets out of the way. He says he's done 40 of those and never needed to do an emergency c/section for Twin B. My doula says she can help me through it and I'm sure she can.

But I'd still like to hear from mamas who have gotten through it without pain meds. I DO NOT want an epidural. I hate being immobilized a lot worse than I hate pain. But there's a difference--at least in anticipation--between the pain of my body working and the pain of the doctor reaching in to move things.

So I'd love to hear from people who have gotten through it! (Or from people whose babies turned head down at the last minute.) Thanks.

QOC ##==>
post #2 of 26
DiannaK did it a few weeks ago. You might PM her though she's babymooning and I don't know how often she's on right now.

Both of my twins were breech and I gave birth to the first one that way. Is he willing to let you push the baby out on your own and then only help if needed? My second twin flipped vertex when his sister got out of the way.
post #3 of 26
My baby B was breech until baby A came out. He then flipped transverse on his own and my midwifes did an external version and held him head down until he came out. I don't remember it hurting AT ALL. I think because he had so much room, and my midwives were really skillful, it seemed like a very quick and easy process.
post #4 of 26
i experienced a breech extraction.
both babes were vertex throughout the pg, but during labor B experienced some distress and raised her hands over her head.

the doc had met w/ us earlier to explain the technique...he said he had trained in it "in the old days" and still practiced a few a week. i felt lucky to have this doctor! anyway, as he reached in my baby was squirming to get away from him and it felt like a boxing match in there! as the doc told us later, it;s very important to be sure to have both feet, not a foot and a hand. it is painful, i won't sugar coat that, but for me it only lasted 7 minutes. and he took a little longer as he was explaining everything he did to another doc.

so initially i thought the baby would be just yanked out, 1-2-3. but actually there's a whole process for the doc in order to avoid hip problems in the baby. IIRC, it was legs out, hold here, turn, then hold here and each arm out, then the head. it was kinda interesting to hear the explanation, though at the time my mind was screaming, "Out! Quit talking!" he did it right, as my baby does not have hip problems. oh - but after delivery her legs were bruised...which contributed to more jaundice - but that was all over w/in a week and she's perfectly healthy!

i say 7 min of pain is much better than delivering one baby vag and the next c-s! oh - and the pain stopped immediately after, too. definitely somethng you could do!
post #5 of 26

BTDT.....

My Baby B was transverse or breech from about 20 weeks on. My OB and I discussed the possibility of a breech extraction at my 16 week visit. Up until that point, I had never heard of it.

I was like you ..... scared to death of the procedure, but knowing in my heart I wanted at avoid a C-section if at all possible. My OB was pushing epidural hot and heavy, but, like you, I did not want to be immobilized, or not be able to help with pushing.

I've got details on my blog, but my labor was FAST and FURIOUS .... leaving me little time to even worry about it. I had been to the L/D on a Monday, with contractions that ended up petering out. Once I refused to be induced, they sent me home Tues morning.
I woke up Thurs (0220), thinking I was going to die .... didn't feel like a contraction per se, but I was in pain, seemingly everywhere ... abdomen, back, pelvis, etc. Water broke at home, and when I got to the hospital at around 0400, I was crowning.

DH told me that I DID tell my nurse that I wanted an epidural ... I don't remember that, but I was miserable. The car ride is about 20 min, and I panted the entire way, to keep myself from pushing.

I ended up not getting an epidural ... since there was no time, and I wanted to have these babies!! OB on call was not happy I did not have an epidural ... warned me about potential for general anesthesia, in case she had to do a crash C section, etc. I told her it was a chance I was willing to take .... I was ready to deliver.

My Baby A (Adam) was born first ... vertex presentation, no problems .. out in about 3 pushes.
OB then (I think) looked around with the U/S ... she wanted to keep the bag of waters intact with delivery, if at all possible. (to prevent cord prolaspe, perhaps?? I don't know) She reached inside me, trying to get ahold of his feet, before I pushed ..... excruciating!! I screamed/cried/cursed ... told her I just wanted to rest a few minutes before we 'went on'. I'm not sure if Baby B (Thomas) had his feet tucked up under him, or what. I felt my water break, and next thing I know, the OB, nurses, and my husband are SCREAMING at me to push. Couple of pushes later (or maybe one big push/pull), he was born. Brett told me later that Thomas was blue ... I don't know if it was a 'normal' little bit blue, or if he was in true distress.

He was very bruised ... you can see it in his pictures, especially his scrotum. His feet were black for a few days.
http://bp1.blogger.com/_5R9w4y0PKG8/...0-h/Thomas.JPG
He had a dip in his blood sugar, as well as his temp shortly after birth, and had to spend some time under the warmer in the regular nursery. Both boys were borderline jaundiced when we went home, but Thomas's level was higher. (neither needed lights)
We are scheduled for an U/S Tues to check his hips out, as well.


To me, it was harder to push with him .... hard for me to say if it was because he was breech, or because I was exhausted, or if it was because I didn't feel quite ready.
I wouldn't have changed a thing .... I felt great afterward ... got up, showered as soon as my IV was out, etc. YES ... it was painful, but you CAN do it .... no epidural for me, and we avoided a Csection, bringing home 2 healthy baby boys .... that was the ultimate goal.

I'd make sure that all the docs in your OB's practice are trained in the procedure .. I did not know that it was an old school kind of thing, but I did get the impression that some of the docs here were more comfortable than others.

Good luck, and please keep us posted!
post #6 of 26
Hi! I had a breech extraction 5 weeks ago with my baby B. No pain meds, just breathed through it - it was definitely bearable, especially b/c I was still in the labor 'zone'. The OB tried an external version first before going to the extraction. I did not have to push with it. I suppose it took several minutes, as she was born 6 min after her sister. The baby had no bruising. Also, she was 7lb 3oz. I honestly have nothing bad to say about the experience; I was mentally prepped for it, trusted my experienced OB, and was just plain excited/relieved to get baby b out!!!

to add: was very glad that my hubby was occupied with baby a and did not witness the extraction - i think it would have traumatized him.
post #7 of 26
Quote:
Originally Posted by Queen of Carrots View Post
Hi,

I'm 37 weeks tomorrow with b/g twins and hoping for a VBAC sometime in the next few weeks. The one thing that's worrying me a little bit is that Twin B (the boy) is still breech, and at this point, I doubt he's going to turn before delivery.

Now my doctor is totally fine with doing a internal version or a breech extraction if he doesn't turn once his sister gets out of the way. He says he's done 40 of those and never needed to do an emergency c/section for Twin B. My doula says she can help me through it and I'm sure she can.

But I'd still like to hear from mamas who have gotten through it without pain meds. I DO NOT want an epidural. I hate being immobilized a lot worse than I hate pain. But there's a difference--at least in anticipation--between the pain of my body working and the pain of the doctor reaching in to move things.

So I'd love to hear from people who have gotten through it! (Or from people whose babies turned head down at the last minute.) Thanks.

QOC ##==>
Congrats on your pregnancy.

Have you heard of and tried the Webster technique? Its a chiropractic method.

Also, I birthed breech twins at home. I am not fearful or concerned about breech. However, I have never had a C-birth or a VBAC (obviously) and I do not know much about that arena and complications.

What do your mothering instincts tell you to do, trust, or research?
post #8 of 26
My baby A came out vertex, and B was a foot-first breech. Before the docs could "do" anything, B's foot slid out, so I pushed him out breech. No problem.

GL!
post #9 of 26
I guess I'm the chicken who decided I'd rather have the epidural in this situation. I agonized over the situation for months, baby B was breach. I still feel I made the right decision for ME, and if you think epidural might be right for you in this situation, don't let anyone else tell you otherwise. It's YOUR decision and yours alone. Here's how mine went: Baby A was head down, ready to go and out in a couple of pushes. Then Baby B flipped sideways and stuck his arm out! The hope was that he'd slip down and be born breach, which my OB was fine with, but when he turned sideways and stuck his arm out, the Dr. had to manually push the arm back in and spin the baby downwards. Oh, and his HR started dipping when twin A came out, which was very scary to me. When he finally did get head down, it took probably close to 10 minutes for him to start coming down into the birth canal, they had the vaccuum thingy and everything, but he just had to make his way down. I was pushing, but the pushes weren't doing anything b/c he was stuck back behind my pubic bone or something. WHen he finally got past that I had no problem at all pushing him out in just a few minutes. My twins were 27 minutes apart. Twin B did look white compared to his brother, and I was worried about him that first little bit. I did not like that manual version no matter if I had drugs or not, it was just flat out creepy! (BUT BETTER THAN A C-SEC!) My mom and DH were watching and I think it traumatized my mom for life! Good luck in preparing for yourupcoming birth! One thing that my OBs kept saying is there is no way to predict what will happen after baby A is out, some twins come right down, others flip all around,
post #10 of 26
I just wanted to thank you for asking this question. I am almost 37 weeks with baby a virtex (we think posterior) and engaged (her head is lower than my bladder!) and baby b oblique-transverse. My midwives are preparing for a breech or breech extraction just in case and want to make sure that I know the risks and pain that it might involve. My intuition is that baby b will either flip vertex (she could go either way) or come out just fine as a footling breech on her own...but still, its good to hear all of your stories and encouragement here. Thank you all!


wish me happy get on the birthing vibes! I am ready to have these babies out of me!!!!!!!!!
post #11 of 26
My baby A came out vertex, and baby B was footling breech. After baby A was born, baby B turned transverse. My doctor tried to do an external version but it didn't budge her. Then we waited to see what she would do on her own with the next contraction, and she went back to footling breech. One foot slid out and my doctor grabbed it, then the other, and I pushed while he guided (not pulled) her out.
post #12 of 26
Hi there Queen of Carrots,

I hope I'm not stirring up a hornet's nest. Truly, there is a time and place for many obstetrical interventions. I'm not picking on you at all, I'm just looking at what you wrote and seeing a familiar pattern:

Quote:
Originally Posted by Queen of Carrots View Post
Hi,
. . . The one thing that's worrying me a little bit is that Twin B (the boy) is still breech, and at this point, I doubt he's going to turn before delivery. . .
Now my doctor is totally fine with doing a internal version or a breech extraction if he doesn't turn once his sister gets out of the way. . .
So I'd love to hear from people who have gotten through it! (Or from people whose babies turned head down at the last minute.) Thanks.
It just seems that frequently, the discussion is assumed to be: breech of a Twin B = breech extraction (if you don't wish for more serious interventions!)

Are we giving our babies and our bodies a fair chance? Or are we being intimidated by the medical professionals and accepting breech extraction as a "middle ground" between a natural birth and a c-section? I'm not a stranger to feeling the intimidation and, yes, badgering from doctors.

This post is offered only for further reflection and discussion - I'm not criticizing any one person's decision. And absolutely there are breech Twin B deliveries best accomplished by breech extraction. But do things jump to breech extraction too quickly and without indications of problems?

My twin B was double footling breech. He was born easily and smoothly with no intervention.
post #13 of 26
Quote:
Originally Posted by Novella View Post
Hi there Queen of Carrots,

I hope I'm not stirring up a hornet's nest. Truly, there is a time and place for many obstetrical interventions. I'm not picking on you at all, I'm just looking at what you wrote and seeing a familiar pattern:



It just seems that frequently, the discussion is assumed to be: breech of a Twin B = breech extraction (if you don't wish for more serious interventions!)

Are we giving our babies and our bodies a fair chance? Or are we being intimidated by the medical professionals and accepting breech extraction as a "middle ground" between a natural birth and a c-section? I'm not a stranger to feeling the intimidation and, yes, badgering from doctors.

This post is offered only for further reflection and discussion - I'm not criticizing any one person's decision. And absolutely there are breech Twin B deliveries best accomplished by breech extraction. But do things jump to breech extraction too quickly and without indications of problems?

My twin B was double footling breech. He was born easily and smoothly with no intervention.
I totally agree. I do not get the whole routine breech extraction thing AT ALL. I can understand an emergency, but why is it routine? Just another way doctors are trying to hurry up the natural process of birth. :
post #14 of 26
Quote:
Originally Posted by Novella View Post
Hi there Queen of Carrots,

I hope I'm not stirring up a hornet's nest. Truly, there is a time and place for many obstetrical interventions. I'm not picking on you at all, I'm just looking at what you wrote and seeing a familiar pattern:



It just seems that frequently, the discussion is assumed to be: breech of a Twin B = breech extraction (if you don't wish for more serious interventions!)

Are we giving our babies and our bodies a fair chance? Or are we being intimidated by the medical professionals and accepting breech extraction as a "middle ground" between a natural birth and a c-section? I'm not a stranger to feeling the intimidation and, yes, badgering from doctors.

This post is offered only for further reflection and discussion - I'm not criticizing any one person's decision. And absolutely there are breech Twin B deliveries best accomplished by breech extraction. But do things jump to breech extraction too quickly and without indications of problems?

My twin B was double footling breech. He was born easily and smoothly with no intervention.
I agree with the sentiment of your post. I too had no interventions on my breech twins, frank and footling respectively. But I was comfortable with no interventions and some women are not. I actually was not comfortable WITH interventions. I had to trust my own instincts and those of my birth team.

I am hesitant to tell women to do anything other than to trust their instincts and to do their research. I understand and loathe what the culture of medical birth has done. I have many a long soapboxes about it and its harm but at the end of the day, one on one with women, I encourage them to trust their birthing and mothering instincts given their options and environment.

My choice to stay far away from medical interventions and/or medically minded midwives created quite the stir and brought much criticism. But I had to trust my instincts and I personally am so glad that I did.

If a women feels safer in the hospital than I encourage her to birth where she feels safe and respected. To do anything other would not feel right to me as a woman with and for women.
post #15 of 26
Quote:
Originally Posted by gemelos View Post
I do not get the whole routine breech extraction thing AT ALL. I can understand an emergency, but why is it routine?
I puzzled about this, too, for quite some time.

From what I understood of our obstetrician's reasoning, she advocated total immediate breech extraction as a case of "making hay while the sun shines".

She said that the cervix would be fully open immediately after Twin A was born. She was afraid it would partially close if I continued to labour. When I pressed her with the notion that it would then re-open through continued labouring, she seemed to fear that the prolonged window would only serve to invite the opportunity for Twin B to start failing. Then, you could have a emergency situation where the cervix has partially closed, failed to fully re-dilate and Twin B needs out NOW for emergency care.

In her eyes, such management of the birth was avoiding an emergency. In our eyes, it was more likely to cause an emergency.
post #16 of 26
Quote:
Originally Posted by hotmamacita View Post
I agree with the sentiment of your post. I too had no interventions on my breech twins, frank and footling respectively. But I was comfortable with no interventions and some women are not. I actually was not comfortable WITH interventions. I had to trust my own instincts and those of my birth team.

I am hesitant to tell women to do anything other than to trust their instincts and to do their research. I understand and loathe what the culture of medical birth has done. I have many a long soapboxes about it and its harm but at the end of the day, one on one with women, I encourage them to trust their birthing and mothering instincts given their options and environment.

My choice to stay far away from medical interventions and/or medically minded midwives created quite the stir and brought much criticism. But I had to trust my instincts and I personally am so glad that I did.

If a women feels safer in the hospital than I encourage her to birth where she feels safe and respected. To do anything other would not feel right to me as a woman with and for women.
Thank you Hotmamacita,

I agree with so many of your words.

I hope no one construes my experience with a natural footling breech twin as preachy. Simply, I want there to be a few voices out there that say "Hey, this is one of the options".

If we constantly speak of c-sections for breech, versions for breech, and extractions for breech, without even mentioning the possibility of non-intervention for breech, then we are steering the choices of others by our omissions.

I've been a benefactor of those who "laid it all out on the table" so that I could hear of options I'd never considered and weigh through those options until I came to my own decisions.
post #17 of 26
There are always risks in childbirth and I guess OBs see the cervix closing as a greater risk than damage being done during an extraction. Sure, it is possible that a cervix would close and the baby could go into distress, but that doesn't mean it will happen. Several mamas on here had their cervix partially close and re-dilate. I guess they would rather err on the side of intervention then err on the side of letting things happen naturally. Because at least if they intervene they can say they tried or whatever.
post #18 of 26
That is a kind way to put it gemelos. I admit I get angry at the arrogant advice and mistruths, of some ob/gyns.

Novella. Don't worry. I am so with you on your opinions. I don't even know what a breech extraction is but it doesn't sound good. However if a woman is informed, researches it and feels it is needed and best for her baby, I can't encourage her otherwise.

In order to trust my own instincts, I had to remove myself from what I felt and experienced to be the arrogance of the medical and certain aspects of the midwifery communities regarding twin/breech birth. Even many midwives are misinforming women, imo, how to care for oneself and the pregnancy not to mention their perspective of birth. Its an absolute mess the whole culture of birth.

I have never had a hospital birth. I would hope that if I had to, I would be able to trust my instincts in the midst of the many agendas and opinions. I prefer women to return to their homes and communities to birth and to use modern medicine for genuine emergencies in pregnancies and birth but barring any grave collapse of the medical community and its corporate culture, that is just not going to happen anytime soon.

I am sorry if I am 1) rambling 2) repeating myself and/or 3) coming off as arrogant. I really don't intend to.

Gemelos: (you bring up such good points) My first frank breech twin was born and my cervix was able to open fully. Who knows if it closed and reopened for the second born footling breech twin an hour and some twenty odd minutes later. Had an arm or leg presented first in a twin birth, my comfort zone would have been tested and I knew my own limits. I was comfortable with an unassisted twin birth but my husband was not so I had to work with my partner on trusting our instincts as a team. Anyway, i am rambling now and I think you already know all this....
post #19 of 26
It's so helpful to have these instinctual reminders DURING pregnancy.
I can do the whole 'all will be well' support for other women, but when it comes to my own body, babies and the threats of standard care, risk assessment etc come up over and over again I shudder and need to flee to the safe comfort of other mothers able to say what needs to be said.

thank you hotmamacita, gemelos, novella and all of you who write so eloquently from your intuition and experience. The fact is that if it all goes 'pear shaped' on the day, we'll deal with it, kwim. Not to say don't research, but this time round I am staying away from the scaremongerers and standard procedure as much as I possibly can. It feels so much safer and more peaceful to be letting my babies just get on with it inside their purposefully hidden world.

This is all kind off topic to this specific thread, but wanted to say that it is so good to read *both* sides of the story on these mothering threads. I think especially those where some apparent conflict occurs are places for each of us to grow. I'm really finding it helpful to see ways of discussing the different angles very strongly without being angry/ offensive back. Hopefully these are gently empowered attitudes we can take into the world of 'managed' pregnancy, labour and birth.

post #20 of 26
Thread Starter 
Thanks for all the stories.

My doctor does plan to wait and see how Baby B does on his own. Hopefully he will find his own way out in good time. OTOH, I feel a need to prepare myself mentally to handle whatever comes up, without panicking about it ahead of time. So I really appreciate hearing from those who handled the breech extraction with no pain meds, as in most other places anyone would gasp in horror at even attempting that. I'm not counting on it occurring, but I like to be able to think, "Well, if it *is* necessary, I can deal with that."

I do feel more comfortable birthing in a hospital. My first birth was a good, intervention-free hospital birth, despite a long, slow labor, and my second birth I got an ambulance ride to the hospital gushing blood. To me giving birth is like swimming in the ocean; I can swim on my own, but I prefer to have the lifeguard station handy just in case. I have a lot of respect for those who birth at home, but I think there's a need for women willing to fight for natural birth in the hospital setting, too.

I've searched the city to find the doctor with the most respect for natural labor, along with an experienced doula, and I don't think I'm going to be railroaded into anything unnecessary.

Now if I can just talk these babies into coming out soon.
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