WWYD-Breech?

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krazykat's picture
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WWYD-Breech?

With all this talk of breech babies lately, I was just curious as to what you would personally do, or if you have been in that situation, what you have done? If you were an uncomplicated pregnancy, past 38 weeks, and the baby was either complete or frank breech, would you attempt a vaginal delivery? What steps and measures would you take? Hopefully this doesn't get heated or anything, I just wanted to know everyone's personal opinion on it and why you feel that way so that I can be informed in the future. I learn so much from you ladies!!

So here's what I am thinking, but I'm not totally sold yet: I would try accupuncture, spinning babies, and all the positioning-type stretches/exercises. I would also try the Hypnobabies breech scripts and visualization. If baby still won't turn, then I would like to schedule an u/s to check for cord length and any physical reasons for being breech. I would have an external version attempted. If that was not successful, I would try to find a doctor or CNM experienced in breech delivery, but would most likely change my birth location to the hospital (much as I would hate to), and consult with them to gather further information before making a final decision. If there are no OBs or CNMs, then I would probably still let my body go into labor on it's own (ONLY if baby were frank or complete breech). And this is where I am stuck and would need to think long and hard... Go with the repeat c/s or not? I just don't know...

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My first son was a natural, non-induced birth. Pretty straight forward and easy. Second decided to be a booger. Found out at 38wks that he was breech. Tried positioning- nothing. Tried an external version- no luck. (And it was not fun. Painful because the OB knew how badly I wanted him turned so he tried really hard three times.) So I had a scheduled c/s. I realize in a bigger city or different practice, I could have had a vaginal delivery. But in the end, I had a healthy baby. Don't get me wrong- I cried and cried and lost so much sleep over the c/s. But now that I'm 2 months out, I don't regret anything. I have two amazing boys. It also helps that Jack has been a great BFer from the beginning. As big an advocate as I am for birthing naturally, I'm even more into BFing. The c/s didn't alter that. So there you go- my experience.

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Pics of my homebirth midwife delivering a footlong breech (real birth pics...) :
http://birthingway.com/footling_breech.htm

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"TyrantOfTheWeek" wrote:

Pics of my homebirth midwife dielivering a footlong breech (real birth pics...) :
http://birthingway.com/footling_breech.htm

DH and I were JUST viewing your pics the other day and didn't even know it!! We were having the breech discussion, and I found a link from alldoulas.com. THANK YOU for sharing that with the public. And totally AMAZING pictures. If you don't mind me asking, what were your thoughts going into the delivery? And what ultimately made you decide to go ahead and deliver even with a footling? Any particular things you had to do during labor/delivery for safety's sake? Or did you go into just like any other labor and delivery? You don't have to answer if you don't want, but I am really interested to hear Biggrin

ETA: And I forgot to ask... were there any inconsistencies with the baby's heart-rate? I see that she monitored almost continuously... did she notice any decels or anything?

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It would all depend entirely on finding a caregiver who not only was willing to do it, but had experience. I'm all for trying a breech birth, but finding someone in the US who is experienced with it is darn near impossible.
Oh and Mindie, those pictures are AMAZING!

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"krazykat" wrote:

DH and I were JUST viewing your pics the other day and didn't even know it!! We were having the breech discussion, and I found a link from alldoulas.com. THANK YOU for sharing that with the public. And totally AMAZING pictures. If you don't mind me asking, what were your thoughts going into the delivery? And what ultimately made you decide to go ahead and deliver even with a footling? Any particular things you had to do during labor/delivery for safety's sake? Or did you go into just like any other labor and delivery? You don't have to answer if you don't want, but I am really interested to hear Biggrin

ETA: And I forgot to ask... were there any inconsistencies with the baby's heart-rate? I see that she monitored almost continuously... did she notice any decels or anything?

Those aren't me...LMAO. I wish.
She is my midwife though. I I just thought they were worth sharing on this discussion to show that it can be done. Most OB/GYNs aren't even TRAINED to deliver breech babies anymore. And at the rate things are going, they won't even be trained to do vaginal deliveries.

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These are my other favorite pics from her archives.
http://birthingway.com/caul.htm

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Here are some pics of another Atlanta midwife.
The Facial presentations would automatically result in a c/s if you were in a hospital. There is another breech birth on there as well.
http://www.newlifemidwiferycare.com/gallery/index.php

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Those last pics are pretty neat with the bag still intact as the head comes out.
I think I would try all the things you mentioned in the beginning first but ultimatly would go for it if all looked good with cord length and all. I'd still do it at home, though our hospital is literally 4 blocks away. My MW have delivered a few before. When I asked her about it she said it wasn't really the PC thing to do but 'if it just happened' and we 'didn't know' then she'd be there for us just like the rest of her clients.

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I just faced this situation a couple months ago. I found out at 34 weeks that my baby was breech- I spent three weeks doing every at home and natural thing you could think of (including chiropractic, accupuncture, moxa, etc). At 37 weeks nothing had changed. Sad We scheduled an external version. In the meantime we also talked about what we would do if the version didn't work. The plan was that I would wait for labor to begin on its own, and if the baby was STILL breech at that point we'd go for the emergency c-section. My midwife offered scheduling a c-section if the version didn't work (so that there wouldn't be any "emergency" about it, and I would know the surgeon). It was more important to me to have labor start on its own. I was not at all into the scheduled c-section. Luckily for me, my version was the unbelievably easiest version ever seen or done by my midwife and the OB. I was incredibly lucky to go on to naturally deliver a beautiful baby girl! Smile

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I would do everything possible to get baby to turn, including external version. If baby was still stubborn, I don't know if I would schedule a c-section or wait till I was in labor to have a c-section but I wouldn't attempt a vaginal delivery. Mainly because there is no one in this area that knows how to do it:-(

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I'd obviously try to turn babe but in the end my mw is experienced with breech and I'd assume a vaginal birth.

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My experiences were back in the 1970s. At that time I would likely have tried what I could to get baby to change position, but in the end, if unsuccessful, would have left the decision to my doctor.

Now though, I have far less trust in doctors, and particularly my present doctor! There are alternatives in my rural area these days, and Mennonites gifted in versions etc... I would take advantage of their talents these days. In the end though, I'd need to research more. I don't know who has the most breech experience in our area.

PS: You know, as I think back to the 70s, I was not as much into research as I am now. I said that I would have left the decision up to my doctor at that time, but truly, I was very confident in Mother Nature doing the right thing, right up to the last minute. Generally I have not changed in that viewpoint.

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I would not do a c/s unless absolutely necessary.. Even if it meant travelling to find a MW who would take me as a vaginal breech. (Its illegal here for a MW to deliver breech).

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It would definately mean changing practitioners. I asked my MWs if they do them and they said no. Hmmmm, wonder if they know someone who does, they have been doing homebirths for years, they probably do.... but then my insurance probably wouldn't cover.

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"TyrantOfTheWeek" wrote:

Those aren't me...LMAO. I wish.
She is my midwife though. I I just thought they were worth sharing on this discussion to show that it can be done. Most OB/GYNs aren't even TRAINED to deliver breech babies anymore. And at the rate things are going, they won't even be trained to do vaginal deliveries.

ROFL I mis-read your post lol and now I feel silly! I was hoping to get some good *inside* info haha!! Yeah, those are some great shots!!!

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I found out DS was breech at my 36 week appointment and my OB turned him via external version at 36+4d. It was successful, and I was able to deliver vaginally, but it caused my water to break the next day and for me to have to be induced.

If this guy is breech, I will try other positioning things first (spinning babies, acupuncture, etc.), but would do another version again. I haven't thought much about what to do if he still won't turn - I'm guessing c-section is the only choice with my OB. I hope I won't end up having to find out.

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Of course I would try everything to try to get the baby to turn, if nothing worked, I think I would prefer to do a vaginal breech, but only if (and that's a big if) I could find a provider who had experience with it. I certainly would not fault any woman for choosing a c-section for breech, though

Robin, who used to post here regularly, had this situation happen to her. You can read her story here: http://breechbirth.ca/Birth%20Stories/Birth%20Story%20Miriam%20Hannah.html

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I would do everything I could to get the baby to turn up to and including a version. I know there is one OB here who will deliver a breech baby (under certain circumstances) so I would also probably try to see about transferring care - I really would try to do everything in my power to avoid a c-section.

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I was recently in that position all though it seems the baby is head down now. We'll still need to confirm when I go into labor but my OB will do a vaginal breech birth so my risk of ending up in a c/s is lower regardless. I know of another in the city who would as well and if she wouldn't have offered I probably would have been knocking down his door!

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My DD was breech and we didn't know until I was in labor and 8cm dilated. I wasn't given an option, just wheeled off to surgery.

I am hoping this one does not end up breech, but if s/he is, I would do spinning babies, chiropractic, etc. I would consider a version as well.

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Even if there are practitioners who are experienced with breech deliveries, would they do a VBAC breech? Hmmmm...

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"krazykat" wrote:

Even if there are practitioners who are experienced with breech deliveries, would they do a VBAC breech? Hmmmm...

I'm sure there are some out there, but probably very difficult to find.

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Christie at the U.S. chapter of Robin's Coaliton for Breech Birth has a list of breech providers she's been compiling for a while. She sent it to me a while ago, but it's probably been updated since then. Some of the comments indicate whether the doctor would do breech VBAC (Christie had 2 c-sections for breech and transverse presentations and then had a breech HBA2C)

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I would do everything I could to turn baby, including an external version if the "natural" things didn't work. If nothing worked, then I'd have a very detailed ultrasound to try to determine if there was something keeping baby from turning, such as a short cord or cord around a body part. If everything with baby & cord looked good, then I'd wait for labor to start & try to get baby to turn with the contractions and perhaps another external version. If that didn't work, then I'd consider both baby's position and how labor was progressing. If baby was in one of the "good" breech positions and labor was progressing, then I would attempt a vaginal birth, but if baby was in a "poor" position and/or labor wasn't progressing, then I'd opt for surgery.

I'm lucky to live in an area with two teaching hospitals. They don't encourage vaginal breeches, but they'll do one if you insist. And you'll have about 20 students vying for a good view, too, but IMHO that's worth it if they all learn that vaginal breech should be a viable birth option.

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Brittany... AWESOME story!! TFS Biggrin

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http://www.midwiferytoday.com/articles/turnbaby.asp

i found this on another site.. just thought I'd share..

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"Illiana" wrote:

http://www.midwiferytoday.com/articles/turnbaby.asp

i found this on another site.. just thought I'd share..

I LOVE Midwifery Today... so many great articles!! Thanks!

*On a side note, I'm pretty sure my LO turned for me. I'm getting kicks back up at the top right, and hiccups down low. I've been swimming almost every day for the past week, so I wonder if that had any effect. Hopefully he stays that way, as I know there is still plenty of time and room for flip-flopping lol Blum 3

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thats awesome that he turned! hopefully he'll stay that way.

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I would have to do some research, but I think that I would do anything to try to get baby to turn, then attempt a vaginal breech. I mentioned to my MW that I was worried about breech this time (don’t know why), and she just laughed and said if we needed to we’d talk about it later. I did mention that a friend of mine’s baby was breech, and she automatically assumed that my friend found an OB who delivered vaginal breech. I don’t think that happened, but given my MW’s reaction, I think that I would have full support to do that (providing it wasn’t a dangerous presentation). On the other hand, I tend to have super fast labours and the hospital is only 5 minutes from our house in case of emergency, so it’s possible that we may “accidentally” have a home breech birth anyway – if it was still breech at that point.

Currently, however, I think that Baby is doing somersaults because I get kicks low for a couple days, then high for a couple days, then on the side… Baby’s got plenty of time to get where he/she needs to be since I’m only at 29wks.

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I asked my midwife if she'd do a vaginal breech delivery, and she said "in my 30 years of being a midwife, it's never ONCE been an issue. We've always got the baby to turn. So while I'm willing to do one, I highly doubt it'd come up".

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To be honest, I'm unsure.

My first baby had an unusually large head at just over 16". It was huge and I worry that this baby would also have a large head...that would make breech delivery complicated and that worries me.

I would obviously try anything in my power to turn baby. And I wouldn't consent to a cesarean until labour starts on it's own and hits a steady rhythm with baby still bum down. I'm just not sure though, although the homebirther in me wants to say I'd go for the breech delivery.