Breech Babies

[meltoine]

If your baby was breech at 32+ weeks, did s/he turn by term? 

AmyRI @notquiteblushing can you share anything about your vaginal breech birth experience? How did you find a supportive provider? How much resistance did you come up against?

DS3 is still breech. For the past month he's been very active turning all over - usually breech but frequently turning transverse and vertex a couple times for short periods. For the past four days he's been breech and hasn't turned transverse at all. Part of me feels silly for being worried about it at this point since I tell my students and clients all the time that almost all babies are vertex at term and no one is going to be concerned about it until 36 weeks. 

But. 

He is super active and moves a ton all the time. Except for the few times he was vertex. Then he was eerily quiet (like no movement at all) until he flipped again, always after less than an hour. This makes me think that there's something that makes him uncomfortable about being vertex - maybe something weird happens with his cord when he's vertex. 

Also, since I POAS this time I've been afraid that this baby was going to be malpositioned. I thought that DS2's birth was so easy and I was afraid that this one would be harder and the only thing I could think of that would make it harder is malpositioning. But I thought it would be sunny side up, breech never occurred to me until a month ago. My other two were vertex and didn't flip anymore at 27 weeks. I brought this up to H and both of the midwives I hired super early on and everyone told me not to worry, that I know all the positioning exercises and everything would be fine. But it still nagged me and now I'm getting concerned. The lack of movement when he's been vertex is what's really concerning me. I feel like he's not ok when he's vertex. 

State law here doesn't allow my MW to attend me at home with a known breech. And I have to have a "risk assessment" in three weeks by an OB at the health department who will not sign off on a home birth if he's breech. And if I don't get that approval my MW is required to transfer care. There are no OBs here who attend vaginal breeches. I'm getting nervous. 

If if you made it through all that, have a drink on me :beer: :drink:

[Velar Fricative]

DD turned head-down by my 36-week appointment. She was breech until 34 weeks and then transverse at 35 weeks. I did nothing to make her turn. OB said that he doesn't worry until 39(!) weeks. Good luck!

[longtimenopost]

Following! DD3 is breech at 31 weeks and I am really hoping she'll flip so I have a chance at a TOL/VBAC.

[meltoine]

Jul 7, 2015 22:07:12 GMT -5 longtimenopost said:

Following! DD3 is breech at 31 weeks and I am really hoping she'll flip so I have a chance at a TOL/VBAC.

I hope she flips for you!

[Deleted]

I didn't plan a breech birth. He was transverse from weeks 32-37 but then was head down during ultrasounds at 37, 38, 39 weeks.

I got to the hospital at 6 cm and I'm not sure if he was head down or if anyone even checked. Very soon after my water broke and I was 10 cm. I felt an urge and pushed and a foot came out.

Afaik the practitioners that do breeches probably won't do footling breeches because of risks but at that point it was too late. I'm just grateful the hospital doc (mine was too late) let me tear naturally and knew how to get him out quick and safely.

Even though I ended up with a breech I still think seeing the chiropractor helped him turn head down fwiw. Good luck.

ETA: I too think there was possibly a reason he wasn't head down. My umbilical cord was off center / which we were watching earlier in the pregnancy - and I wonder if its position kept making him sit sideways.

[lindsaymg]

Here is to hoping your baby turns, I am 35 weeks and footling breech. C section scheduled for 39 weeks just in case because she refuses to move for anyone (dr, ultrasound tech, nurses).

[teatimefor2]

Both of mine didn't turn until 36 weeks. My first was down at 28 weeks and then turned around again until closer to 37 weeks!

[humpforfree]

He never flipped. Had to be taken out at 37 weeks due to low fluid, so he wouldn't have flipped in those last 3 weeks.

[meltoine]

Jul 7, 2015 22:55:37 GMT -5 connie0000 said:

Two girlfriends of mine both had breech babies pretty late. They both swear by acupuncture and it turned both babies. It just took one appointment. Maybe that is an option?

I'm seeing a chiro and doing positioning exercises at home. I'm not aware of an acupuncturist in my area (I know there wasn't one two years ago when I was researching local resources for my doula certification) but I should look again. Thanks for the reminder!

[AmyRI]

Well, baby was transverse until 33/34 weeks.  I saw a Webster certified chiro at 32 weeks and baby flipped vertex after my 2nd adjustment and stayed that way until 40w5d.  I thought contractions were starting and stopping, but in hindsight that's when she flipped.  I went into spontaneous labor after my water broke early the next day thinking she was vertex.  I had planned a hospital birth, so that wasn't part of my equation.  The nurse that checked me when we got to the hospital missed her position when she checked me and I was 3cm.  My midwife discovered the baby was breech when she checked me and I was 7or 8cm.  So, it was completely unplanned.

As far as providers... I got lucky.  I can take no credit.  I had been seeing an OB group until 32w.  They handled my care awfully and I switched to a midwife before my 34w appt.  She is not trained in breech births, so when she found baby was breech, I was transferred to the hospital's on-call OB.  Turns out he and his partner OB are the only 2 in the state that I've found are trained in breech births. 

As far as the decision to try for a vaginal breech instead of jumping straight to C-section, it was made very thoughtfully in my case because we caught it before I was pushing.  Basically I had no risk factors for trying the vaginal birth - I had a med-free vaginal birth with my DS, that labor was under 8 hours and only 15 minutes of pushing, the baby was estimated to be within 1/2# of my DS's weight at birth, I had gone into labor spontaneously and was dilating quickly (almost 5 cm in under 2 hours), the baby was tolerating labor just fine, baby did not have hand or cord under her chin and her chin was tucked down, and she was frank breech.  The OB said that both options were very safe in my case, and we talked about risks and he basically said that both options were very low risk, but the risk during a vaginal breech birth was to the baby and the risk of a C-section is to me, so we had to choose. 

There was really no pushback, but that was because I lucked into a well-trained provider who was supportive of what I wanted.  Any other OB, including the OB that I had been seeing for years prior to my awful 32 week experience, would have ordered an immediate C-section.  My midwife stayed through the whole thing acting somewhat as a doula and at the end, being trained by the OB.  She and the OB were both very supportive.  No idea what the nurses thought, but quite frankly I did not give a fuck at that point.  (There's Transition hormones for you.)  In general, the hospital was very supportive - they had an entire second staff of nurses and a second OB scrubbed and waiting in the OR and the anesthesiologist in the hallway, but I was allowed to deliver in the normal L&D room and med-free.  I was forced into a single bag of IV fluids in case the need for anesthesia came up and monitoring was constant through pushing.  In the end, it was a very similar, easy, uncomplicated delivery to my first.  My body worked just the way nature intended.  The room was just much brighter and with many more people in the room than my first med-free birth, lol.

Going back to the flipping and movement thing: the Webster chiro said that he hates when clients wait until 36+ weeks (or worse, 38+ weeks) to show up for help.  He prefers to start in the 32-34 week range when baby still has plenty of room to move around, but is more likely to stay head down once they get there because it's how they have the most room.  Re: movement, my DD's movements were way more painful when she was transverse because none of her was actually in my pelvis.  It was all my ribcage and lungs taking the hits.  When she was vertex, she moved as frequently but it was way less painful and I had to pay attention to count movements to make sure all was well.  If there's really no movement when he's vertex, I'd be trying to get an u/s or something to check for cord wraps and other issues that would complicate a vaginal delivery is a good idea. 

If you want details on what the actual breech birth was like, I'm happy to talk about that, too, because I found the "what to expect" part of the breech birth discussion very helpful in keeping me and DH calm.  (That's a total lie - it kept DH calm and kept me in a state of mild panic instead of the full blown crying mode I was in when I was first told she was breech.)

And if you made it through this, drinks are on me in ~8 weeks. 

[meltoine]

AmyRI and @notquiteblushing thanks for sharing!

I have an appt with my MW tomorrow and will be asking extensively about all of this. I've been seeing a regular chiro because the closest Webster-certified one is 40 mins away, but I think it's time to switch. You're absolutely right about going earlier and I need to make the move. On the other hand, the lack of movement in vertex makes me not want to try all that hard to turn him.

A not-small part of me wants to drive up the The Farm if he's still breech in a few weeks. But I'm not sure if that's unreasonable or not.

[matildasun]

Jul 8, 2015 7:54:37 GMT -5 meltoine said:

A not-small part of me wants to drive up the The Farm if he's still breech in a few weeks. But I'm not sure if that's unreasonable or not.

I would normally cheer you on for this choice,the Farm intrigues me and you would be in good hands, but if you are concerned that he is uncomfortable vertex there may be a larger problem that hasn't been discovered. I worry that whatever it is would make a breech birth dangerous.

[meltoine]

Jul 8, 2015 9:26:11 GMT -5 matildasun said:

Jul 8, 2015 7:54:37 GMT -5 meltoine said:

A not-small part of me wants to drive up the The Farm if he's still breech in a few weeks. But I'm not sure if that's unreasonable or not.

I would normally cheer you on for this choice,the Farm intrigues me and you would be in good hands, but if you are concerned that he is uncomfortable vertex there may be a larger problem that hasn't been discovered. I worry that whatever it is would make a breech birth dangerous.

I would rule this out first. I trust that The Farm would not accept me as a client without verifying that it's safe for me to deliver the baby vaginally. 

[matildasun]

Jul 8, 2015 9:31:59 GMT -5 meltoine said:

Jul 8, 2015 9:26:11 GMT -5 matildasun said:

I would normally cheer you on for this choice,the Farm intrigues me and you would be in good hands, but if you are concerned that he is uncomfortable vertex there may be a larger problem that hasn't been discovered. I worry that whatever it is would make a breech birth dangerous.

I would rule this out first. I trust that The Farm would not accept me as a client without verifying that it's safe for me to deliver the baby vaginally. 

I figured you would. I didn't mean to sound condescending. My initial thought was, "Yes! Go to the Farm", and then I backtracked. Just thinking out loud . Hopefully it will be a choice. Good luck!

[Deleted]

Are there any OBs that will try a version if you're still breech at 36 weeks?

My sister also had a breech birth, but it was also a surprise. Foreign trained doctors tend to have experience with breech births. Hers was from the Middle East somewhere.

If you can't try a version, and if there are no doctors that will do a breech birth, I would consult with the Farm and see what they say. I don't think that's unreasonable.

[AmyRI]

I'd consider going to the Farm in your shoes. I switched to the OB that delivered my DD in case we have a 3rd kid. I want to be 100% sure that no matter what happens, I know I am in good hands. From everything you've said about your current care options, I don't think you're going to get what's in your and your baby's best interest where you are unless you have a textbook home birth.

How far away is it? Is there any way for you to get up there to someone trained that can tell you if you're a good candidate or not, and check for potential issues with the cord? (Or maybe a regular ole OB where you are can check for cord issues). Birthing is just so important to me that I think it's worth the hassle, and given your profession and everything you've posted about it, I think you feel the same. I often think about how different my recovery would have been if I hadn't been so lucky, and how it would have affected the decision to try for a 3rd, and my care leading up to a 3rd delivery.

[meltoine]

Jul 8, 2015 10:10:37 GMT -5 @tokenhoser said:

Are there any OBs that will try a version if you're still breech at 36 weeks?

My sister also had a breech birth, but it was also a surprise. Foreign trained doctors tend to have experience with breech births. Hers was from the Middle East somewhere.

If you can't try a version, and if there are no doctors that will do a breech birth, I would consult with the Farm and see what they say. I don't think that's unreasonable.

No OBs for versions, but there is one midwife who has had good success with versions. But given his behavior when he's been vertex, I'm not sure how I feel about attempting a version out of the hospital. I know she would monitor with the Doppler throughout, but it still makes me uneasy.

[meltoine]

Jul 8, 2015 10:24:26 GMT -5 AmyRI said:

I'd consider going to the Farm in your shoes. I switched to the OB that delivered my DD in case we have a 3rd kid. I want to be 100% sure that no matter what happens, I know I am in good hands. From everything you've said about your current care options, I don't think you're going to get what's in your and your baby's best interest where you are unless you have a textbook home birth.

How far away is it? Is there any way for you to get up there to someone trained that can tell you if you're a good candidate or not, and check for potential issues with the cord? (Or maybe a regular ole OB where you are can check for cord issues). Birthing is just so important to me that I think it's worth the hassle, and given your profession and everything you've posted about it, I think you feel the same. I often think about how different my recovery would have been if I hadn't been so lucky, and how it would have affected the decision to try for a 3rd, and my care leading up to a 3rd delivery.

It's five hours. We could drive up for a weekend to be looked at. I'm more concerned about having to camp out there from 37 weeks on. DS1 will be in school and I'm uncertain what H's work situation will be at that point. As of right now he has 27 days of PTO he has to use before sept. 30, so he could take them time. But he's waiting for a spot in a training program and if he gets in he can't take any PTO until it's over (6 months). 

ETA: Birthing is important to me. I think it sucks that even though ACOG agrees that breech vaginal birth is as safe as csection, I'm denied the choice because they don't train their doctors to do it. It's a legitimate procedure that is on-par, safety wise with the other available options. There's no excuse for them not to teach it and for hospitals to forbid it. So part of it is principle, too. 

[jorja]

I can't remember the exact week (I had weekly U/S and they all end together in my memory now), but I'm pretty sure DD was breech at 32 or 33 weeks...I asked about it and no one was concerned. She flipped and stayed by 35 weeks and was born at 37.