I'm 35w4d and lo is frank breech. I go for weekly BPPs to monitor for IUGR so I know that despite lots of good activity, she has not changed positions since 27w, and even before that she had been transverse. I'm already trying spinning babies, and my second appointment with a Webster technique chiro is tomorrow. I'm reading up on versions, and seeing a lot of people say they wouldn't want to even try it but not explaining the reasoning. Stats I'm seeing are that complications are few and most providers stop the procedure if there is a sign of distress, so while it is a serious risk, an emergency c-section seems very unlikely. My OB doesn't do them and already started talking about scheduling a c-section, but there is another OB in the group who does. I also plan to ask my MFM specialist about it when I see him again this coming Friday. I would really like to try everything for a vaginal birth before defaulting to a scheduled c-section. But if I'm going to push for one, I want to be sure it's a good idea and I don't feel like I really understand both sides of the debate. Thoughts would be appreciated!
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About 4% of babies present breech at full term. My son was in that 4%. My feelings were that gravity really encourages babies to be head down and if he was remaining breech despite 96% odds, then potentially there was an anatomy reason (like my uterus shape encouraged breech babies) or something with him (like the cord around his neck or a short cord keeping him from flipping). My OB also said that she was physically sore after an ECV, which freaked me out.
Full disclosure, I wasn't a candidate for an ECV due to bleeding issues so I didn't consider it heavily. I did briefly consider it for my daughter who was breech until 36 weeks, though. When I had a second breech baby I ulimtately decided (and my doctor concurred) it was anatomy -- she of course, ended up flipping ..... I think my son was just stubborn!
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My baby was breech and also went transverse during pregnancy. I didn't ECV after factoring personal feelings/beliefs as well as the following: fetal risk, chances it wouldn't work, chances baby could turn back again after it did work. She ended up head down at the buzzer with a few flips in final week or two. She remains a very flexible, wiggly child!
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My kiddo was breach for awhile before flipping (chiropractor got him to flip). We were told the problem with EVC is it is really painful and doesn't have a high success rate. If this LO is breach, I'd rather do a breach delivery. If that's not an option, I'd try it.
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@LBee: Really good points about anatomy. The chiropractor said I'm really tight on my left side, and she's folded up entirely to the right so I was thinking that's probably it. I have hyper mobile hips and physical therapy in the past has indicated that I'm sort of jacked up on one side so I just assumed she's cozier that way.
@808love: Can I ask what the personal belief was that swayed you against it? I see people on other boards in old threads say this and I feel like I'm missing something I don't know.
@Pollywog: Breech delivery was not an option according to my OB.
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@starchild: you can search other threads on this but I’ve had 2 breech babies and did not due an ecv. My reasons being frank breech is the hardest to turn, it was my first baby meaning a tight uterus, my dr said it’s easier to turn babies on second or third time moms because they have stretchier uterus. Finally my lo butt was basically engaged in my cervix so my dr didn’t even think she could get a hand under there to turn her. My mom and 2 breech babies so idk if this tends to run in families? Both my babies were full turn and my water broke on it’s own. Both babies were breech at least from 20 weeks. I think in another thread someone’s dr said they’re sore the day after doing one so that’s the amount of force it takes.
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My son was transverse and then breech. We did discuss an ECV but I decided against it. Only a few providers at my practice do them and I don’t think they have a high success rate. I didn’t want to risk something happening to the baby- meaning maybe he was that way for a reason? I had a c section and the recovery was better than I expected. The OB commented on how low he was and how he was “really wedged in there.” It’s a tough decision though- but I would have th c section if I had to do it over again.
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@starchild: my last OB wouldn't do it either. My new practice will under certain circumstances (I don't respond well to anesthesia, so I would have to do it without an epidural and my midwife strongly recommends it for them)
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Both my babies were breech, and I didn’t do an ECV with either, but I wasn’t a good candidate - with both babies I had low fluid and the doctor wouldn’t try. I do have a friend who did it successfully. I would absolutely have tried it if I had been a candidate, because I would have really preferred to not have c sections.
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@starchild: I had an ECV at 38ish weeks pregnant with my first child (she’d flipped breech at 34 weeks) and it was ridiculously successful! Baby literally took only 30 seconds to flip down and once her bum was out of the my pelvis over she went.
My thought process was that without attempting the ECV I had no shot at a vaginal birth but by attempting an ECV I at least had a 50% shot at it and my OB also pointed out that what happened with my first baby would effect what happened with subsequent pregnancies.
The risk levels at my hospital was 0.05%, the procedure was done at the delivery suite and I had an IV line in so I was in the right place if anything went wrong. My OB also repeatedly reminded me that he would stop at any time I asked him to but as it was my ECV was only mildly uncomfortable.
I would wholeheartedly attempt another ECV if I needed to.
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@starchild: I simply believed she would move on her own if necessary.
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My third was breech until almost 36 weeks, and although he flipped on his own, I was considering an ecv. My doc does them with an epidural in the or just in case, so I felt comfortable with the risk level.
I went to a chiropractor too, and I think she helped him turn. -
My 2nd LO was breech and I did an ECV that was ultimately unsuccessful. I was considered an "ideal candidate" since it was my 2nd pregnancy and I'd previously had a vaginal birth so it likely wasn't my anatomy at least. I felt like the risks were very low and I was in an excellent hospital in case something did go wrong.
I have mixed feelings about it after the fact. If it had been successful it would absolutely have been worth it. But OMG it hurt way worse than I could have imagined. I remember researching beforehand and it seems like there's a pretty big range of experiences on pain level, but mine was terrible. And my scheduled C-section ended up being a really pleasant experience and my recovery was a breeze - even easier than my uncomplicated vaginal delivery with LO1.
Even with that though I think I'm mostly glad I did it. Even 7 months later I keep thinking "what if I had tried X, would he have flipped? or is it because of Y?" but then I remind myself that I had 2 trained professionals trying to physically turn him and he wouldn't budge, so no I probably didn't cause it. It's probably because of his 99.8% head. But while I'm glad I tried, if a future LO is breech, I wouldn't try an ECV again.
I hope somewhere in this mini-novel there's something helpful for you
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LO1 was footling breech and we attempted an ECV. My OB does them after having an epidural placed and injecting terbutilene (sp?) To relax the uterus. Then he tried turning the baby while monitoring his heart rate and using ultrasound to guide him. My LO couldn't be turned because I have a partially heart shaped uterus. We followed up immediately with a C-section, but if the ECV had been successful, I would have rested overnight and then been induced to minimize the probability that LO would flip back. Like you, I wanted to maximize my chances at a vaginal birth and I have no regrets trying the ECV.
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This is 100% anecdotal but my friend had an ECV that ended in a very scary emergency c-section because she and the baby both were in distress. They are fine now, but she had a miserable recovering and it was pretty traumatic for both her and her husband. Given her experience, it's not something I would want to try.
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I want to second @LBee:'s comment regarding breech presentation at birth - such a small percentage (and also that we share a similar opinion regarding breech babies being that way for a reason)! That said, my second flipped to breech at 35 weeks, and he stayed that way until my scheduled c/s at 39 weeks (it was scheduled due to his position). I was not a candidate for ECV because my Peri didn't have a clear view of cord position, etc., so he did not want to attempt one. Prior to that appointment, I had already decided that if it (an ECV) was offered to me, I would decline--the risks weren't worth it to me (especially not when combined with the possibility of the baby flipping back to breech again).
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Thank you everyone! No idea if I'd even be a candidate yet but wanted to explore the possibility more. I can see the pros and cons. I'm doing Webster technique with my chiro and that is 82% effective. I have an appointment with MFM on Friday so I'll also see what he says.
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Just an update: my MFM specialist is great! We are going to schedule the version with delivery immediately to follow. My situation is maybe a little different because we are being monitored for IUGR, so I am not going to be able to wait to go into labor regardless of the breech concerns as we need to schedule delivery during week 38. His version success rate is high, too. He does them with an epidural which helps so you're relaxed and then there is no interference with any medications that might be needed during delivery. It will take place in L&D, and we'll be monitored the whole time. If it is successful, I'll be induced immediately. If it is not, I'll go in for the c-section. His view is that if you're going to end up having the c-section either way, you may as well try it in the best conditions, and the contraindications are the same as they would be for vaginal birth.
This approach addresses a lot of the concerns I've seen others having and would make me reconsider. It's often painful, but the epidural should help that. If it is successful, there won't be waiting to go into labor during which she could flip back again since we'll be induced immediately. We'll have a c/s already on standby and I'll already be medicated so in the event that there becomes an urgent need, we'll be in the best case scenario already. And as for trusting that she's in the position that is best for her and hasn't flipped for a reason, unfortunately she doesn't have the luxury of hanging out in there till she's ready to be born, though I can appreciate that if I were able to wait out 40+ weeks and let her do her thing I may have a different opinion on moving forward this way.
So while it's certainly not the birth I would have imagined, it is probably the best I could want given our situation (breech and IUGR). My doula is also able to be there for all of it, too. I'm going to continue going to the chiro in the meantime to help hopefully create favorable conditions. And if anyone reading is wondering, I'm not against scheduling a c/s itself. I primarily want a vaginal birth for delayed clamping, skin to skin, and the benefit of vaginal seeding. Next up will be talking to my docs about any of those being options if we do have a c/s.
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I see you already made your decision, just wanted to chime in that I had a great experience with my ECV. I passed on the epidural, something about being in the OR was just too scary for me. It didn't hurt very much at all and was over in less than 5 minutes. I was back at work a few hours later and felt fine. I went on to have my daughter vaginally 4 weeks later. My thoughts were exactly like your doctor said, if it was going to end up in a csection either way, I had to at least try! I am a bit jealous that you get induced right after, I was constantly nervous that my stubborn child would flip back to breech! All in all, it was a good experience and while it was scary in the moment..I would try again if my next is breech.
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