36 weeks, big baby AND . . .

[schums]

BREECH!! Could I even ask for any more fun. Had an ultrasound done this week to see why I was measuring a little big. Turns out the baby is already 8 lb, 9 oz. and is most definitly head up. The ultrasound is probably pretty accurate weight wise, since DS was 10 lb 9 oz full term.

How likely is it that the baby will turn on her own this late in the game? Has anyone ever had a doctor "turn" the baby successfully? Also, how difficult are breech deliveries? My doc seems to think it won't be a problem. I would prefer not to have a c-section if I can avoid it, but have no problem if medically necessary. It seems like everyone I talk to that had a breech baby had a c-section just because the baby was breech. Is this common medical practice now?

I just want to make an informed decision if asked to schedule a c-section instead of trying to deliver vaginally.

Sarah

[egoldber]

It is common medical practice in the US to deliver breech babies by C-section. But that doesn't mean it is any safer. There ARE particular breech positions that are definitely not safe to deliver vaginally, but I am sure your OB will watch for that.

Since you have already given birth vaginally to a large baby and have an OB willing to try, I say go for it!

I had a positive C-section experience with DD, but I still wouldn't wish an unnecessary C section on anyone, especially with a toddler too!

HTH,

[MegND95]

My dd was breech, and I ended up with a c/s. We tried around 37 weeks or so to get her to turn using external cephalic version, where two doc's try to manually manipulate the baby into a favorable position. DD did not turn, but I am so glad I tried. And I have since read about many other techniques you can try at home in order to get your baby to turn. Check out some other parenting sites for links to these suggestions, as I can't remember any right now! Plus, there is always the possibility your baby could turn....

Both my kids were born at the National Naval Medical Center in Bethesda, and the staff there really wanted me to try a vaginal breech delivery. One of the reasons they were so eager is that most hospitals and doctors will not attempt vag breech deliveries anymore, so many younger ob's have never seen or delivered one, and they wanted to use my birth as a teaching tool. I opted for a planned c/s b/c I was more comfortable with that option.

Good luck and I hope your baby turns!

[cilantromapuche]

I just had a breech baby on 7/2 and they tried to turn him up until almost 39 weeks. I tried every home turning technique known to mankind. He was butt first and quite embedded in my pelvis. to me it wasn't worth the risk of a vaginal delivery, i just wanted a healthy baby and there were to many unkowns. the c-section went fine.
chris

[dogmom]

I would ask your doctor how often he (and his service, because it may not be him) does vaginal breech deliveries. I didn't have to face this problem personally, but there were some other possible issues in my pregnancy. It definately made me more comfortable knowing that this wasn't a "once in a blue moon" thing at my hospital.

[chrissyhowie]

3-4% of all term pregnancies will be breech, so you are not alone :)!

There IS actually much medical literature which shows that planned cesarean delivery of a breech fetus is safer for the baby. In fact, a randomized trial of over 2000 deliveries was published in Oct 2000 which found that infant mortality in childbirth as well as death or significant injury of the child after birth was significantly higher in the planned vaginal delivery group (5.7%) when compared to the planned cesarean group (0.4%). This study's findings are what prompted the American College of Obstetrics and Gynecologists (ACOG) to issue in their 2001 Obstetric Practice Committee Opinion that "Patients with persistent breech presentation at term in a singleton gestation should undergo a planned cesarean delivery."

Some women will still choose to attempt a vaginal breech delivery. In this case, the fetus should be in either a frank breech (butt first with legs outstretched) or complete breech (butt first with knees bent) position. A footling breech (feet first) or other presenting part positions should not be even considered as candidates. Vaginal breech delivery should be attempted only after much careful discussion with your provider about the risks, and only after evaluation if you would be a good candidate (good pelvic bone structure, not too big fetus, proper fetal position, etc.). This type of delivery should only be attempted if the provider is comfortable and experienced with this type of delivery as well.

You should definitely be offered a version attempt (trying to turn the baby) when you are around 37 weeks, as the risks of the version attempt are low and do decrease the rate of cesarean section. Version success rates vary widely in the literature, but usually the average is about 65% success. Another option is to forgo the version attempt and just schedule an elective c-section at 39 weeks. Your doctor will likely talk to you about all these options and help you make your final decisions.

Having had a c-section myself after a failed version attempt, I can tell you that it wasn't so bad at all! Good luck with everything!

[mollyi]

I also had a c-section due to breech presentation. In fact, I was not even offered the possibility of vaginal breech delievery - I'm pretty sure ds was feet first, perhaps that is why. My doctors attempted the external version when I was about 38 weeks - they tried and tried, but ds was stubborn! So I had a scheduled c-section at about 39 weeks. The one thing I still wonder is what if I had just waited and waited - would ds have eventually turned on his own? The doctors didn't think so, but I suppose there would have been a small chance. I did find the c-section alittle tough to recover from - but the important thing is that I ended up with a healthy baby!

Molly (Mommy to Andy 2/8/02)

[Rachels]

There are two other options for you. There's a chiropractic technique called the Webster Technique that has more than a 90% success rate for turning breech babies. And there's an acupuncture technique called moxibustion that has a success rate of about 75%. Both are pretty much painless. If I ever have a breech, I'll try these without hesitation.

That said, even with my natural birth bandwagon, if I had a breech who didn't turn, I'd be comfortable with a cesarean. With a baby in the vertex position (head down), the biggest part of the baby is born first, so you don't have to worry that the rest will follow. With a breech, the head comes last, and there have been instances in which the rest of the baby comes out fine but then the head gets stuck. Then you run the risk of really having to contort the baby's head and neck to get it out. That's why a butt-first breech is safer for a vaginal delivery than a footling breech-- at least there's something substantial widening the birth canal. But personally, I'd go for the section. It would make me sad, so I'd try the version and chiropractic and moxibustion first, but I'd feel okay that I was doing a safe thing for my baby.

Let us know what happens!


-Rachel
Mom to Abigail Rose
5/18/02