Turning a Breach Baby and what is a NST?

[Philly Mom]

I am having ultrasounds every 4 weeks because I have VCI. At my last ultrasound (30 weeks), the baby was still breached and my placenta was in front. I just had my latest OB appointment. My OB said that because of the VCI, if the baby does not turn, then they will want to do a C section. I have another ultrasound in two weeks and then another one scheduled before my due date. Any thoughts on how to encourage the baby to turn?

Also, because of the baby being breached and the location of the placenta, I do not feel as much movement as normal. My doctor suggested that I may want to have weekly NSTs for peace of mind. What are they and what will they show?

TIA

[TxCat]

NST stands for non-stress test. They hook you up to the electronic fetal heart monitor and the tocometer (contraction monitor) and look at baby's heart rate over a 15-20 minute period. They are looking for good beat-to-beat variability and sustained accelerations above the baseline heart rate. It has generally been accepted as reassuring measure of fetal well-being.

As for turning a breech baby, a lot of people recommended spinningbabies.com to me. FWIW, I tried all of their recs, but to no avail. However, I think I just have unfavorable anatomy - I've had two breech babies now. Clearly, there is a big "no exit" sign in my pelvis.

[georgiegirl]

Drink some juice before you go in to make baby active. My little guy was napping ( stable heart rate) so they had to use this buzzer thing to wake him up.

[Philly Mom]

NST stands for non-stress test. They hook you up to the electronic fetal heart monitor and the tocometer (contraction monitor) and look at baby's heart rate over a 15-20 minute period. They are looking for good beat-to-beat variability and sustained accelerations above the baseline heart rate. It has generally been accepted as reassuring measure of fetal well-being.

As for turning a breech baby, a lot of people recommended spinningbabies.com to me. FWIW, I tried all of their recs, but to no avail. However, I think I just have unfavorable anatomy - I've had two breech babies now. Clearly, there is a big "no exit" sign in my pelvis.

Thank you. I was hoping you would respond. Do you think the nst is worth doing? I am assuming I need to call my OB and have her write me a script for it. In putting the c section on the calendar, I forgot to ask to get a script before I left.

[TxCat]

Thank you. I was hoping you would respond. Do you think the nst is worth doing? I am assuming I need to call my OB and have her write me a script for it. In putting the c section on the calendar, I forgot to ask to get a script before I left.

Your OB was suggesting the NST completely for your reassurance, right? I think it would depend on 1) how much movement you are typically feeling now, 2) if a weekly appt. is easy for you to fit into your schedule now. My first baby was breech with an anterior placenta, so I know what you are talking about with regard to diminished appreciation of movement. However, I could still usually feel 5-10 kicks/hour, and if I wasn't, I could usually feel them once I rested on my left side and drank something cold and sugary. The NST will definitely be reassuring (I had this monitoring twice weekly for both pregnancies for different reasons, starting at 33-34 weeks), BUT, even though its results are technically "good" for 3-4 days, you would still need to be monitoring fetal movements at home/doing kick counts the other 6 days of the week, and still would need to call your OB if you weren't feeling enough movement. I guess I would do it if it was relatively easy to fit into your schedule, while acknowledging that it might not really change anything (ie, you still might have extra calls to your doctor or extra visits later in the week if you weren't feeling enough movement). Does that make sense?

[Philly Mom]

Your OB was suggesting the NST completely for your reassurance, right? I think it would depend on 1) how much movement you are typically feeling now, 2) if a weekly appt. is easy for you to fit into your schedule now. My first baby was breech with an anterior placenta, so I know what you are talking about with regard to diminished appreciation of movement. However, I could still usually feel 5-10 kicks/hour, and if I wasn't, I could usually feel them once I rested on my left side and drank something cold and sugary. The NST will definitely be reassuring (I had this monitoring twice weekly for both pregnancies for different reasons, starting at 33-34 weeks), BUT, even though its results are technically "good" for 3-4 days, you would still need to be monitoring fetal movements at home/doing kick counts the other 6 days of the week, and still would need to call your OB if you weren't feeling enough movement. I guess I would do it if it was relatively easy to fit into your schedule, while acknowledging that it might not really change anything (ie, you still might have extra calls to your doctor or extra visits later in the week if you weren't feeling enough movement). Does that make sense?

She was suggesting it for reassurance I believe. I am not sure if I feel 5 kicks an hour every day. Haven't really been keeping track because I have not felt a ton but the ultrasounds show lots of movement and I am feeling contractions and some movement each day especially when I lay down. Sugar definitely makes a huge difference for movement. After my appointment I was feeling stressed so had a donut from a local Amish market. Baby movement all over the place. Same with my glucose test, lots of movement after I drank the substance. I work full time but could fit it in. This pregnancy is just so different from my first. Thanks for your help. I will concentrate on counting over the weekend and then follow up with my OB.

[citymama]

BTDT! How many weeks are you now? I had a breech baby with DD1, and she kept returning to breech. At 33 weeks or so I successfully turned her myself using the ironing board method (legs elevated for extended periods - I would lay in bed with my legs up over a stack of pillows and read the New Yorker!). Then she returned to breech. I used acupuncture, moxibustion, acupressure, no dice. At about 36-37 weeks or so (can't remember exactly as this was 7 years ago!) I had a manual version performed where the doc was able to move her to a head down position. They had me monitored the whole time and I had quite low fluid levels, so after that I had to have weekly non-stress tests until I gave birth at nearly 42 weeks! In the end, she moved into transverse during labor, so this was a baby who did not want to be head down. But many babies stay in place past a particular point in the pregnancy, so your experience may differ.

[Philly Mom]

BTDT! How many weeks are you now? I had a breech baby with DD1, and she kept returning to breech. At 33 weeks or so I successfully turned her myself using the ironing board method (legs elevated for extended periods - I would lay in bed with my legs up over a stack of pillows and read the New Yorker!). Then she returned to breech. I used acupuncture, moxibustion, acupressure, no dice. At about 36-37 weeks or so (can't remember exactly as this was 7 years ago!) I had a manual version performed where the doc was able to move her to a head down position. They had me monitored the whole time and I had quite low fluid levels, so after that I had to have weekly non-stress tests until I gave birth at nearly 42 weeks! In the end, she moved into transverse during labor, so this was a baby who did not want to be head down. But many babies stay in place past a particular point in the pregnancy, so your experience may differ.

I think I am 31 weeks. Due the end of the first week of November. If she does not stay down by the ultrasound I have in 6 weeks, I am pretty sure they will insist on the c-section. The umbilical cord is attached to the placenta in the wrong place so they will not want to move her manually. I am going to try the method you mentioned and perhaps acupuncture as well.

[marymoo86]

DD2 was transverse causing severe sciatica. After a few visits with a pregnancy specialist chiro I was pain free and the baby turned head down. Maybe worth a shot?

I'm doing weekly NSTs now due to age. Not sure why that would be a big reassurance over a Doppler or u/s?

[schrocat]

I have a Velamentous Cord Insertion too this pregnancy. Will be doing weekly or twice weekly NSTs soon. I have to have the NSTs because of high blood pressure and GD too.

[shawnandangel]

For turning a breech baby try scrubbing the kitchen floor on your hands and knees. I've heard midwives at The Farm suggest that. They also do this couch thing - like them in Facebook and scroll down. They just posted something a week or wo ago about turning a breech baby.

I've had 3 NST this week because of worries of oligohydramnios and "post dates". They are reassuring, but I still count kicks.

[llama8]

I had the same thing. I had weekly scans for piece of mind because I never felt the baby move with my DD1. She was transverse (sideways) breech and 9lbs at birth. I also had the placenta in the back which is opposite of most There was no way she was going to turn and my OBGYN specialist is very much against manual turning of the baby by a doctor. She has seen too many go wrong so I opted for the c-section. There are some movements that you can try that others have said may help the baby turn, but they don't work in all circumstances. Good luck, but a c-section is not that bad. I opted for a c-section for DD2 and she was head down and I felt her all of the time.

Advice for the NST: Drink a lot and have some sugar before or you will be there forever until the baby wakes up and they get a good read.

[Philly Mom]

I have a Velamentous Cord Insertion too this pregnancy. Will be doing weekly or twice weekly NSTs soon. I have to have the NSTs because of high blood pressure and GD too.

Sorry to hear you have the triple whammy. Pregnancy is just so stressful.

[Philly Mom]

Sorry for the slow reply. I was away at a wedding. 4 hours of driving in a day with no one to share the driving. Get to repeat next week too to see my parents for Yom Kippur while DH is traveling for work.

Anyway, Thanks everyone for your help. I am going to try some of these suggestions before my next ultrasound and I think I will call my OB about the NSTs. Now that she has mentioned them, I think it would be more stressful not to have them. I am also trying to focus more on the kicks and when they occur.

Last question: why does lying on your left side as opposed to right side make a difference?

[TxCat]

Sorry for the slow reply. I was away at a wedding. 4 hours of driving in a day with no one to share the driving. Get to repeat next week too to see my parents for Yom Kippur while DH is traveling for work.

Anyway, Thanks everyone for your help. I am going to try some of these suggestions before my next ultrasound and I think I will call my OB about the NSTs. Now that she has mentioned them, I think it would be more stressful not to have them. I am also trying to focus more on the kicks and when they occur.

Last question: why does lying on your left side as opposed to right side make a difference?

Left side down relieves pressure on the large blood vessels in the body, improving blood flow to the placenta (via improved blood return to the heart). That being said, lying on your right side is not dangerous ( really just want to avoid being flat on your back), and some babies move more with lying on the right (DD2 did). It's usually recommended to start out lying on your left, and if you still haven't counted enough kicks after 30 minutes or so, I would turn to my right and see if that improved things.

[Philly Mom]

Left side down relieves pressure on the large blood vessels in the body, improving blood flow to the placenta (via improved blood return to the heart). That being said, lying on your right side is not dangerous ( really just want to avoid being flat on your back), and some babies move more with lying on the right (DD2 did). It's usually recommended to start out lying on your left, and if you still haven't counted enough kicks after 30 minutes or so, I would turn to my right and see if that improved things.

Thanks! This baby does seem to move more on my right side and at night I tend to switch sides every hour. I was a bit concerned that laying on my right side was bad.