C-Section or Vaginal for Breech - rambling/rationalizing/trying to decide what's best

[mayacat]

This is kind of a rambling that I want to get out there. It's been on my mind almost all the time since we found out for sure that baby is breech and not wanting to turn.

I'm all about decisions and options and glad I do have one in this case. I do not mean to offend anybody's choice in this case - I can legitimately see benefits to both options. I'm actually quite torn

Baby's in a frank breech position, kind of reclined with head up a few inches under my right boob and bum down near my left side with feet kind of up on the left. We tried a ECV procedure on Friday with no success, and right now we have two options: try for a natural birth or schedule a c-section.

The information the hospital gave us is awesome. It is totally enough to make an informed decision, but I'm still having trouble. From what they've said, there's a 40% chance that an attempted vaginal birth will end in a C-section anyway because they don't take any chances with baby's health (fair enough, imo). They said there's no difference in long term effects between breech babies born vaginally vs. C-section, but there is a higher short-term morbidity for vaginal breech babies (bruising, compression of the cord, taking longer to get screaming, etc). The Dr even gave the history of a couple of different studies done on the topic, which was fantastic. I'm also under the opinion that there's less risk to mom for a vaginal birth vs. a C-section if all goes well either way.

My first instinct was to say let's try for a vaginal birth since there's no long term difference between the two and that's what I've been planning for so far (I don't take changes in plans well usually). And I said that way I feel like I've tried, and if something happens, like baby ends up too small (I have an U/S on Friday to confirm the baby has actually grown enough - was only measuring 5.5lbs at the 36 week U/S that confirmed the breech), or the feet or cord come first or one of our BPs go off in a weird direction, I can say I tried. I already signed the consent form for it after the ECV on Friday since I was that certain.

But I got to thinking last night about it. With no difference in long-term effects either way, but with there being a difference in the short-term (day or two, maybe less), am I doing the right thing by choosing vaginal over the C-section? The 1% chance of the head getting stuck also scares me, (even though this isn't a big baby and my hips kill at night, so they've definitely spread). I'm finding myself questioning my initial response a little, wondering if I'm being selfish wanting to try a vaginal birth when it has a higher chance of hurting the baby a little, even if it's very short term. But baby won't even know the difference or remember any of it, so does it matter?

I also don't want to plan a date for a C-section if I can avoid it. I want the baby to show up when it's ready and at least start labour naturally. Within reason. They won't induce a breech pregnancy, but if it goes over 41 weeks, I'm going to care even less about how baby comes out and will happily go with a planned C-Section, lol.

Best-case scenario is if the baby moves on its own. Apparently my husband was breech until 38 weeks and he turned on his own (and he was over 9lbs when he was born a couple weeks later!) With a baby as small as ours, who I hope will get close to or a bit over 7lbs, there's maybe a higher chance of it turning in that time frame. But it seems pretty freaking happy where it is! The ECV hurt a fair bit. Considering how hard they were pushing on my uterus, I'm guessing random flippy exercises are probably not going to help any either. I'm trying ice packs daily and get some head-butts but not much turning.

I'm trying to make a logical, rational decision, but it's really hard. Thankfully, I did not make a written birth plan and I'm not hard-set on any particular scenario. I am disappointed that baby is making things difficult as I was looking forward to just having to choose between various pain meds and when to call parents rather than a have to choose a natural birth or major surgery. I'm kind of worried that if baby takes a few extra minutes to go from squeaking to crying and comes out blue that I'm going to panic a little, even though I know it's going to be okay. I'm also worried I may feel a bit guilty. But I may also feel bad about putting myself through extra stress of a surgery (though it's not like we'll have any shortage of help after baby comes!).

I'm possibly way over-thinking this. It tends to happen, lol . Anybody go through the same kind of dilemma? I would love to hear others' stories. That is, if you made it through to the end of this extremely long ramble to read the last paragraph, lol.

 

[Ecoden]

This is tough. My hospital doesn't even do vaginal deliveries for breach babies so that's great you even have a choice. Sorry, I don't have any advice other than that you said you're not great at changing plans so it might be worth asking yourself whether or not you'll more easily handle change now or in the event of an unplanned c-section during labor. Sending support and positive energy your way, you sound like you have great care so I'm sure you'll have a healthy baby either way. I hope baby flips and makes the decision for you.

 

[lomelly]

I had an ecv at 40 weeks which thankfully worked (my ob didn't catch her being breech till a few days previous), but I know there is a small chance baby can flip back. Since I'm paranoid i suspect this has happened, and at my hospital only half of the obs will attempt a breech delivery. I will attempt a vaginal delivery with a breech baby if that is the case, because i have a toddler and the recovery is far less. I should add I'm also terrified of being cut open, so I'm gonna give vaginal delivery a shot.
Baby is a few days overdue, so I'm just waiting to make sure she is head down. If i was in your position and i trusted the drs delivering, i would try vaginal. But that's just me

 

[misspriss]

I know you said there was no measurable difference in the morbidity for your baby long term, what are the differences in risks for c-section vs vaginal for you? It is my understanding that a c-section carries more risks for the mother. I didn't see much about that in your OP, but I may have read it fast on my phone its harder to read long posts.

I would try for vaginal first, it is just my gut reaction, having had a c-section my recovery was long and painful (no complications though).

 

[ZooMa]

If your docs feel comfortable delivering a breech vaginally, that sounds great. I understand your hesitation to schedule a c-section - but it's also (usually) an option if you labor naturally and things stall. So maybe you don't have to make the decision right now.

Another important thing to consider: do you want more children? If so, there is a slightly increased risk for more complications in future pregnancies should you have a uterine scar. If not, a c-section may save a lot of potential damage to your perineum (and bladder and bowel and other things that can stretch and tear an prolapse). I'm now pregnant with #2, and my docs are very amenable to a VBAC but did offer a planned c-section given the risk of potential perineal trauma - again, though, they recommended it mainly if I was planning to stop at #2.

More of my details if this helps at all:

I had an unplanned, though not urgent/emergent c-section after 30+ hours of labor with a head-down but face-up baby. I got to the pushing stage, but she wouldn't make it past a certain point. She turned out to be 9.5 lbs, so a guess an overdue, OP big baby just doesn't fit sometimes! Afterwards, I felt pretty fine except for a very sharp, acute pain that lingered for 4 weeks - it was located in a very small area at one end of my incision and may have been related to a "tight stitch" according to one doctor. As long as I kept up with the Percocet and ibuprofen it was manageable. I was very worried I'd have this pain forever, but then it suddenly disappeared over the course of 72 hours. Most people recover more quickly than me.

I haven't had a vaginal birth, but I do have a friend that had only one child but had a lot of issues with pelvic floor weakness and urinary issues requiring pelvic therapy. We're on the FB friend level, so I don't know how she's doing now. She's pregnant again so I guess it didn't scare her away!

Good luck with your decision. The one thing I learned from my one labor - you can't control how things go. You really can't. You can prepare, you can do your best to help things along in the throes... but you can't control it through planning and sheer will. Good luck, and best wishes!

 

[BabyCleo]

Its awesome you have a hospital who is willing to give you a choice (to a point)!

I think I would have to try vaginal first. If the people catching your baby are familiar with breech vaginal birth, then there is no reason to not trust them. They would also be familiar with the idea of an emerg. C-section if needed.

There is a website out there (but I cant remember it for the life of me) dedicated to vaginal breech birth stories. Type into google maybe to look for some? I even read breech vaginal home birth stories. They have pictures too, really cool!

 

[babykate]

I am only 33 weeks but baby is also breech and has been for some time. I am considering same options as you-- i will wait for labor to start naturally and them take it from there. As previous posters have said, sometimes babies wait to turn until labor begins. My second turned at 38 weeks without me knowing and was born 9 lb 13 oz 2 weeks later. You never know!

 

[mayacat]

Thanks for your replies guys! That's kind of what I'm thinking too. I'm still going with the vaginal option if I can for now. We'll see how the actual day ends up working out!

We do want another kid after this one too, so that's another reason I'm hesitant about the section. I guess if it's possible, vaginal is probably still the way to go since it's best on average for everyone. I had my 38 wk appointment yesterday and the OB made me feel a bit better about it and reminded me that if the Dr I saw for the ECV thinks vaginal is safe as an option, then it likely is (he's the high risk Dr at the hospital and has a very good reputation based on several opinions I've heard in the last few days!).

I guess I'll stick to my original decision and see how it all goes when the day comes!

 

[SAmummy]

I would also try vaginal ... Im sure they will monitor your labour very closely and if there is any concern they can always intervene with a c-section. There is always a risk in any birth, even if a baby is the right way they can get stuck. Fortunately with monitoring, there is usually time to do the necessary intervention. It's still less risk than a c-section .

 

[mayacat]

I would also try vaginal ... Im sure they will monitor your labour very closely and if there is any concern they can always intervene with a c-section. There is always a risk in any birth, even if a baby is the right way they can get stuck. Fortunately with monitoring, there is usually time to do the necessary intervention. It's still less risk than a c-section .

Oh for sure. I think I'm going to be hooked up to every monitor they can think of, lol. I imagine I'll probably end up going in earlier than normal so they can keep track of the labour. They're going to be super picky, but I don't mind. I like knowing all the numbers too