delivery question

I am going to be induced on the 19th and My goal is to deliver both vaginally. They are letting me try but my practice will not deliver a breech baby vaginally. So if she doesn't turn or they can't get her to turn I will end up with a c-section for her.

My question: Has this happened to anyone and if so what all did they do to try and turn the baby and how was recovery?

I am getting nervous!

 

No experience, just wanted to send you some good luck vibes and :hug: :hug: :hug:

 

Bummer that they won't do a breech extraction on Baby B, from what other people who have had that experience say, it isn't too bad b/c everything is already opened up from Baby A.

Anyway, I just wanted to send you some Baby B head down vibes and best wishes for a smooth delivery!

:good:

 

No experience here either, I just wanted to wish you a lot of luck. My OB practice had said if A was head down and B was breech, they would still try a vaginal delivery but it turned out A was breech, so I had a c-section.

 

No direct experience, but I've heard that once baby A is delivered there is suddenly so much room that baby B may well turn around (or be coaxed to turn around). Good luck, and hope everything goes easily!

Rachel

 

I had a breech extraction, so they never tried anything. My doc says it's safest and fastest to do breech extraction and that external turning puts a lot of stress on the baby (scientific research says the same), and breech extractions are safe. Unfortunately a lot of doctors don't have sufficient experience. Hope you get lucky!

http://www.ncbi.nlm.nih.gov/pubmed/7485286

Suspected fetal distress that led to cesarean delivery occurred significantly more often in parturients who underwent attempted external version (4/21) than total breech extraction (0/23, p = 0.04). The incidence of eventual abdominal delivery was also significantly higher in patients who underwent attempted external cephalic version (10/21) rather than breech extraction (1/23, p = 0.001). For twin B the occurrence of low Apgar scores at 1 minute was significantly higher for infants after attempted external version (7/21) rather than breech extraction (1/23, p = 0.02), but the mean pH, number with Apgar scores < 7 at 5 minutes, and number of neonatal intensive care unit admissions were similar. No perinatal traumatic injury occurred in either group. CONCLUSION: On the basis of our experience, total breech extraction of the nonvertex second twin is preferable to external cephalic version because it appears to be associated with a significantly lower incidence of fetal distress and abdominal delivery with comparable neonatal outcome.

And a lot of similar studies and outcomes:
Six hundred eighty-two consecutive twin deliveries were reviewed. Included in the study were 136 sets of vertex-nonvertex twins with birth weights greater than 1500 gm. A primary attempt at delivery of the second twin by external version was performed on 41 twins, 55 twins underwent attempted breech extraction, and 40 patients had a primary cesarean section solely because of physician preference. There were no differences in the incidence of neonatal morbidity or mortality among the modes of delivery. External version was associated with a higher failure rate than primary breech extraction (p less than 0.01). External version was associated with complications (fetal distress, cord prolapse, and compound presentation) that were not seen in the other two groups. Primary breech extraction of the second nonvertex twin weighing greater than 1500 gm appears to be a reasonable alternative to either cesarean section or external version.

 

There are two reasons why your practice may not attempt a breech extraction: First, the doctors in the practice don't have any or much experience doing it. If this is the case, you'd be better off with a c-section. Second, at least one doctor in the practice has been sued following a botched or just unsuccessful breech extraction. It's unfortunate that litigation drives so many medical decisions, but it's the reality in this country. My doctor also told me (very honestly, I thought) that many doctors are more hesitant to attempt a breech delivery when the mother has been through fertility treatments to get pregnant. They call these (when they speak amongst themselves; I don't think they advertise it) "premium pregnancies," especially when the mother is over 35, because it cost so much for the mother to get pregnant and would likely be difficult for her to become pregnant again. Also, damages would be higher in the event of a future lawsuit. Again, it's a shame that litigation and such cost/benefit analyses drive these decisions, but it's reality.

You may not have many options at this point, unfortunately, since it is unlikely a new doctor would take you on this late in the pregnancy. It's really important to talk to your doctor very early in the pregnancy about delivery and his or her comfort level with breech deliveries so that you can change physicians or physician's offices if necessary.

I don't think they try to turn babies much anymore. My doctor told me it's considered kinda old-fashioned. Usually the babies either turn themselves or a breech extraction is performed.




QUOTE(2moreontheway @ May 14 2009, 07:18 AM) [snapback]1313061[/snapback]
I am going to be induced on the 19th and My goal is to deliver both vaginally. They are letting me try but my practice will not deliver a breech baby vaginally. So if she doesn't turn or they can't get her to turn I will end up with a c-section for her.

My question: Has this happened to anyone and if so what all did they do to try and turn the baby and how was recovery?

I am getting nervous!

 

Good luck! don't be nervous! Everything will be fine. As long as babies and mom are healthy, then everything is good.

I too wanted a vaginal delivery. I had one with my first son, but I also knew that I was going to have to be much more flexible this time around. Both my babies were head down for several weeks leading up to delivery. I was to be induced on a Tuesday morning (because I was past 38 weeks and my babies were getting cramped in there!). Well, that Monday night Baby B flipped into a breech position. It felt like she was trying to bust out of the top of my uterus!!! Anyways, that morning of the induction my doctor and I talked about it and he felt more comfortable with the c-section. He didn't have a ton of experience with breech extraction. Anyways, after discussing the risks and then real possibility that I could end up delivering one vaginally and one by c-section (this had just happened to a friend of mine...not b/c her baby B was breech but because his arm came out first and he got wedged in there) we went with the c-section. I was glad because he had trouble pulling Baby B out with the c-section. He tried to turn her around to pull her out head first, but he ended up pulling her out feet first (he joked that she was insisting on backing into the world). It all ended up just fine. The recovery wasn't as bad as I imagined. The 2nd day was the worst as far as getting up and down out of bed. I mean, if I had a choice between vaginal and c-section, I go vaginal...but its not always our choice ..... healthy mommy, healthy babies

 

Baby A was head down and Baby B was transverse and then did get her to go head down adn I delivered both vaginally.

good luck!!

 

I delivered Baby B breech. They were trying very hard to get David to turn and the Drs were unsuccessful. The pain of them trying to turn them was excruciating. Yes, I had an epidural, but they stopped it an hour before I started pushing.

They got him out after his head getting stuck in the birth canal. 50 minutes after Jonathan was born.

I am very glad that I did not end up with a c-sec after a vaginal birth.

If I were you, I would do what the Drs feel comfortable with,
Jenn

 

Mine were the same way-Baby A head down, Baby B Breech. . .

It just depends on the OB. . .My OB wasn't really comfortable with a breech extraction and I was fearful that I would need a C-section after having Baby A, so we opted for a c-section. I was DEATHLY afraid of a c-section b/c I have a low pain tolerance, but I don't really think it was too bad. Of couse there is pain afterward with both c-sections and vaginal. I had my singleton vaginally and I actually preferred the c-section. . .After having my son (vaginally), in which I tore, I had a LOT of pain. . .(TMI warning) and sex was painful for almost a YEAR!! With my c-section with the twins, I think the pain was a little worse in the beginning BUT after a couple of weeks I was good as NEW! Sex with DH is not painful at all, which, in my view, was totally worth having the c-section. So I really think there are pro's and con's to both. . .Good Luck!!

 

I was having this talk with my OB a couple weeks ago. She said if both babies are head down, then of course we will deliver vaginally. If Baby A is breech, then C-section. If Baby A is head down and baby B transverse then will try vaginal, because usually she said baby B will turn down once baby A is out and there is more room. If baby A is head down and Baby B is breech then C-section. She said if you deliver baby A and then baby B is delivered breech, by the time baby b's head is delivered the last part, your cervix could clamp back down around the babies neck, so not chancing it!

I am just praying the babies are head down!!

 

My babies were A vertex and B breech. B (Sabrina) actually went transverse after Sydney was born and didn't want to budge, despite the Dr. and a midwife trying to change her, so I was getting prepped for a c-section. But her water broke, she dropped and turned breech and with 1 push (and the Dr. grabbing her feet to pull), she was out. I'm always surprised by how many people aren't allowed to have a vaginal birth when A is vertex and B is tranverse, since you're completely dilated by the time baby B is born. I could see it if the 2nd baby was considerably larger, but I don't think that's often the case. But I guess I was also lucky enough to have an OB with 20 years of experience delivering twins (we were her 15th set that year). She'd only once in all that time had to deliver baby B by a c-section, after baby A was born vaginally. So I was very comfortable with her abilities.

 

Our baby A was head down and Baby B was transverse. They did do a breech extraction but it was touch and go for who would be on call and willing to do the breech extraction. It turned out to be my OB and a Maternal Fetal Medicine specialist on the big day so I felt very comfortable going ahead with the plan. My logic was...I didn't want a section. So why opt to have a section just because I MAY end up having one anyway. Sort of like...you'll never win the lottery if you don't but a ticket, right?
I realize it is a personal decision...so just go with what feels right to you....or reserve the right to change your mind!

 

My Baby B turned breech at 38 weeks...little stinker! Anyways, once A came out B did turn vertex on her own without any help and delivered just fine. And she ended up being 3/4 of lb. bigger than A. No issues here.

 

This is very interesting to me... I am scheduled for a c-section this coming Monday and my OB feels that because Baby B is butt down and A is head down, that it would be safer to do a c-section than try and hope B flips... I was looking forward to a vaginal delivery and was/am disappointed that I am not set for a c-section, but if she doesn't feel comfortable doing it, then I am going to do what she recommends. I guess it depends on the one delivering and how comfortable they feel delivering a possible breech baby..

My goal is to have two healthy babies so as long as I keep that in mind, I think I will manage with having to need a c-section. trying hard to stay positive!

 

I think the bottom line in this matter, as some have said, that a lot of doctors are not properly trained to do breech extractions, nor do they have sufficient experience. It's sad, but I agree in that case it's safer to go by c-section.

My hospital (one of the largest hospitals in the Midwest and one of the best in the country) still teaches breech extractions. In my case there was a resident present, and I heard my OB say things like "counterclockwise ... clockwise, turn this, turn that, ...". Felt in good hands, all 6 doctors from my practice would have done it.

Good luck!!!