February 2013 Moms

Have to decide if I should schedule a c-section or not

Three weeks ago my baby was head down, engaged and ready to go. Last week we did the ultrasound and he had flipped and is now butt down, feet over his head and doesn't care what I do, he does NOT want to flip! I've gone to the chiropractor, done the exercises on spinningbabies.com, tried the frozen peas, prenatal massages and my husband just plain yelling at him to move! He moves his head from my left side to my right side, but he hasn't moved below the belly button in a week and he's almost term. Tomorrow I have my doctor's appointment and I think I'm going to have to make the choice of whether to schedule a c-section for 38 weeks or not. For those of you with more than one baby, did your baby flip after 38 weeks or should I just expect that if baby is still breech the day before, he's staying that way and surgery is the safest option? Baby measured 6.5 lbs on his 36w ultrasound.

Note: As much as I'd love to have a natural or vaginal birth, there is no way I would ever put my son at risk for what can happen during a breech vaginal birth.

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Re: Have to decide if I should schedule a c-section or not

  • For 38 weeks? Why not 39? That's early, is it necessary?

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  • Because the date available at 39 weeks is the anniversary of my father's death and my miscarriage. I will not have a child on that day.
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  • Also, term is 37 weeks, with 38 weeks being the time that is generally accepted as a safe time for an elective c-section. There is no medical reason to wait beyond 38 weeks, from what my doctor says, my best friend who is a pediatrician says or any of my OB classes said. 38 weeks is safe and many babies are born at that time.
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  • imageBunnyBuni:
    Because the date available at 39 weeks is the anniversary of my father's death and my miscarriage. I will not have a child on that day.

     

    Totally undestandable...but I didn't necessarily mean exactly 39 weeks...there are other days that week as well. Also if it were me I would personally be asking to schedule it closer to 40.  It was and honest question...I dontt know what they offer in this kind of situation, I've never needed to worry about it.  I was just under the impression that most hospitals have rules against csections or inductions before 39 weeks unless necessary...I really didn't know whether or not a breech baby fell into that category @ 38 weeks.

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  • imageBunnyBuni:
    Also, term is 37 weeks, with 38 weeks being the time that is generally accepted as a safe time for an elective c-section. There is no medical reason to wait beyond 38 weeks, from what my doctor says, my best friend who is a pediatrician says or any of my OB classes said. 38 weeks is safe and many babies are born at that time.

    Many babies are born at 38 weeks, but the ACOG doesn't reccomend induction before 39 weeks unless medically necessary.  Not ALL babies are ready to be born at 38 weeks, hence that reccomendation.  I wasn't trying to flame you....just asking.

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  • imageBunnyBuni:
    Also, term is 37 weeks, with 38 weeks being the time that is generally accepted as a safe time for an elective c-section. There is no medical reason to wait beyond 38 weeks, from what my doctor says, my best friend who is a pediatrician says or any of my OB classes said. 38 weeks is safe and many babies are born at that time.

    And that's actually untrue.

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  • My first child was breech (as was I and my mother)and I chose the c-section option. It was probably the best decision I could've made for me personally. After my obgyn told me of the risks...and the fact that I am type A and like to have a plan for everything...we showed up in the beginning of the 39th week at 6:30 am and my son was here @ 9:18 am. While it isn't for everyone...I am very happy with my decision and I know you will make the right decision for you. Good luck!
  • The ACOG, AAP and March of Dimes all advocate waiting until at least 39 weeks to deliver unless mom goes into labor spontaneously or there's a medical reason to induce/schedule a C. While 37 is technically term there is still a possibility that the baby isn't fully ready to be born yet.

    I would wait until at  least 39 weeks (or even 40) or until you go into labor on your own. And the baby can easily flip between now and then. My cousin's daughter flipped two days before a scheduled C at 40 weeks even

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  • I'd go ahead and schedule it and if the baby flips great, if not, you are ready to go with your c/s.

    Also, I am surprised your doctor would schedule you at 38 weeks.  I was under the impression that it was considered unethical for OBs to do c/s earlier than 39 weeks without a medical reason.  I get you trying to avoid that one date, but maybe a day before or after that would be ok for you?

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  • imageBunnyBuni:
    Also, term is 37 weeks, with 38 weeks being the time that is generally accepted as a safe time for an elective c-section. There is no medical reason to wait beyond 38 weeks, from what my doctor says, my best friend who is a pediatrician says or any of my OB classes said. 38 weeks is safe and many babies are born at that time.

    This is just not true.  My OB won't do a C/S a day before 39 weeks unless mom and/or baby are in distress.  I understand not wanting to schedule the birth on the exact date of the anniversaries but you could do the 39th week.  I have a RCS at 39+3.  It doesn't have to be exactly 39 weeks.  

    Good luck! 

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  • I understand you not wanting to risk a breech vaginal birth, but I agree with PP's I wouldn't schedule a C-section at 38 weeks. You never know, your baby might still turn. Plus, if you at least wait until you go into labor naturally, you can still do the C-section, but at least that way you ensure your baby was ready to be born.


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  • I want to start by saying that every woman is entitled to make decisions regarding their body and LO and I am by no means judging anyone.  I also might get flamed for my response below.

    Maybe I am just sensitive to elective measures to induce labor prior to 39+ weeks as I do not have a choice anymore but to deliver at or before 37 weeks due to pre-e with a multiple pregnancy.   I know there is still a risk albeit small that my babies will need intervention at 37 weeks but I still sometimes feel like I failed my boys as my body isn't cooperating to take them to 38 weeks (standard gestation age at birth for multiples). Thus I don't understand people trying to induce labor early.  It just bothers me when people are so ready to get LO out before LO might be ready just because that's the date they want or they are over it or the doctor said I could etc.

    I completely understand, agree and support with induction methods early when there is a medical necessity.  Our goal during pregnancy is to get LO here safe so if early is safer, I am all for it obviously.

    Again your body, your LO, your decision.  I completely understand you wanting to avoid the date of your 39 weeks but what about 38+6 or 39+1 etc?  Those extra few days will make a huge difference as LO's gain about half a lb per week.

    Best of luck to you whatever you decide to do!


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  • image2moms2b:

    I want to start by saying that every woman is entitled to make decisions regarding their body and LO and I am by no means judging anyone.  I also might get flamed for my response below.

    Maybe I am just sensitive to elective measures to induce labor prior to 39+ weeks as I do not have a choice anymore but to deliver at or before 37 weeks due to pre-e with a multiple pregnancy.   I know there is still a risk albeit small that my babies will need intervention at 37 weeks but I still sometimes feel like I failed my boys as my body isn't cooperating to take them to 38 weeks (standard gestation age at birth for multiples). Thus I don't understand people trying to induce labor early.  It just bothers me when people are so ready to get LO out before LO might be ready just because that's the date they want or they are over it or the doctor said I could etc.

    I completely understand, agree and support with induction methods early when there is a medical necessity.  Our goal during pregnancy is to get LO here safe so if early is safer, I am all for it obviously.

    Again your body, your LO, your decision.  I completely understand you wanting to avoid the date of your 39 weeks but what about 38+6 or 39+1 etc?  Those extra few days will make a huge difference as LO's gain about half a lb per week.

    Best of luck to you whatever you decide to do!


    I want to correct my post as I misunderstood your initial post on one point.  For breech I would totally support at c-section.  I am having one due to the same reason.   I still don't get the 38 weeks.

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  • imagesecondaryPULSE:
    imageBunnyBuni:

    Note: As much as I'd love to have a natural or vaginal birth, there is no way I would ever put my son at risk for what can happen during a breech vaginal birth.

    Firstly, breech birth is not as dangerous as we are led to believe. If my baby were breech, I would absolutely attempt a vaginal birth with a midwife skilled in attending breeches (and yes, I would do that at home).

    Anyways, to answer your question--I would not schedule a c-section. Have you and your practitioner discussed the possibility of a ECV (external cephalic version)? Have you considered acupuncture?

    I've heard of babies flipping just before or even during labor. I would wait to go into labor and see if baby flipped before signing up for an elective c-section, especially before 39 weeks. 

    You expect her to find a midwife skilled in delivering breech babies when she is already this far along? Most OBs are simply not trained to deliver breech babies because the standard practice for them is to do a c/s.

    To answer your question, I completely understand your preference for your LO's birthday given those circumstances and  I would talk to your OB about it to see if other dates are available before scheduling a 38 week delivery. I would want to deliver closer to 39 weeks than 38 weeks. I also understand not wanting to go all the way to 40 weeks so as to avoid an emergency c/s instead of a scheduled one. 

    Best of luck to you! 

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  • I tried moxa acupuncture and it didn't work. My OB GYN does not recommend regular acupuncture. I will not attempt external manipulation due to the risk of tangling the cord. My doctor feels it is unsafe to force a baby to flip and I agree with her.

    I'm not having it at 38w0d... it would be 38w5d, which is a perfectly safe time to have a baby. If I wait longer, I risk going into labor, since I am already starting to efface and dilate. Also, I very much want my doctor to deliver my baby because I trust her and she will be on vacation the following week. Although some people may think it's safe to have a breech baby vaginally, I think it's an extremely careless decision to make unless the baby is  small. The cord can prolapse, the cervix can close on the neck, the use of forceps to remove the baby is much higher and many babies go into fetal distress because they get stuck. I would much rather put the suffering on myself and have the c-section than risk my baby being born with a disability because I ignored the warnings. My doctor is a huge proponent of natural birth and she would never recommend a c-section unless there was a considerable risk to mother and/or child. I will NOT put my baby at risk for a vaginal breech birth. My question was did anybody's baby turn naturally after 37 weeks, not whether you think breech birth vaginally is a good idea... I know it's a bad idea to have a breech vaginally and I've read the literature to back it up. I also know it's safe to have a baby at 38w5d and have also read the literature to back it up. My question is whether babies generally turn after 37 weeks because I have not read anything on that topic to know.

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  • I'm lurking from April, but wanted to tell you that in answer to your question, yes, when I was pregnant with my twins one of them was breech at 37 weeks and at 38 weeks both babies were head down. It's possible!
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  • imageBunnyBuni:

    I tried moxa acupuncture and it didn't work. My OB GYN does not recommend regular acupuncture. I will not attempt external manipulation due to the risk of tangling the cord. My doctor feels it is unsafe to force a baby to flip and I agree with her.

    I'm not having it at 38w0d... it would be 38w5d, which is a perfectly safe time to have a baby. If I wait longer, I risk going into labor, since I am already starting to efface and dilate. Also, I very much want my doctor to deliver my baby because I trust her and she will be on vacation the following week. Although some people may think it's safe to have a breech baby vaginally, I think it's an extremely careless decision to make unless the baby is  small. The cord can prolapse, the cervix can close on the neck, the use of forceps to remove the baby is much higher and many babies go into fetal distress because they get stuck. I would much rather put the suffering on myself and have the c-section than risk my baby being born with a disability because I ignored the warnings. My doctor is a huge proponent of natural birth and she would never recommend a c-section unless there was a considerable risk to mother and/or child. I will NOT put my baby at risk for a vaginal breech birth. My question was did anybody's baby turn naturally after 37 weeks, not whether you think breech birth vaginally is a good idea... I know it's a bad idea to have a breech vaginally and I've read the literature to back it up. I also know it's safe to have a baby at 38w5d and have also read the literature to back it up. My question is whether babies generally turn after 37 weeks because I have not read anything on that topic to know.

    it is actually safer to deliver a large breech baby.......

    And to answer your question, dd flipped, to breech, at 38w5d.  I personally wouldn't schedule. 

  • I personally would consider an ECV and see if that is successful first. If you don't have a successful version then I would consider the cesarean, but definitely not before 39 weeks. I work in Ob/Gyn and we don't let anyone get a c-section prior to 39 weeks unless medically necessary. I would try for a day or two after 39 weeks assuming the version fails, but that's just my advice.
  • imagesecondaryPULSE:
    imageJuliaBug:
    imagesecondaryPULSE:
    imageBunnyBuni:

    Note: As much as I'd love to have a natural or vaginal birth, there is no way I would ever put my son at risk for what can happen during a breech vaginal birth.

    Firstly, breech birth is not as dangerous as we are led to believe. If my baby were breech, I would absolutely attempt a vaginal birth with a midwife skilled in attending breeches (and yes, I would do that at home).

    Anyways, to answer your question--I would not schedule a c-section. Have you and your practitioner discussed the possibility of a ECV (external cephalic version)? Have you considered acupuncture?

    I've heard of babies flipping just before or even during labor. I would wait to go into labor and see if baby flipped before signing up for an elective c-section, especially before 39 weeks. 

    You expect her to find a midwife skilled in delivering breech babies when she is already this far along? Most OBs are simply not trained to deliver breech babies because the standard practice for them is to do a c/s.

    No, I don't. I was just responding to a comment OP made that was inaccurate. 

    I see. I misunderstood you. My apologies.  

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  • with my first I was doing everything like you are.  The difference was she was never head down.  We decided against the ECV and I waited and scheduled my section for 40 (due date) and that was only because I had GD and was told that I was not allowed to go past my due date.  If you really want a vaginal delivery, then wait.  If there's no medical reason to deliver at 38 weeks, then don't.  The baby can still turn.
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  • Thank you to the moms who told me their experiences rather than trying to convince me that my doctor is irresponsible/not trained in breech vaginal birth (non of which are true) and that it's not a risky way to give birth. If 39 weeks were a possibility with my doctor, I would do it at 39w5d, but she'll be on vacation and I would rather risk 2 days before 39 weeks than having a major surgery done by a doctor I've never met before and do not trust on the day of my father's death (they only schedule one day a week at my doctor's office). I don't want to wait until 40 because there is a good chance I will go into natural labor before then based on family history/last ultrasound and, again, I don't want to end up with someone I don't know/trust. Here's hoping that baby will turn on his own over the next week and a half so we'll be able to cancel and have the birth we wanted to have.
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  • A good friend's LO was head down until 39w6d then flipped breech. It was her 2nd, so she was still planning on a vaginal delivery (here it's allowed if you've had a vaginal delivery in the past), but her LO flipped again to head-down at something like 40w5d and she ended up going into labor at 41w3d. There's still time for LO to flip. I would schedule a c/s for closer to 39w (again - it doesn't have to be exactly 39w) and see what happens.


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  • DD was breech, I went into labour at 38w 3 days, my csection was scheduled for 39 weeks. There was no issue with me going into labour. I had met the doctor who delivered DD once the day before as my doctor was away on holiday. The experience wasn't any more scary because it wasn't my doctor, I don't think I even saw him for more than a minuet the whole time, it could of been any doctor to tell you the truth.

    I'd schedule for some time in week 39 which will give LO a bit more time to possibly flip.

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  • imagesecondaryPULSE:
    imageBunnyBuni:

    Note: As much as I'd love to have a natural or vaginal birth, there is no way I would ever put my son at risk for what can happen during a breech vaginal birth.

    Firstly, breech birth is not as dangerous as we are led to believe. If my baby were breech, I would absolutely attempt a vaginal birth with a midwife skilled in attending breeches (and yes, I would do that at home).

    Anyways, to answer your question--I would not schedule a c-section. Have you and your practitioner discussed the possibility of a ECV (external cephalic version)? Have you considered acupuncture?

    I've heard of babies flipping just before or even during labor. I would wait to go into labor and see if baby flipped before signing up for an elective c-section, especially before 39 weeks. 

    All of this.

    I had luck turning DD by spending time on the inversion table.  Two five minute sessions upside down and she flipped.  Good luck.

        
  • imageBunnyBuni:

    I tried moxa acupuncture and it didn't work. My OB GYN does not recommend regular acupuncture. I will not attempt external manipulation due to the risk of tangling the cord. My doctor feels it is unsafe to force a baby to flip and I agree with her.

    I'm not having it at 38w0d... it would be 38w5d, which is a perfectly safe time to have a baby. If I wait longer, I risk going into labor, since I am already starting to efface and dilate. Also, I very much want my doctor to deliver my baby because I trust her and she will be on vacation the following week. Although some people may think it's safe to have a breech baby vaginally, I think it's an extremely careless decision to make unless the baby is  small. The cord can prolapse, the cervix can close on the neck, the use of forceps to remove the baby is much higher and many babies go into fetal distress because they get stuck. I would much rather put the suffering on myself and have the c-section than risk my baby being born with a disability because I ignored the warnings. My doctor is a huge proponent of natural birth and she would never recommend a c-section unless there was a considerable risk to mother and/or child. I will NOT put my baby at risk for a vaginal breech birth. My question was did anybody's baby turn naturally after 37 weeks, not whether you think breech birth vaginally is a good idea... I know it's a bad idea to have a breech vaginally and I've read the literature to back it up. I also know it's safe to have a baby at 38w5d and have also read the literature to back it up. My question is whether babies generally turn after 37 weeks because I have not read anything on that topic to know.

    It sounds like you already made up your mind, so I'm not sure why you're asking for anyone else's input.

    But your info about breech birth is false and your comment about it being a careless decision is extremely offensive.  How would you feel if I told you that I think scheduling a c/s for no good reason (or for the convenience of having the doctor you want) prior to 39 weeks  was careless?  We all have a level of risk that we are comfortable with.

    Breech birth IMO, is one of those things like VBAC, that the OB community is just behind the times on.  For years people were saying VBACs were oh so dangerous and OBs wouldn't touch them with a ten foot pole.  But years of research have now proven that a VBAC is safer than a RCS, and now ACOG has changed their stance.  I have a feeling breech birth is going to be like this one day.

    For a skilled practitioner (and no, your OB is not skilled in it or else they would be attempting it like my friend's OB did), a vaginal breech delivery (frank breech) is perfectly safe.  When DD was breech I planned one at home and she eventually flipped.

    Schedule your c/s, because that is what you want to do.  And go on pretending that there is absolutely no risk to scheduling one before 39 weeks.  There IS a tiny risk, just as there IS a tiny risk with any decision, including a vaginal breech.  Good luck with whatever you decide.

        
  • One of the issues I think a lot of people have is that having a c/s at 38 weeks is "all well and good" according to your OB but it's not 100% sure that you are 38 weeks. You never know, you may have a LO in there that thinks they have a bit longer to finish up the last min. development things.
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