November 2014 Moms

So confused and scared- already scheduled forC section

I am almost 31 weeks and doctor scheduled my c section for 39 w because baby is breech. I thought baby still has plenty of time to turn- does it not? I am afraid doctor is doing it for pure convenience and to get more money but i am just so scared right now and not sure what to do or think. Anyone experienced the same?

Re: So confused and scared- already scheduled forC section

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  • I had the same thing happen to me today. However, my doctor made it very clear that he was only scheduling the c-section to ensure I had a time on the books in case it was needed, and he told me that we will only keep the section if baby is still breech when I have my next ultrasound which will be at 36w3d. Perhaps this is the case for you too, it might be worthwhile to find out.
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  • Thanks all!! Seems doctor said we are doing it just in case , hospital is busy etc. i just got such a weird feeling!

  • lissydee said:
    I had the same thing happen to me today. However, my doctor made it very clear that he was only scheduling the c-section to ensure I had a time on the books in case it was needed, and he told me that we will only keep the section if baby is still breech when I have my next ultrasound which will be at 36w3d. Perhaps this is the case for you too, it might be worthwhile to find out.
    There is no reason to put it "on the books" this early. Baby could remain breech and she not come in until she is in labor on her own, which at that time a section would be performed (and really this may be idea because lots of good things happen, physiologically and biologically speaking when the baby is exposed to the hormones of labor). A L&D unit should be able to accommodate anyone needing a section at any time, and if not, then I'd seriously question how that unit is run. The doctor is simply scheduling this for their schedule and convenience. That's it.
    A L&D can do a section at any time, but scheduling it in advance can give you much better times. There are advantages to having a CS at 730AM rather than 5pm.  Having it scheduled does not mean the OP will get a CS, it just means a slot is available. Things that are on an OR schedule can ALWAYS be cancelled but it can be harder to add them on closer to the date and get a reasonable time. 

    OP, why don't you just call your doctor and ask what their plan is? Are they going to do more ultrasounds?  They really need to before they would do a CS since baby has plenty of time to flip beforehand. Doctors do not generally get paid per procedure. I've never been asked to do more procedures to make more money for my division and most doctors are salaried so doing an extra CS does not mean a bigger paycheck for the Dr. 
  • Can I just add in here that even if baby stays breech, a c-section isn't the only option....  Maybe it's different where I am, but there are a lot of OBs in my city who are willing to attempt vaginal breech delivery (depending on a lot of factors, most important of which is the type of breech position baby is in).  One of our hospitals has at least one OB on staff 24 hours a day who is able to attend a vaginal breech delivery.

    Just something to think about and look into if you're interested.
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  • Yes my doc will still due ultrasounds. Every time. They will be checking.
  • He could have scheduled it just to reserve ideal OR time/space, your baby has plenty of time to flip but as the date gets closer the OR schedule may get super jammed up. Better to have to cancel than have no openings available if she doesn't flip.
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  • Hopefully thats it thanks!!
  • The only other thing I can add is maybe your OB wanted to schedule it on a day where he/she will be the attending in L and D and is the one to perform the delivery and not whomever is on call.  I would allow it to be scheduled (open slots depend on how busy the L and D unit is at your chosen hospital as well as number of ORs and staffing) but do NOT sign a consent.  Most hospitals will even check the baby's position by ultrasound in the pre-op area right before the CS just to make sure the baby still hasn't flipped to vertex.  I would make it clear to your OB that you want to explore all options first and have a CS as a last resort.  

    You may want to do some independent research into external cephalic version.  Here is a basic "breech baby" info sheet https://www.acog.org/Patients/FAQs/If-Your-Baby-Is-Breech just FYI.
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  • mussalynn said:
    Can I just add in here that even if baby stays breech, a c-section isn't the only option....  Maybe it's different where I am, but there are a lot of OBs in my city who are willing to attempt vaginal breech delivery (depending on a lot of factors, most important of which is the type of breech position baby is in).  One of our hospitals has at least one OB on staff 24 hours a day who is able to attend a vaginal breech delivery.

    Just something to think about and look into if you're interested.
    It's a good thing there are still a few providers that attend vaginal breech birth. My midwife will attend a breech, but knows if baby doesn't come on his/her own then a transfer is necessary. The majority of providers are not trained to address or observe a breech birth, so they move right on to c-section.

    My youngest was frank breech until 32 weeks when he flipped vertex, and then was oblique breech at 34 weeks, and moved back to vertex by my 36 week appt. She would have been comfortable with a vaginal breech because I have a "proven pelvis" and extremely fast and easy births.
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  • lissydee said:
    ------- Advantages such as? We schedule sections all times of day on my unit, not just the mornings. A non emergent section is a non emergent section. Whether it's at 7a or 7p. It being on the books 9 weeks early is simply a matter of convenience at this point. And rather unnecessarily this early as baby still has a lot of time to flip. Now that slot is being hogged when someone else, closer to their actual due date, may need it (and in all likelihood in this instance, OP's date will likely be changed changed/bumped a couple of times because their doc scheduled it too far in advance).
    Advantages of having an OB and anesthesiologist earlier in the day when they are fresher and less tired. More hands available if they need help. There are many more people available during the day than 7pm. And as far as I can tell in any OR I've worked in, it's an exciting day when the OR runs on time towards the end of the scheduled times.  The earlier cases are more likely to go on time, but a scheduled late afternoon case would have a good chance of going late. I would also prefer avoiding nursing change of shifts. If it's at a hospital that has peds present at all CS, if the CS is done after 5 or so you will be getting the skeleton peds crew and there is a chance there is no peds attg in the hospital if there is an issue. In terms of mom's comfort, I think most people would prefer a case earlier in the day rather than wait around all day not being able to eat/drink and be anxious.  The OB may only have scheduled OR time on certain days, depending on the hospital, so sometimes if it isn't booked, it would get done by someone else, which may or may not be ok with the OP. Most people want their own OBs to do their CS. It sounds like they will still be doing ultrasounds on the OP (which is totally appropriate) and can cancel the slot if it is no longer needed. 
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