by Katy (Lindale, TX)

I am 34 weeks pregnant and my baby has been in a breech (full breech-feet down) position for nearly 6 weeks. I know I still have some time for him to turn, but I am worried he won't and I'll have to have a c-section. I am doing a lot of the natural techniques to get him to turn myself, but I don't know that they will work.

Considering the risks would you recommend a version?

Also, if we opt not to try and turn him, what are the risks of waiting for labor to start,checking his position, then possibly having a c-section.

Mostly, I would like to know what “natural” options I would have for a c-section? Things like delaying cord clamping, pitocin, epidural vs spinal block etc.

I know I could technically deliver my baby vaginally, but I don't have an experienced doctor for that and I wouldn't trust her for it (I do trust my doctor, just not in something she rarely,if ever, does).

I have done quite a bit of research, but I still feel like I don't know enough about my options.

Anything to ease my mind at all would be greatly appreciated.

Thanks, Katy

Answer:

Hi Katy,

It's great that you're working on getting him to turn, and I encourage you to keep doing so. Since you've been doing your research you've probably come across both of these resources, but I will mention them again:

My article Turning Your Breech Baby

and

Spinning Baby's page on Breech Babies.

Both of these have information on turning babies.

Opinions on manual / external version vary and some doctors and midwives feel comfortable doing them and others don't. Personally if I had a provider that had done them with success and felt comfortable with the procedure, I would give it a try. Otherwise, though, I wouldn't.

I would try other things before the version. Have you seen a chiropractor? There's a chiropractic technique that often works very well for turning a breech baby. Look for a chiropractor that regularly works with pregnant mothers.

Talk to your doctor, but if you do need a cesarean there's a good chance you can wait for labor to begin on its own – even labor a bit before the procedure. This benefits your baby a lot because baby's body is getting prepared for birth with hormones and chemicals.

Most of the time you can labor for an hour or two and still be fine. If you've had a previous fast labor your doctor may not feel comfortable with that, but in most cases it's fine.

With a cesarean you can delay clamping of the cord for a moment while baby takes his first breaths, then have it clamped.

Your baby can be brought right to your arms in the operating room, and you can request that your baby be brought to you as soon as possible in the recovery room for cuddles and nursing.

If you want to labor for a little bit without pain medication before a cesarean you can opt for a spinal block. It takes effect almost immediately so it can be used just before the surgery (it's what you'd get for an emergency c-section). It's effective, complete pain relief and plenty effective for c-section.

I don't think you'd need pitocin during the procedure, but I'm not 100% positive. It's possible you could be given some to help your uterus contract and clamp down post-surgery, but it would most likely be an injection – not a continuous IV drip. You will be hooked up to IV for other fluids most likely, however.

Check with your doctor for other ways to make a cesarean more special for you. Some hospitals will allow music to be played and other special touches in the OR and other won't. Your doctor will know. Do let her know that you want your baby with you as soon as you can have him in recovery. Babies brought to Mom in recovery are often there quickly and there's a lovely chance to bond.

Best of luck with you as you work on turning your little one and prepare for his birth!