Vaginal breech versus c-section? Which one should I have?

So I am looking this up because I am currently 34 weeks pregnant, and my baby has been in the breech position every time we go to the doctor. I swear this baby already has a mischievous sense of humor, just like their dad. But hey, I’m keeping my fingers crossed that he will pull a last-minute surprise and do a graceful flip in there. Maybe he is just waiting for the perfect dramatic moment! Now, when it comes to delivering then doctors prefer to go with a c-section when they are in breech position. I understand that the delivery can be more complicated in such cases, but I’m curious to know if having an operation is actually safer then going with the old natural way.

I’ve been looking at studies, and yes, it seems that there are different risks associated with both vaginal delivery and c-section. However, when looking at short-term health outcomes, c-section appears to be more favorable.

Meta-analyses conducted over the past ten years have shown that the relative risk of perinatal mortality (fetal death from 22 weeks gestation up to 7 days after birth) is 5.48 times higher in the vaginal delivery group. Birth trauma is 4.12 times more likely in the vaginal delivery group, and Apgar scores below 7 at 5 minutes after birth are 3.33 times more common. Neonatal admission to the intensive care unit (ICU) is also higher in the vaginal delivery group. However, maternal morbidity is 0.30 times lower in the planned c-section group compared to the vaginal delivery group.

These findings suggest that planned vaginal delivery for breech presentations is associated with increased risks of perinatal mortality, birth trauma, Apgar scores below 7, and neonatal ICU admission. On the other hand, planned c-section delivery is linked to slightly higher maternal morbidity. Therefore, the decision regarding the delivery method should be individualized, taking into account the specific circumstances and preferences of pregnant women with breech presentation.

After all the reading I’ve done, I’ve come to the conclusion that it would be best to obtain specific data from the hospital where you will be delivering your baby. Some hospitals may have better expertise and experience in handling vaginal breech presentations than others. Midwives can often provide guidance on what they feel more confident doing in your specific situation.

If you do decide to go for a c-section, please be aware that there may be long-term health concerns for babies delivered that way. C-section babies tend to have higher rates of allergies and asthma. This is likely due to the absence of exposure to their mother’s microbiome during a vaginal birth. Considering options like vaginal seeding or carefully planned probiotic treatment might be necessary in such cases.

After learning this I think I am going to first have a serious heart-to-heart talk with my little baby. I’ll be like, “Hey, kiddo, you better listen up! It’s time to turn that head down and get into the correct start position.” I might even bribe him with promises of endless cuddles and milk.

But if my baby decides to play hard to get, then I’ll pull out all the stops. I’ve read some tricks that people swear by, like strapping an ice bag to my upper abdomen and a cozy warm bag to the lower abdomen for ten minutes. If my baby has any sense, he’ll choose warmth over the icebath and make his grand head-turning debut.

I would just so love to have a natural birth with my little one cooperating like a champ. I don’t want to miss out on the magical experience of bringing new life into the world.

Oh, and there’s this thing called ECV, or as some call it, the “baby-flip maneuver.” It’s like an acrobatic stunt where skilled doctors try to coax the baby into the right position from the outside. It sounds like something out of a circus act, but hey, if it’s safer than a c-section, why not give it a try?

So, there you have it, my determined plan to get my baby to cooperate. Let’s hope my persuasive powers and clever tricks will work. Wish me luck!

References to studies.

Breech Presentation: Vaginal Versus Cesarean Delivery, Which Intervention Leads to the Best Outcomes?

Collea JV, Chein C, Quilligan EJ. A randomized management of term frank breech presentation: a study of 208 cases. American Journal of Obstetrics and Gynecology

Gimovsky ML, Wallace RL, Schifrin BS, Paul RH. Randomized management of the nonfrank breech presentation at term: a preliminary report. American Journal of Obstetrics and Gynecology

Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial: Term breech trial collaborative group.

Maternal and fetal risks of planned vaginal breech delivery vs planned caesarean section for term breech birth: A systematic review and meta-analysis

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