Version/Induction?

[allonsy221b]

Hi ladies!

So I am hoping to attempt a VBAC with this LO.  I went to me 37 week appointment this morning and just happened to ask when we should be worried about position and if that's something we should look at.  He felt around and then asked his student doctor to bring in the ultrasound machine to "put my mind at ease" only to find out LO is BREECH. I'm making a chiro appointment and going to try everything I can to turn him on my own but here is the situation I'm looking at as well as a few questions.

I can schedule a version for probably this Friday (I will be 38 weeks), then doctor would give me a belly binder thing to make it hard for LO to turn back to breech if it's successful.

The other option is to wait until next week sometime and do the version and induce directly after (closer to 39 weeks).  

My childcare happens to be out of town this weekend (I posted about in spam and now I'm even more pissed at them), and I think I would like LO to cook longer if I can.  I'm kind of waiting for the doctor to call me back about how he wants to schedule.

My questions:

Has anyone been through a version that wouldn't mind kind of walking me through it step by step what to expect (this helped me a lot in preparing for my c/s last time)? My doctor said if I decide to induce after the version that they would do the epidural, then try to turn the baby, then induce so I was comfortable the whole time. He also made it seem like that was the method he preferred and I think I do too. I just wanted to kind of know what would happen when I walk in.

If you had the choice would you do the version then wait it out or version then induce? (I know ultimately only I can decide but other ladies thought processes could be helpful).

Ultimately I'm going to go with LO's safety over anything, my doctor is confident a version would be successful, it's just me who is on the fence haha.

[dacora]

Ugh I'm sorry your LO is breech! No experienced opinion, but I think I would go with the induction option at 39 weeks.

[misshart00]

Feb 9, 2015 18:42:09 GMT -5 dacora said:

Ugh I'm sorry your LO is breech! No experienced opinion, but I think I would go with the induction option at 39 weeks.

I agree with this. One, I would rather be comfortable with the epidural. Two, there's not really a chance to turn back around.

[allonsy221b]

That's what I was thinking too, I just put in the request for the 19th (day after my birthday!) hopefully they'll call me back with an answer soon

[allonsy221b]

Looks like 2/19/15 is the day unless he turns on his own!

[misshart00]

Feb 9, 2015 20:23:06 GMT -5 allonsy221b said:

Looks like 2/19/15 is the day unless he turns on his own!

Yay! As stressful as it is, it's kind of nice knowing that there is an end.

[allonsy221b]

Feb 9, 2015 20:26:02 GMT -5 misshart00 said:

Feb 9, 2015 20:23:06 GMT -5 allonsy221b said:

Looks like 2/19/15 is the day unless he turns on his own!

Yay! As stressful as it is, it's kind of nice knowing that there is an end.

It really is, my DH is a super planner and was so stressed out about not knowing when it was going to happen, so he is kind of relieved to have a date. I am too, it's nice to know the end date. Also I can have childcare in place as it's not this weekend when my mom and sister are out of town. Figures my two go to's thought it was a good idea to leave town when I'm due anytime.

[misshart00]

Feb 9, 2015 20:30:48 GMT -5 allonsy221b said:

Feb 9, 2015 20:26:02 GMT -5 misshart00 said:

Yay! As stressful as it is, it's kind of nice knowing that there is an end.

It really is, my DH is a super planner and was so stressed out about not knowing when it was going to happen, so he is kind of relieved to have a date. I am too, it's nice to know the end date. Also I can have childcare in place as it's not this weekend when my mom and sister are out of town. Figures my two go to's thought it was a good idea to leave town when I'm due anytime.

I understand. My parents are going to India next month. I'm glad I wasn't due that late. And I'm also a planner so it was nice having everything in place with DD. I should've planned a bit better. Both of my kids were born on the third but DD was born at 6:11 and DS was born at 6:04. I tried to hold out the 7 minutes but they were already crossing my legs waiting for the doctor.

[beth1212]

I think this is one of those situations where it's impossible to know what the best choice is because of the unknowns - you could wait and LO could turn again just before you deliver, or you could wait and get to avoid pitocin and have a straightforwards vaginal delivery when your LO decides he/she is ready.

I don't know if this is helpful now that you've decided, but I think I'd go for a version sooner and then wait. Spontaneous reversion to breech is only around 3%. The sooner you try for an ECV, the smaller the baby is and some studies indicate that this leads to better chances of the version working. Also, if the version fails on Friday, they can try again, but the longer you wait the less time there is to give it a 2nd try. Lastly, I am generally of the "if it's not medically necessary than don't do it" frame of mind, and would (1) prefer to let LO decide when to come, and (2) would rather avoid an induction because of the increased risk of C-section.

Someone mentioned going for an induction because they'd want an epi. FYI, there is some evidence that an epi helps make a version more successful, so even if one doesn't induce after a version often one can get an epidural during the version.

[agm04]

Feb 9, 2015 17:21:07 GMT -5 allonsy221b said:

My questions:

Has anyone been through a version that wouldn't mind kind of walking me through it step by step what to expect (this helped me a lot in preparing for my c/s last time)? My doctor said if I decide to induce after the version that they would do the epidural, then try to turn the baby, then induce so I was comfortable the whole time. He also made it seem like that was the method he preferred and I think I do too. I just wanted to kind of know what would happen when I walk in.

If you had the choice would you do the version then wait it out or version then induce? (I know ultimately only I can decide but other ladies thought processes could be helpful).

I had an ECV at 36w5d and am happy to answer any questions you might have!  It didn't work for us, but don't let that discourage you.  We are trying to decide right now whether or not we want to attempt another at 39 weeks, and I think we probably will.  My OB also wants to induce if it's successful, but we will decline that.  So I guess that answers your second question - it's just really important to us that LO picks her own birthday (although I realize if something goes wrong during the ECV that goes out the window), but it's a totally personal decision and I can see what you'd go ahead with that.

Here's how it went down for me.  The end might sound a little bit scary, but I knew we were in good hands and a few feet from an operating room if we needed it, and I think it was helpful for me to go into this knowing this kind of reaction from baby was a possibility - so I don't mean to scare you at all, just sharing my story.

I was told to fast (no food OR drink) beginning at midnight the night before.  I had dinner around 9 and then continued to drink until bedtime.  Fluid levels are pretty important, and I'm a huge water drinker, so this concerned me, but I did what I could.  We were scheduled for a 12pm ECV (that's when we had the OR reserved just in case).  They told me to show up 1.5 hours early, so I did.  I filled out paperwork, changed into a hospital gown/socks, got an IV.  They started monitoring me/baby (one strap for baby's heart and one for contractions - the same set up as they use in labor), and decided to give me a couple bags of fluid.  They also drew blood for some lab work.  It was just the nurse at this point - the dr. showed up just in time to begin.  I was contracting pretty regularly (probably because I was dehydrated by now), so they decided to give me terbutaline (which I knew was a possibility - it's a shot meant to relax the uterus).  It made me really jittery/shaky (as expected), but it wasn't too terrible.  The dr. arrived, they did an ultrasound to check her position and my fluid levels.  They were a bit disappointed in my fluid levels (which, hello - I haven't been able to drink anything in 12+ hours...) but said it was still "average".  Then they lubed my belly up with glycerin and ultrasound gel and started.  They try to get one hand on the butt and one on the head and lift her up (out of the pelvis - my LO wasn't/isn't engaged but they still lift a bit) and then push to try to turn her.  They stopped to check her heart rate and her position (with ultrasound) every few minutes.  They'd get her head to one side, but then as soon as they let go, it would pop right back into place.  At one point, her heart rate went down a bit so they stopped to let her recover - maybe for 3-5 mins?  But it wasn't alarming.  They tried 3 times, but only tried turning her one way.  On the last attempt, when they stopped to check her heart rate, it had dropped into the 60s, so they stopped completely, had my roll on my side, put an oxygen mask on me, and said they couldn't continue.  It was a little scary at that point, but her heart rate recovered pretty quickly - jumped into the 180s actually (her baseline had been around 150-160) and stayed there for quite a while.  They wanted to monitor me for 4 hours after that.  Once the terbutaline wore off, I started contracting again - a bit longer and stronger now - so they wanted to give me something to stop the contractions.  They checked me and I wasn't dilated, so I wasn't overly concerned about those (I still suspected dehydration).  They also gave me a rhogam shot before I left, even though I'd already had one, because I'm rh negative.

So it was a disappointing experience, but I'm glad we tried.  It was definitely painful, but manageable.  I was bruised for a few days.  They wanted me to watch her activity very closely for the next 24 hours, and that part was unsettling.  She was probably a bit traumatized, and was pretty quiet compared to usual (but still moving enough to keep me from going in), but by the next afternoon she was back to normal.

Sorry for the novel.  Like I said, I'd be happy to answer any questions!

[allonsy221b]

Feb 10, 2015 12:28:11 GMT -5 agm04 said:

Feb 9, 2015 17:21:07 GMT -5 allonsy221b said:

My questions:

Has anyone been through a version that wouldn't mind kind of walking me through it step by step what to expect (this helped me a lot in preparing for my c/s last time)? My doctor said if I decide to induce after the version that they would do the epidural, then try to turn the baby, then induce so I was comfortable the whole time. He also made it seem like that was the method he preferred and I think I do too. I just wanted to kind of know what would happen when I walk in.

If you had the choice would you do the version then wait it out or version then induce? (I know ultimately only I can decide but other ladies thought processes could be helpful).

I had an ECV at 36w5d and am happy to answer any questions you might have!  It didn't work for us, but don't let that discourage you.  We are trying to decide right now whether or not we want to attempt another at 39 weeks, and I think we probably will.  My OB also wants to induce if it's successful, but we will decline that.  So I guess that answers your second question - it's just really important to us that LO picks her own birthday (although I realize if something goes wrong during the ECV that goes out the window), but it's a totally personal decision and I can see what you'd go ahead with that.

Here's how it went down for me.  The end might sound a little bit scary, but I knew we were in good hands and a few feet from an operating room if we needed it, and I think it was helpful for me to go into this knowing this kind of reaction from baby was a possibility - so I don't mean to scare you at all, just sharing my story.

I was told to fast (no food OR drink) beginning at midnight the night before.  I had dinner around 9 and then continued to drink until bedtime.  Fluid levels are pretty important, and I'm a huge water drinker, so this concerned me, but I did what I could.  We were scheduled for a 12pm ECV (that's when we had the OR reserved just in case).  They told me to show up 1.5 hours early, so I did.  I filled out paperwork, changed into a hospital gown/socks, got an IV.  They started monitoring me/baby (one strap for baby's heart and one for contractions - the same set up as they use in labor), and decided to give me a couple bags of fluid.  They also drew blood for some lab work.  It was just the nurse at this point - the dr. showed up just in time to begin.  I was contracting pretty regularly (probably because I was dehydrated by now), so they decided to give me terbutaline (which I knew was a possibility - it's a shot meant to relax the uterus).  It made me really jittery/shaky (as expected), but it wasn't too terrible.  The dr. arrived, they did an ultrasound to check her position and my fluid levels.  They were a bit disappointed in my fluid levels (which, hello - I haven't been able to drink anything in 12+ hours...) but said it was still "average".  Then they lubed my belly up with glycerin and ultrasound gel and started.  They try to get one hand on the butt and one on the head and lift her up (out of the pelvis - my LO wasn't/isn't engaged but they still lift a bit) and then push to try to turn her.  They stopped to check her heart rate and her position (with ultrasound) every few minutes.  They'd get her head to one side, but then as soon as they let go, it would pop right back into place.  At one point, her heart rate went down a bit so they stopped to let her recover - maybe for 3-5 mins?  But it wasn't alarming.  They tried 3 times, but only tried turning her one way.  On the last attempt, when they stopped to check her heart rate, it had dropped into the 60s, so they stopped completely, had my roll on my side, put an oxygen mask on me, and said they couldn't continue.  It was a little scary at that point, but her heart rate recovered pretty quickly - jumped into the 180s actually (her baseline had been around 150-160) and stayed there for quite a while.  They wanted to monitor me for 4 hours after that.  Once the terbutaline wore off, I started contracting again - a bit longer and stronger now - so they wanted to give me something to stop the contractions.  They checked me and I wasn't dilated, so I wasn't overly concerned about those (I still suspected dehydration).  They also gave me a rhogam shot before I left, even though I'd already had one, because I'm rh negative.

So it was a disappointing experience, but I'm glad we tried.  It was definitely painful, but manageable.  I was bruised for a few days.  They wanted me to watch her activity very closely for the next 24 hours, and that part was unsettling.  She was probably a bit traumatized, and was pretty quiet compared to usual (but still moving enough to keep me from going in), but by the next afternoon she was back to normal.

Sorry for the novel.  Like I said, I'd be happy to answer any questions!

Thank you! That was exactly what I needed. I just like to have an idea of what to expect. I'll still ask my doctor the procedure but just hearing the step by step from someone going through it helps me a lot. I get hospital anxiety, so if I go in and can say "okay they'll give me fluid and put the monitors on and then do this etc" I can keep myself calm. If I go in blind I'll be a mess.

I did expect to fast but thought water would be okay, that's good to plan for too! I'll have to ask for an exception so I can take my HG meds or I'll be throwing up on everyone

Did you get an epi with yours?

[agm04]

Feb 10, 2015 15:31:30 GMT -5 allonsy221b said:

Feb 10, 2015 12:28:11 GMT -5 agm04 said:

Thank you! That was exactly what I needed. I just like to have an idea of what to expect. I'll still ask my doctor the procedure but just hearing the step by step from someone going through it helps me a lot. I get hospital anxiety, so if I go in and can say "okay they'll give me fluid and put the monitors on and then do this etc" I can keep myself calm. If I go in blind I'll be a mess.

I did expect to fast but thought water would be okay, that's good to plan for too! I'll have to ask for an exception so I can take my HG meds or I'll be throwing up on everyone

Did you get an epi with yours?

No problem at all!  I know what you mean - being able to prepare mentally is really helpful.  I've heard it's more effective if you can really relax, which is hard when you're in a strange place and stressed out.  I plan to listen to a hypnobabies soundtrack (or something similar) this time.  

Re: water...honestly I plan to drink water this time.  I think the dehydration really worked against us (both because I was contracting and because there was less fluid), and people have emergency c sections all the time after having eaten/drank.  Not at all recommending that you do that, but I am comfortable with the risk/reward trade off there for sure.

I did not have an epi, though I have read it can help.