Wednesday, February 11, 2009

Cautiously Optimistic...

We had our weekly sonogram and doctors appointment today, and we received some good news.  The umbilical cord had moved from around the baby's neck enough that the doctor is comfortable with performing the external cephalic version/ECV/manual baby turning procedure.  To recap, this procedure is to turn the baby, who is currently breech, into a head-down position in order to avoid a c-section.  

Brian and I are excited about this turn of events, BUT we understand that the odds of this working are not in our favor.  Depending on the doctor/hospital stats this procedure is usually successful 60% of the time.  Because of the small size and weird shape of my uterus along with the fact that our "little" guy is estimated to weigh 7 pounds 10 ounces at 37.5 weeks, the odds are definitely decreased in our situation.  

That being said, Brian and I are very hopeful that we will leave the hospital tomorrow with a head-down baby and then wait to go into labor on our own.  If the procedure is not successful, then we will feel confident that we've done all we can and move forward with the scheduled c-section on 2/20.  We are getting so excited to meet our son no matter how he decides to come out!

Our procedure will be done in labor and delivery just in case emergency intervention is needed. (This is standard protocol).   Brian and our doula, Elizabeth, will be there with me. The procedure is scheduled for 8 am, and we should be home again by about 10 am. We'll keep you posted on the outcome!

And for those who desire more information, below is a brief explanation of the procedure from Dr. Spock's website.  

Turning a Breech Baby: External Cephalic Version

by Marjorie Greenfield, M.D.
reviewed by Marjorie Greenfield, M.D.
External cephalic version (ECV) is a procedure to change a baby from breech or other non-headfirst presentation to headfirst (cephalic). The physician pushes on the baby through the mother's abdomen, either creating a forward roll like a somersault or a back flip. For details about the procedure itself, see "The External Cephalic Version Protocol."

Why do external cephalic version?
Since all transverse babies and most breech babies are born by cesarean, moving the baby to cephalic presentation increases the chance of having a vaginal birth. Research has shown that offering ECV to all mothers with breech babies at 36 weeks gestation decreases the cesarean rate for that group of women. The success rate for rotating a baby to headfirst position is quoted as anywhere between 35 and 86 percent. The procedure is more successful in women who have had other children, since the baby can move around more easily, than it is for a first-time mom whose baby sits low in her pelvis.

The risks involved
Often the baby's heart rate will slow during or immediately after the version, especially when it is successful. The heart rate usually comes back to normal within a few moments, and there is no evidence that these short-lived heart-rate changes harm the baby in any way. In very rare situations, the heart rate stays slow long enough that practitioners will start the initial preparations for a possible emergency cesarean section. Although preparation is sometimes necessary, emergency C-sections are extremely rare under these circumstances.

While it's rare to have a serious complication of ECV, it may be uncomfortable or even moderately painful. You always have the right to stop the procedure for any reason. (Remember, it's your body!) If you can keep your abdominal muscles relaxed, you might be more comfortable and the procedure may be more likely to succeed. You may feel sore for a few days. Ideally, you will want a support person with you during the version, and you'll need someone to drive you home afterward.

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