Breech and Extended Breech Presentation

Breech and Extended Breech Presentation

In this blog post I will talk about my experience of Breech and Extended Breech Presentation.

We were first told that Maisie was breech presentation during a routine examination at one of my antenatal appointments during the early stages of pregnancy. She said that she could feel Maisies head close up to my ribs and that her bottom was low down. As it was so early on, the midwife assured me that it was nothing to be concerned about as there was still plenty of time for her to turn. She said that it wasn’t something they would worry about until 36 weeks. I had loads of time!

As a precaution, I did a little bit of research into what I could do to help her turn. There was a website that kept popping up that lots of women recommended on the many forums that I used to read and that was called Spinning Babies. This was a really helpful and informative website which provided videos of movements that were similar to Yoga positions that would potentially help baby to turn. In my eyes, anything was worth a try. The main position involved kneeling on the sofa or end of the bed and tipping your body over so that the top of your body and head are pointing toward the floor with your weight resting on your forearms and elbows. It takes a little bit of getting into position, especially during the later stages of pregnancy but once in position you can feel how it could potentially work. It is important however to make sure that you have someone with you to help get in and out of position and ensure your safety throughout. You can see the video here 

I only practised myself very once or twice as my understanding was that it wasn’t really worthwhile until much later in my pregnancy. I.e 32 weeks onwards. Up until my lecturer appointment I didn’t feel that Maisies positioning had changed however when I was examined the next time, I was assured that Maisie was head down.  To be quite honest, this confused me slightly as I knew that her position hadn’t changed since last time and I could only assume that the last midwife must have been mistaken?!  At every antenatal appointment from then onwards I saw a different midwife each time and every one assured me that Maisie was head down so I thought no more about it.

PPROM

As you’ve probably read from previous blog posts, at 34 weeks I PPROM‘ed. This stands for Pre-term Pre-labour Rupture of Membrane, in other words, my waters broke. I didn’t go into labour immediately however I was advised that when this happens, 60% of women go into labour within 24-48 hours and consequently I was admitted for 3 days. Over the 3 days, other than the worry (and the constant leaking, gross I know!) I felt absolutely fine and there were no signs of impending labour. As part of the observations I was sent for a scan to determine the amount of fluid that was remaining and this is when it became apparent that Maisie was in fact breech! She was Extended Breech also known as Frank Breech. I wasn’t fully aware of what this meant I just knew that she was the wrong way around. The scan also revealed that I had no fluid left at all which meant that unless it regenerated (which is possible) she would not be able to turn. Consequently, I was booked in for a cesarean section at 37 weeks and they hoped I would be able to hold out until then.

Extended Frank Breech
Extended Frank Breech

I left the hospital on Sunday evening with antibiotics to prevent infection but unfortunately this was very short lived, I was back by 7am on Monday morning in full labour! By 8.33am Maisie was born by EMCS. She was 34 weeks.   The moment that she arrived she let out the loudest scream which was just incredible but all I can remember is seeing over the screen and them lifting her out onto the trolley. Her legs were up by her sides?! I thought I must have seen wrong.  Greg was allowed to look at her and take photos before she was taken away. When I looked at the photos, I was right. Her legs were up by her sides, behind her arms! Had I had a disabled baby?? This was frightening and I certainly wasn’t prepared for it! I hadn’t done much usual reading and research as I hadn’t had time since arriving home the night before and nobody in the theatre said anything. I was taken into the recovery room and we didn’t see Maisie again for a good few hours however they assured us that she was doing well and had been given a 9/10 and a 10/10 for her Apgar Scores. These are scores given to every baby when they are born and they are to summarise the health of a newborn, breathing, colour, heart rate etc etc.

I didn’t see Maisie again until after Midday as they struggled to get my temperature back up. When they took me up to see her, she was in intensive care in an incubator. To be honest, this part is all a bit of a blur to me but the first thing I noticed was her little feet popping out of the blanket next to her ears. Initially I didn’t ask questions about this as I think I was still in a state of shock however it was a concern.  Greg asked the question to several of the Neonatal nurses that day and it seemed that none of them could give a definitive answer as to whether Maisies legs would be affected long term. This was a huge worry for us for several days and we just couldn’t get a clear answer. We were told that she would be sent for a hip scan at 6 weeks old.

If you are reading this and you are worried about your little ones legs, in our experience there is no need to worry! The very same day that Maisie was born, we could already see that her legs were starting to come down towards a more normal position.  As each day went by, the positioning got better and better. It became less and less of a worry however we were still waiting for that reassurance.

On Day 3 we saw the consultant. We FINALLY got the news that we had been waiting for. Maisies legs were absolutely fine, nothing thing to worry about. At this point, I was in tears again!! Tears of relief.  We were told that this was very normal for an Extended Breech baby and the consultant apologised that we had not been reassured sooner.  I just wish that I had been prepared for this before she had arrived. That way, I would have expected it and it would have alleviated a lot of unnecessary worry and stress for both of us.

We spent 8 days in Neonatal Care and by the time we were due to go home, there was a clear improvement in the positioning of her legs. She looked like a little frog now rather than a contortionist.

Extended Breech Leg Position
Extended Breech Leg Position

I asked if there was anything that we could do at home to help her, any form of exercise or baby massage and the consultant assured us that this wasn’t necessary as Maisies legs would naturally correct themselves. We received a letter for a routine hip scan at 6 weeks which we attended and thankfully, all was perfect.

Routine Hip Scan

The scan itself took no more than 5 minutes. It’s not distressing in any way and is nothing to worry about. In fact, Maisie slept through hers! We were asked to take off Maisies bottom half of clothing and lay her on her side on the padded bench. The radiographer opened one side of Maisies nappy and rubbed on the gel. It is just like having a scan during pregnancy with a handheld device that shows up the scan on the screen. Maisie was then turned onto the opposite side and the same procedure repeated.

The radiographer explained that occasionally babies can get a clicky hip after being born extended breech but generally this is easily corrected when picked up so early. We were lucky in that Maisie hadn’t encountered any issues.

There are so many different types of breech presentation. Unfortunately I was unaware of this before my experience. Had I have been aware of this, I wouldn’t have worried quite so much when Maisie arrived with her legs by her ears! Despite this experience, it is important to remember that babies are extremely resilient and can bounce back easily and naturally from certain issues.  If anything, being born extended breech is a benefit to Maisie as I reckon that in 18 years if she is double jointed, it’s going to be one hell of a party trick!!! 😂

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