I’ve lost count of the number of friends who’ve been through hours – sometimes days – of painful labour, only for it to end in an inevitable emergency caesarean.
Afterwards, bruised and traumatised, many of them were told the baby would never have come out naturally, or that it was “impossible” due to the position or size of their baby.
But imagine if these women were given a late-term ultrasound, where a scan at 36 weeks could have shown them what they were likely facing before they got their hopes up about a home or water birth.
This (arguably sensible) solution may be about to become a reality, following new research into scanning women in late pregnancy.
Researchers from the University of Cambridge and the University of East Anglia (UEA) performed ultrasounds at 36 weeks in 3,879 women in England having their first child.
They discovered breech presentations – meaning the baby was lying feet or bottom first – in 179 women (4.6%). In more than half of these cases (55%), the baby’s position had not previously been picked up.
At the moment, the position of an unborn baby is only determined by midwives who feel the mother’s bump using their hands. And currently, women are only offered two routine scans: at eight to 14 weeks, and between 18 and 21 weeks.
With an extra scan at 36 weeks, the researchers said, there would be time for doctors to “turn” a breech baby before it is born, using a procedure called an external cephalic version (ECV).
And, according to the study, published in the journal PLOS Medicine, this could save the NHS money by reducing the risk of major surgery. It could even save lives.
Dr Ed Wilson, from UEA’s health economics group, said: “We estimate that UK-wide routine scanning could prevent around 15,000 undiagnosed breech presentations, more than 4,000 emergency caesarean sections and between seven and eight baby deaths per year.
“If ultrasound screening could be provided at such a low cost, for example by making it a part of a standard midwife appointment, routinely offering ultrasound scans could well represent a good use of NHS resources.”
Professor Basky Thilaganathan, spokesman for the Royal College of Obstetricians and Gynaecologists, said identification of a breech baby before labour would provide an opportunity to turn the baby to enable a vaginal delivery, or to have a planned caesarean birth.
“These are much safer options than discovering a breech baby during labour, which may lead to an unplanned vaginal breech birth or emergency caesarean – both carry increased risks of complications for both mother and baby, especially in a first pregnancy,” she said.