What to Do if Your Baby Is Breech?

What to Do if Your Baby Is Breech in Pregnancy

Pregnant woman holding earphones to stomach.
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A breech baby is a commonly used word to refer to a baby who is not in a head down or vertex presentation. Usually, this means a baby who is bottom down towards the cervix. About 3-4% of babies at 37 weeks gestation are breech.

It is more common to have a breech baby if:

  • Your baby has anomalies.
  • Your placenta is low lying or you have placenta previa.

Most babies are head down by 32 weeks into pregnancy and of those who are not, the vast majority will be head down by the time labor starts. There are ways to increase the chances of your baby turning to a head down position.

Non-medical Methods of Turning a Breech Baby

  • Tilt Positions
    These are probably the most frequently heard about. You can do it the easy way and use an ironing board lying on the couch. Place your feet up and your head down. The theory behind these is that your baby's head, the heaviest part of his or her body, will disengage from the pelvis and baby will turn head down. It's generally recommended to do this 20 minutes a day until baby turns. Some women report dizziness from being in this position. Always discuss this or any other exercise with your midwife or doctor.
  • Light/Music
    The use of light or music directly at your pubic bone is to encourage the baby to come towards the light or sound. Many women report success with this and this has no side effects. For a nice touch, you can have your partner talk towards your pubic bone, again to encourage baby to move towards the sound. Do this as often as you like until baby turns head down.
  • Water
    Some claims state that diving into a pool or simply being in a pool will encourage baby to turn. Again, no real problems noted from being in a pool. Double check about the diving.
  • Acupuncture
    This has been used along with moxibustion for success in turning breech babies. The biggest difficulty here may be finding someone who practices these techniques.
  • Chiropractic Care
    Chiropractors skilled in certain techniques may be able to help turn the baby. Check with your local practitioner for more information about the Webster Technique.

Medical Methods of Turning a Breech Baby

  • Homeopathy
    Homeopathics, generally pulsatilla, have been used for centuries in assistance in turning a breech baby. However, speaking to a knowledge practitioner is a must when trying to use this to help turn the baby.
  • External Cephalic Version (ECV)
    External version is generally done around 37 weeks. To be a candidate one must have adequate amounts of amniotic fluid to cushion the baby. The most common way to see this performed is in a hospital with fetal monitoring, ultrasound, and many times IV medications to relax the uterus. Performed prior to 37 weeks and you run the risk of premature labor and many babies may have turned on their own. The biggest risk to the ECV is a separation of the placenta which rarely occurs mostly due to the guidance of the ultrasound. There are also potential complications with cord involvement. Recent studies show that epidural anesthesia may actually increase the success rates of external version, which are stated to be between 65-70 by an experienced practitioner.

    Still Breech?

    Say you've tried all of these and your baby is still breech. What does this mean?

    There is actually a lot of misinformation about the mode of birth for breech babies. Many people will tell you that the only method of delivery that is safe is an elective cesarean. This is absolutely not true. Many of the problems that were once thought to be caused by the vaginal breech birth were not actually caused by the birth but by something prior to the birth. Most of all breech babies born in the United States are currently not being born vaginally (though this statistic varies drastically from practice to practice). Many criteria have to be met prior to considering a vaginal birth for a breech baby, though even the experts disagree on what they should all be. Generally speaking your chances of delivering a healthy breech baby vaginally increase with the following:

    • Baby is frank breech (feet straight up).
    • You've had a baby or babies vaginally prior to this birth.
    • Baby is not thought to be excessively large.
    • You have no pelvic or uterine anomalies.

    Some breech babies are generally better off being born by cesarean. Only your practitioner can help you determine if your baby is one of them. This would also not mean that all of your subsequent babies would be breech or necessarily be born via cesarean section.

    Sources:

    Cardini F. & Weixin H. (1998). Moxibustion for correction of breech presentation: A randomized controlled trial. JAMA 280(18), 1580-1584. Free full text: http://jama.jamanetwork.com/article.aspx?articleid=188144

    Cluver, C., G. J. Hofmeyr, et al. (2012). “Interventions for helping to turn term breech babies to head first presentation when using external cephalic version.” Cochrane Database Syst Rev 1: CD000184.

    Coyle ME, Smith CA, & Peat B. 2012. Cephalic version by moxibustion for breech presentation. Cochrane Database of Systematic Reviews 2012, Issue 5. Art. No: CD003928. http://www.ncbi.nlm.nih.gov/pubmed/22592693

    Vas J, Aranda-Regules JM, Modesto M, et al. (2013). Acupuncture Medicine 31: 31-38. http://www.ncbi.nlm.nih.gov/pubmed/23249535

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