Breech 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. About 3-4% of babies at 37 weeks gestation are breech.
It is more common to have a breech baby if:
- If you've had several babies before.
- You have excessive amounts of amniotic fluid (polyhydramnios).
- Your uterus has growths or anomalies.
- Your baby has anomalies.
- Your placenta is low lying or you have placenta previa.
Babies will usually begin turning head down between weeks 28 and 32, and continue to turn on their own even during labor. There are ways to increase the chances of your baby turning to a head down position.
- 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.
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 to this 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.
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.
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.
Homeopathics, generally pusatilla, 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 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 in an experienced practitioner.
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 where not actually caused by the birth but by something prior to the birth. About 50 of all breech babies are currently 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 baby(ies) 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.
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