My Baby is Butt or Feet First- Breech Babies. The Real Deal.
Who wants to talk baby butts? Specifically- breech babies.
So you went to your doctors appointment and you were told your baby is in a breech position. Now what? If it is prior to 32 weeks… Not to worry! Most babies turn head down before the 32 week mark. But here’s some more information on breech and what your options are!
Breech position (butt first AKA Frank Breech Presentation or feet first AKA Footling Breech Presentation) is present in 3% to 4% of full term pregnancies. But 1/4 of babies are breech prior to 28 weeks gestation. This percentage drops to around 7% by 32 weeks.
The vast majority of breech babies in the US are currently born by planned Cesarean. However, it does not necessarily have to be that way- and a lot of the time, you do have options! There are a few ways that can be successful in turning a breech baby prior to delivery, and ACOG (The American College of Obstetricians and Gynecologists) actually does not state that a cesarean is the only way to go when it comes to a breech presentation. More on that soon.
Methods of Getting a Breech Baby to Turn into a Head Down “Vertex” Position
ECV or External Cephalic Version
External = from the outside, cephalic = head first, version = turning
An external cephalic version is when a doctor uses their hands on the outside of the mother’s belly and manually turns the baby into a head-down position. This is also called an ECV, version, or “hands to belly” procedure. This procedure is done with anesthesia in place so that the mother does not feel much pain. The procedure is not without risk- but does have success approximately 50% of the time. Not all pregnancies are good candidates for an ECV, but it is worth talking to your provider about! Complications may include the following:
Premature Rupture of Membranes
Changes in the baby’s heart rate
Great article on Breech Versions here: https://evidencebasedbirth.com/what-is-the-evidence-for-using-an-external-cephalic-version-to-turn-a-breech-baby/
Chiropractic “Webster Technique”
Chiropractic care during pregnancy has been known to help with breech presentation. Namely- preventing it in the first place. It is a myth that chiropractors “turn breech babies,” however, proper pelvic alignment oftentimes helps baby turn naturally into the most optimal position for birth. It is important to seek out a chiropractor early on to help ensure that the pelvis is in an optimal state of alignment for vaginal delivery to see the best outcomes. More on this here: http://pathwaystofamilywellness.org/Chiropractic/can-chiropractors-turn-breech-babies.html
Moxibustion to turn breech babies
Though this is a common recommendation, Moxibustion alone does not seem to do the trick. However, Moxibustion combined with postural changes and acupuncture has shown some promise. A great article on this from Science and Sensibility here: https://www.scienceandsensibility.org/blog/can-moxibustion-help-turn-breech-babies
Bottom Line on Bottom First Babies!
Though there are a few methods used that can be successful to flip a breech, ACOG does not always recommend it! Believe it or not, breech birth with a skilled provider can be safe and effective. Per ACOG, if a mother desires a vaginal delivery of a breech baby, and the provider is educated and comfortable with it- the recommendation is to attempt delivery vaginally! It is important to discuss this with your provider and possibly even consult with other providers in your area if your provider is not skilled in breech birth. Knowing what we know about cesarean complications and recovery- it may be a reasonable option to “shop around” for a provider that will attempt a vaginal breech delivery if your current provider does not feel comfortable. Here are ACOG’s Recommendations!
The American College of Obstetricians and Gynecologists makes the following recommendations:
The decision regarding the mode of delivery should consider patient wishes and the experience of the health care provider.
Obstetrician–gynecologists and other obstetric care providers should offer external cephalic version as an alternative to planned cesarean for a woman who has a term singleton breech fetus, desires a planned vaginal delivery of a vertex-presenting fetus, and has no contraindications. External cephalic version should be attempted only in settings in which cesarean delivery services are readily available.
Planned vaginal delivery of a term singleton breech fetus may be reasonable under hospital-specific protocol guidelines for eligibility and labor management.
If a vaginal breech delivery is planned, a detailed informed consent should be documented—including risks that perinatal or neonatal mortality or short-term serious neonatal morbidity may be higher than if a cesarean delivery is planned.
(ACOG Committee Opinion #745)
Want to attempt a vaginal breech delivery in Central MS? Contact me today. I am happy to suggest some providers that may be able to help! Need more info on finding a provider near you? Shoot me an email! Also- check out the resources below for more information.