Turning a breech baby
A breech baby is a baby who sits upright in your womb rather
than headfirst. About one baby in four is breech at 28 weeks, but most
turn around at 36 weeks. Often babies who come early are breech because
they haven’t turned yet.
Although plenty of women have given birth successfully to breech babies, it does pose more of a problem with a vaginal birth.
A baby gets its oxygen through the umbilical cord, until its head
emerges as it is born and it can breathe in the air. If it comes out
bottom first the cord can become squashed and the oxygen supply to the
baby may reduce, putting the baby in danger.
However, if your pelvis is wide enough and the doctors think there
is plenty of room for breech delivery, there is no reason why you
shouldn’t give birth naturally, but sometimes doctors do advise women
to have a Caesarean section.
If you go into labour before term (at 37 weeks or earlier) and your
baby is breech, you will probably be advised to have a Caesarean
because of the risk to your baby's health if you give birth naturally.
Talk over the reasons for this with the midwives and doctors who are looking after you if you are not happy.
With a breech delivery you are probably more likely to have an episiotomy
so that your baby has plenty of room to emerge. There is evidence that
shows giving birth in the ‘all fours position’ can help give your
breech baby more room.
Every mother and baby is different, and you and your baby will be
individually assessed to see whether it is safe for you to deliver
vaginally. You may feel disappointed if you are advised to have a
Caesarean, but the medical staff will make the decision based on the
safety of your baby.
Can a baby be turned before birth?
Breech babies can
sometimes be turned using a technique called an External Cephalic
Version (ECV). There are good results with this and the Royal College
of Obstretricians recommend that ECVs are performed on women expecting
breech babies who have had uncomplicated pregnancies and have reached
37 weeks. The ECV must be performed at a hospital because the procedure
needs to be carried out by a skilled professional due to the risk of
the baby becoming distressed.
An anaesthetic is not required for an ECV but you will need to be
monitored because of the risks to your baby. You will be given an
injection to relax the muscles in your womb and a doctor or midwife
will attempt to externally turn your baby to face head down. This can
be painful for you, but probably not as painful as having a Caesarean
section. Talk this procedure through with your midwife if you are
worried and ask what your options are if you don't have an ECV. Never
try to turn your baby yourself - this procedure can be dangerous for
your baby and must be performed by a skilled medical professional.
Methods you can try at home
There are methods of turning
your baby which some women swear by. Here are some of the top
techniques for encouraging your baby to turn head down:
The knee-chest position
In a study of 71 breech babies, 65
of them turned when their mothers adopted the knee-chest position
several times a day. Kneel with your hips flexed and your hips,
shoulders and upper chest resting on a mattress (so on the bed in front
of you). Do this for fifteen minutes every two hours for five days.
All-fours
Spend time in the all-fours position rocking back and forwards
Lie down
lie on your back with your head lower than your feet (you can use a pillow to prop your feet up)
Music
Play music to your lower abdomen or between your legs (!) to encourage your baby to move into the head down position.
Follow the light
Shine a light towards your lower abdomen to see if your baby investigates the light and turns head down.
Dads can help
Ask
someone close to the baby (the father) to talk in a soothing voice
towards your lower abdomen and ask your baby to move head down.
Visualisation
Visualising
your baby turning head down in your womb may help your baby turn. Speak
softly to your baby and ask it to turn for you.
Moxibustion
This
is an acupuncture technique that is supposed to help, so ask your
midwife to help you find a registered acupunturist in your area.
Frozen veg (recommended by a midwife!)
Put
a bag of cold peas on your tummy where you think your baby's head is.
Your baby might move away from the coldness and hopefully into a head
down position.
The information in this feature is intended for educational
purposes only. If you have any concerns about your health, the health
of your child or the health of someone you know, please consult with a
doctor or other healthcare professional.
All
Third Trimester articles are relevant to the UK medical health system
and may differ from the experience of having a baby in other countries.
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Last Modified: 09/12/2008
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