Breech Presentation and Birth
Presenting Baby ... Bottom First
The numbers vary somewhat, but generally speaking, about three to four percent of full-term births are breech. Usually, a few weeks before birth, the baby will drop into a head-down position and the head will lock into the pelvis in preparation for birth. It this does not happen, then chances are the baby is in breech position with buttocks and/or feet in place to be delivered first. The three breech presentations are:
· Frank breech with the baby's buttocks aimed at the birth canal and both feet straight up in front of the body, feet by the ears
· Complete breech with buttocks down and legs folded at the knees. The feet are tucked near the buttocks
· Footling breech sees the baby with one or both feet pointing down into the birth canal and head up into the stomach area
Although the reasons for a breech presentation are not clear, there are some indicators that are common to breech births:
· This is not the first baby born to the mother
· Multiples, such as twins or triplets
· A previous history of premature delivery
· Too little or too much amniotic fluid in the uterus
· Uterine growths or anomalies, such as fibroids
· Placenta previa, where the placenta lies low in the uterus
A breech presentation is usually discovered by the doctor during an examination a few weeks before the baby is due. Often, nothing is done until the 36th week since babies tend to move a lot prior to that time and can change position easily. However, once week 37 arrives, the baby is considered to be full-term and the amount of swimming space in the womb has decreased appreciably. Although it can happen that the baby will turn himself around to a head-down position, the chances are he'll remain breech.
Giving Birth Vaginally to a Breech Baby
Giving birth vaginally to a breech baby is less common than it used to be, primarily because of the risks presented to the baby. Breech babies tend to be more at risk for certain problems than babies who are born head first. Birth defects are more common; however, it may be a birth defect that is causing the baby to be in a breech position in the first place.
The primary problem with delivering a breech baby vaginally is that the largest part of the baby is the head, which, in a normal birth can mold to fit through the birth canal. A breech baby may end up with the head stuck because it doesn't have the opportunity to mold to the passageway. Additionally, there is a significantly higher risk of umbilical cord prolapsed, when the cord comes out before the baby. In a cord prolapsed situation, oxygen and blood may be cut off as a result of the cord being crushed or damaged. An immediate emergency is created. Some babies are born with neurological deficits as a result of cord prolapse. Consequently, many doctors prefer to deliver a breech presentation by cesarean section. While it has its risks, a c-section is often safer in terms of the baby's health. In order for a breech presentation to become a vaginal breech delivery, there are several considerations that have to be in place.
· The baby must be full-term and in the Frank breech position
· There are no signs of distress and heart rate is monitored
· Labor is going along well, the cervix is dilating properly and baby is moving downward
· The baby is neither too large nor too small to pass through the mother's pelvis
· The room is set up for an emergency c-section if it becomes necessary
How You Can Help Baby Turn Around
There are some natural ways a woman can help her baby turn that are worth trying if a vaginal birth is desired.
· The breech tilt is best done on an empty stomach and during a period of time when the baby is active. Lying on the floor, use solid pillows to raise the hips 12 inches (30cm) off the floor. Repeat this three times a day for 10 to 15 minutes at a time.
· Babies are able to hear external sound quite well. Using music or a vocal recording, place earphones on the lower abdomen. The baby may move toward the sound and out of the breech position. This method has been effective in some cases.
· Homeopathic medicines have also been effective; however, a trained holistic practitioner should be consulted before taking any type of homeopathic treatment.
If your baby is in a breech position, it is possible for your doctor to turn the baby using a special technique called external version. Learn more about the options for delivery in our article in this section.