Registered midwife Pippa Hime explains what you need to know, and what you can do, if your baby is breech.
During pregnancy, your baby will assume various positions in your uterus and you, and your doctor, will soon have a clear idea of where his head, feet and hands are lying. You may find that your baby’s position changes regularly, but most babies move into a head-down, or cephalic, position between 32 and 34 weeks gestation and remain there until birth. However, about 5% of babies will be in a breech position on their due date.
What breech means
There are different types of breech positions, depending on how your baby is lying.
- A frank, or extended, breech is when your baby has his bottom in your pelvis with his feet up towards his face, almost kissing his toes.
- In a complete breech, your baby is sitting cross-legged in your pelvis.
- An incomplete breech means that one of your baby’s feet will present first.
If you feel an increased amount of pressure on your diaphragm from your baby’s head, or feel regular kicks into your bladder or deep into your pelvis, your baby may be breech.
Why is your baby breech?
He may simply find this position more comfortable, but the location of the placenta can play a role. If the placenta is lying low in your uterus, a condition known as placenta previa, your baby is more likely to be breech. Also, if you have an irregular-shaped uterus or any history of fibroids, your baby may end up in the breech position. Whatever the reason, if your baby remains head-up past week 36 of pregnancy, you are more likely to have a breech delivery.
Just as with any pregnancy, there are two ways for your baby to be delivered. A C-section is often favoured for breech babies, but a vaginal birth may be considered if you have had a previous vaginal delivery without complications, your baby is on the smaller side, there have been no other pregnancy complications, and your doctor or midwife is confident in delivering a breech baby.
Getting baby to turn
In the last few weeks of pregnancy, there are a few things you can do to help your baby turn naturally.
- Some mothers have reported their babies turning after they have played music or shone a flashlight onto the bottom of their stomachs. The babies then turn their heads towards the sound or light.
- Doing prenatal yoga.
- Doing regular hip tilts, also know as the breech tilt. This involves raising your hips about 30cm off the floor and remaining in the position for a few minutes. Use large cushions to support your back and keep you relaxed.
- Failing this, chat to your healthcare provider about external cephalic version. This is when your baby is manually turned by pressure deliberately applied to your stomach. It is usually done at around 36 weeks and is only considered for mothers with no other risk factors, and no history of bleeding in pregnancy. It is usually more successful in those with plenty of amniotic fluid.
There are always concerns about a breech vaginal delivery as the baby’s head could get stuck in the birth canal, which can deprive the baby of oxygen. To avoid this risk, a C-section is often recommended.
Cord prolapse is another concern. Since a baby’s bottom doesn’t fit as snuggly as the head does into the pelvis, there is a risk that the umbilical cord could slip down into the birth canal. This can lead to compression of the cord, which deprives the baby of oxygen.
If this happens, you will be directed to get onto all fours with your bottom higher than your head to relieve the pressure on the cord. This is an obstetric emergency and will be dealt with as a matter of urgency.
Babies who are breech are more likely to suffer from hip instability or dysplasia as a result of having limited mobility in the womb. This means that most babies born in the breech position will have to have an ultrasound of their hips after birth. Your baby may also have what is known as positional clubfoot, which will usually remedy itself over time, but you may be referred to a paediatric orthopaedic doctor for further assessment.
Pippa is a Registered Professional Nurse and trained as a Registered Midwife at Chris Hani Baragwanth Hospital. She has extensive experience in all things baby related with a special interest in preparing couples for the exciting journey of parenthood as well as supporting them in the weeks that follow the birth. She and her husband Richard are the proud parents of Becca age 6 and Tom age 4. Pippa has a comprehensive private clinic service that includes Childbirth Education classes, a Well Baby Clinic including Immunization as well as Post Natal and Lactation support. With over 5 years of running a private clinic facility and raising 2 children Pippa comes with a wealth of knowledge and first-hand experience of parenthood. Learn more about Pippa Hime