Baby’s position

It’s never too early to try and get baby into a good position for birth (and I discuss lots of ways you can do this on my hypnobirthing and pregnancy yoga courses).
The later on in pregnancy you get, the less room there is for baby to turn, but there are still plenty of things you can do in the last few weeks to try and get your baby to turn.

How common is it?

At 25 weeks, approximately 25% of babies are breech.
This has reduced to around 7% by 35 weeks. Only about 3% of babies remain in the breech position at full term.

What does breech mean?

If you aren’t already aware, there are actually 3 different positions a breech baby could be in.

Footling Breech (also known as incomplete breech) where baby has one or both feet positioned to be born first.
 

Breech baby
 

Frank Breech where baby has buttocks presented first and legs are sticking straight up to their head.
 

Breech baby
 

Complete Breech where buttocks are presented first and knees are bent with feet down near the buttocks.

Breech birth
 

Vaginal breech birth

First of all I hope that vaginal delivery has been discussed as an option and you’ve been given all the relevant information to make a properly informed decision. If not, go back to your consultant and get all the information you need from them and open the discussion up, although obstetricians aren’t always the best people to talk to about vaginal breech birth as this is a midwifery skill so if you haven’t already, make sure you also speak to a consultant midwife. Find out what support there is locally to you for breech vaginal births. Some areas have more experience and are much more supportive of this option.

The key factors for a successful vaginal breech birth are:

  • Being informed and confident in your decision
  • A supportive midwife who is experienced in vaginal breech birth
  • A hand off, physiological birth with minimal intervention
  • Remaining upright in labour and avoiding lying on you back to deliver
  • Understanding the labour process and how you can help the labour go as smoothly as possible

A very experienced midwife who has supported many breech vaginal births both at home and in hospital, Mary Cronk, suggests moving around actively during the 1st stage of labour, and then delivering the baby on hands and knees. She points out that breech babies born vaginally may need help to get them breathing after birth, but that this is likely a safety mechanism by the baby to protect them during the birth so they don’t breathe too soon.

It is possible for a breech baby to turn naturally during labour.

Turning baby
There are some old wives’ tales for turning a breech baby which you might like to try:
Torch

Place a torch against your bump in front of your baby’s face (this only works if you know which way your baby is facing), then slowly move the torch down towards your pelvis. This apparently works because babies will move towards the light.

Frozen peas and hot water bottle

Hold the hot water bottle at the bottom of your bump and the frozen peas on the top. This one apparently works because baby doesn’t like the cold and will turn towards the warmth.

Other options
Forward leaning inversion & breech tilt

The website www.spinningbabies.com has loads of information about positioning a baby.

The forward leaning inversion is here: http://spinningbabies.com/learn-more/techniques/the-fantastic-four/forward-leaning-inversion/
so you do this for 30 seconds and then follow with
the breech tilt: http://spinningbabies.com/learn-more/techniques/other-techniques/breech-tilt/

Please read the pages carefully before trying anything. 

Moxibustion

This is a part of Chinese medicine and involves burning a stick called moxi close to the acupuncture point on the outside edge of your little toes. I know this sounds like a strange one for a lot of women but it really has worked to turn babies on many occasions. I would advise you go and see an acupuncturist who specialises in pregnancy, they will often usually give you some moxi sticks so you can continue the treatment at home. 

Some studies have show moxibustion to be more effective at turning babies than ECV (below) so it is definitely worth considering.

Chiropractic care

I would always advise my clients to see a chiropractor specialising in pregnancy if their baby is breech (and in many other circumstances). You may wish to find one who is trained in the ‘Webster’ technique as this is a highly successful approach in helping to turn babies head down. But if not, one that specialises in pregnancy should be able to help you.

External Cephalic Version (ECV)

This is a procedure performed by an obstetrician who will attempt to turn your baby by placing their hands on your bump and manipulating the baby into a head down position.

It is usually offered after 37 weeks and overall it has roughly a 50% success rate, although each consultant has their own personal success rate so you might want to find out what your consultants rate is.

There is substantial evidence that ECV can reduce the caesarean section rate by turning a breech baby.

It is important to note that this procedure can be extremely uncomfortable for mum, and also carries risks so, as always, make sure you are fully informed before making any decisions.

Caesarean Birth

If you make the informed decision to go for a planned caesarean birth then there are many ways to make this more ‘family centred’ and this is something I always discuss with my clients to improve their experience, their bonding, their recovery and their breastfeeding journey.

Baby knows best?

It is worth noting that there may be a good reason why baby is in the breech position such as a short or tangled cord, or the placenta being in an unusual location so perhaps if you have tried to turn it unsuccessfully then baby is in the right position.