Having a breech baby

You might have heard the terms ‘breech baby’ or ‘breech birth’ but what exactly does it mean? Here’s what you need to know…

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While it is common for your unborn baby to move around in the womb during pregnancy, what happens when you near your due date and your baby is still in the breech position?

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What is breech?

Breech is when your baby is lying in the womb bottom first, instead of head first. In early pregnancy, it is very common for your baby to be in the breech position, and as pregnancy continues, your baby usually turns naturally into the head first position. However, three in every 100 babies are in the breech position at the end of pregnancy, according to the NHS.

There are four types of breech presentation:

  • Frank breech is the most common, with 65% of breech babies being in this position. This is where your baby’s bottom comes first, legs extended and his or her feet near the ears.
  • Complete breech is where your baby’s hips and knees are flexed so that your baby is sitting crosslegged, with feet beside the bottom.
  • Footling breech is where one or two feet come first, with the bottom in a higher position. 
  • Kneeling breech is extremely rare. This is where your baby is in a kneeling position, with one or both legs extended at the hips and flexed at the knees

How do you find out if you have a breech baby?

Most midwives will feel for the position of your baby from around 28 weeks of pregnancy during routine antenatal examinations.

“Your midwife or doctor will do an abdominal palpation to feel the position of the baby. If they think the baby is breech then you will be advised to have an ultrasound to confirm this,” says Eleanor May-Johnson, independent midwife based in Southampton. 

If you’re 36 weeks pregnant or more, the ultrasound will be used to confirm whether your baby is breech or not so that you have time to discuss and plan your options before the birth. Having a breech baby can mean you have to consider alternatives to the birth you planned.

What can you do to help turn your breech baby?

As long as you and your pregnancy are otherwise normal and healthy, Lorraine Berry, a registered midwife and Natal Hypnotherapist, from Birth Affinity, suggests you try some of the following natural remedies to help turn your baby.

  1. Walking – Go for a walk. Walking uses gravity to “pull” the heaviest part of your baby downwards to your pelvis
  2. Cold Compress – Hold a cold flannel on top of your bump and baby may try and move his head away from the cold!
  3. Light – Shine a torch down low on your abdomen to encourage your baby to go and investigate
  4. Music and sound – Place a headphone low down on your abdomen, just above your pubic bone, and play music or a tape of your voice to encourage your baby to seek out the source of the sound. Your partner could also try talking to the baby from this position too, for the same reason.
  5. Massage and positioning – Lie on your back with pillows under your hips, so your hips are higher than your head. Gently massage your tummy in a circular motion, encouraging baby to do a forward roll into your pelvis. Ask your midwife which side your baby’s back is on, to massage in the right direction. Do this at a time when your baby is awake and therefore most likely to respond

What’s an ECV?

Your doctor may offer you an external cephalic version (ECV) procedure. This is where your doctor will try to turn your baby into a head down position, using her hands but guided by an ultrasound.

“This is not always a comfortable procedure to have done. However, when successful, it means you can go ahead with your plans for a normal vaginal birth without concern,” says midwife Lorraine.

An ECV is usually performed in hospital, between 36 weeks and full term, so your baby’s heartbeat can be monitored before and after and his position checked by ultrasound following the procedure.

Midwife Eleanor also suggests you could try a moxibustion treatment, which is a form of Chinese traditional medicine.

“This is where they have a piece of burning moxa, which is a herb rolled up like a cigar and burns like one too, held near their little toe. This creates uterine and foetal activity and has a 75% success at helping breech babies to turn, with no known side effects,” says Eleanor.

“Women can also look at doing some exercises like swimming and yoga to help the baby turn. Try Spinning Babies for yoga positions and ideas to help your baby turn,” adds Eleanor.

What a breech baby means for your labour

Every mum-to-be is different when it comes to choosing the right birth. Most doctors will recommend having a caesarean rather than a vaginal breech birth. Research from 2004 suggests it’s safer for breech babies to be born this way. However, Karina Dyer, former NHS midwife and current independent midwife, says that this research has since been challenged.

“Some midwives and doctors feel that a vaginal birth is just as safe, provided that the midwife or doctor has the skills and experience needed to help a woman give birth to a breech baby vaginally. Further studies have supported this view, so there are really no hard or fast rules here,” explains Karina.

Karina suggests you discuss this with your obstetrician and midwife, as every case has to be looked at individually because of the many different factors including age and obstetric history.

You may still be able to have a home birth with a breech baby, although some professionals will not recommend this option because your baby may need resuscitation after birth, says independent midwife Eleanor.

“If a water birth is what you want, your midwife will most likely advise you that you can labour in a birth pool but when it comes to the actual birth you will need to get out. This is because gravity is needed to birth the baby effectively,” explains Eleanor.

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Around 50% of women who start labour with a breech baby will successfully go on to give birth vaginally, while the remaining 50% will require a caesarean. Talking to your doctor will help you understand what is best for you and your baby.

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