What is breech?
Breech is when the baby is lying in the womb bottom first, instead of headfirst. In early pregnancy breech is very common and as pregnancy continues a baby usually turns naturally into the headfirst position. However, according to the NHS, 3 in every 100 babies are breech at the end of pregnancy.
There are 4 types of breech presentation:
Frank breech is the most common with 65% of breech babies in this position where the baby’s bottom comes first, legs extended and his or her feet near the ears
Complete breech is where the baby’s hips and knees are flexed so that the 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 but is where the 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 your baby is breech?
Most midwives will feel for the position of the baby from around 28 weeks pregnant 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 on www.hampshirehomebirths.co.uk.
If you are 36 weeks 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. Many women will have already chosen what sort of birth they want before this point and will therefore want to know how having a breech baby may change this.
What can you do to help turn your baby?
Lorraine Berry, BSc (Hons) Registered Midwife and Natal Hypnotherapist at www.birthaffinity.co.uk, suggests you try some of the following natural remedies to help turn your baby, as long as you and your pregnancy are otherwise normal and healthy.
Exercise Go for a walk. Walking uses gravity to “pull” the heaviest part of the baby downwards to your pelvis. Going for a swim or doing yoga might also help.
Cold Compress Hold a cold flannel on top of your bump and baby will try and move his head away from the cold!
Light Shine a torch down low on your abdomen to encourage baby to go and investigate
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.
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 baby is awake and therefore most likely to respond!
What is an ECV?
If your baby hasn’t turned by around 36 weeks, your doctor may offer you an external cephalic version (ECV) procedure. This is where the doctor will try to turn the baby into a head down position, using their hands but guided by an ultrasound. It’s usually performed in hospital so that your baby’s heartbeat can be monitored and his position checked.
“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 Lorraine.
What does having a breech baby mean for your labour?
Many doctors recommend having a caesarean section rather than a vaginal breech birth. However, 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, explains Karina Dyer, former NHS midwife and current independent midwife.
You can still have a home birth with a breech baby and you want a a water birth, your midwife will probably 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.
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 section.