Perhaps you’ve heard of a breech baby, or you’ve found out your baby is in a breech position. You might be thinking: What does the word “breech” mean? Is my baby unsafe in a breech position? Can I still have a vaginal birth? Or do I have to give up my planned vaginal birth for cesarean birth?
We know the fear of the unknown—especially during pregnancy, such a precious time in your and your baby’s life—can be scary. Every mother wants her baby to be born healthy, and our goal is to help you take the proper steps toward ensuring your best possible pregnancy and delivery.
Today, we’re here to answer your questions about breech births, offer advice on how to promote the best outcomes for your breech baby, and reassure you that no matter what type of delivery you have, you’re already a fantastic mother.
What Does it Mean When “Baby is Breech?”
Right around your due date, most babies are positioned head-first in your uterus for vaginal delivery. This allows the baby’s head to be the first thing out when they emerge into the outside world for the first time. However, a baby sometimes assumes their delivery position bottom-first or feet-first.
This phenomenon is called a breech birth or a breech baby. Babies can assume a breech presentation early in pregnancy, and most turn to head down on their own by the time of delivery.
Why is My Baby Breech?
Premature babies, babies part of multiple births (twins, triplets, etc.), or babies in the presence of an abnormal level of amniotic fluid or an abnormal shape of a mother’s uterus can all lead to a breech.
As you approach labor and delivery, your doctor will be able to tell you if your baby is breech or not through a physical exam, ultrasound, or both. If your baby is breech, here’s what to expect.
Types of Breech Positions
When in any type of breech position, your baby’s bottom sits in a downward position toward the birth canal, and his or her head is faced upright. There are a few varieties of breech presentations which your baby can take on. These types of breech positions include the frank breech, footling breech, and a complete breech.
Frank Breech
Frank breech babies have their feet near their face with legs sticking straight up in a V shape at the front of their body. This position can make it very challenging for the baby to pass safely past the mother’s pelvis through the birth canal.
Footling Breech
With the baby’s body still in an upright position, a footling breech presentation occurs when a baby’s feet point downward because one or both of their legs are hanging below them, below the baby’s buttocks. When delivered by vaginal breech birth, a footling breech baby’s legs and feet will be the first part of their body to leave the birth canal.
Complete Breech
As if they’re sitting “criss-cross apple sauce style,” a baby in complete or “flexed” breech position will have their feet touching or tucked under their bottom due to their legs being crossed at the front of their body.
Health Risks and Precautions When Your Baby is Breech
You should be seeing your doctor regularly throughout your pregnancy. If your baby is breech, they can tell you early on, monitor the situation, and help you plan what to do. There are several ways that can get most breech babies to the ideal head-first position for normal vaginal delivery, and your doctor may suggest some natural methods to try.
These will likely be the first attempts to help your baby reach a vertex presentation if you’re still in an early pregnancy stage, at a time when there aren’t any immediate health concerns for you or the baby. Another option is to do a procedure called the external cephalic version. If your pregnancy is further along, your doctor may go ahead and schedule a c-section.
External Cephalic Version (ECV)
External Cephalic Version, or ECV, is one way to turn your baby around to a vertex presentation for regular vaginal deliveries. It involves your doctor applying pressure to your stomach to turn the baby from the outside with the help of an ultrasound.
Risks Associated with ECV
Though the risks of ECV are minor and rare, they include:
- Early-onset labor
- Umbilical cord prolapse
- Premature rupture of the membranes
- Minor blood loss for either you or the baby
- Fetal distress leading to an emergency c-section
When Do I Avoid ECV?
Many women who have totally normal pregnancies set on a planned vaginal delivery can have ECV, but you shouldn’t have ECV if you have:
- Vaginal bleeding
- An abnormally shaped uterus or a reproductive system with abnormal growths
- Placenta previa is a condition that causes a mother’s uterus to be entirely or partially covered at its opening by a low-lying placenta.
If your placenta covers your uterus, your doctor will likely perform a cesarean delivery despite your baby’s position. - A low level of amniotic fluid in the sac surrounding your baby
- An abnormal fetal heart with certain birth defects
- Premature rupture of the membranes
- Twins or more than one fetus
ECV is usually done in a hospital toward the end of pregnancy, around 37 weeks. Before the procedure, the doctor will do an ultrasound to confirm that your baby is, in fact, breech. They’ll likely use electronic fetal monitoring to check your baby’s heartbeat and ensure it’s normal.
What Happens During an ECV Procedure?
You may be given medicine to relax your uterus and pelvic muscles by injection or IV. It’s completely safe and won’t hurt your baby at all.
You’ll lie down, and your doctor will place their hands on your stomach. After locating the baby’s head, they’ll gently try to turn the baby to the head-first position using gentle pressure. After this, your baby’s heart rate will be monitored again to make sure everything’s still normal.
If the ECV is successful, you shouldn’t have to stay at the hospital, and the likelihood of having a normal vaginal delivery is very high.
Does ECV Guarantee Normal Delivery?
Not necessarily. There is a chance that your baby could turn back around. The success rate of ECV depends on a few different things:
- How close you are to your due date
- How much fluid is surrounding your baby
- How many times you’ve been pregnant
- How much your baby weighs
- How the placenta is positioned
- How your baby is positioned specifically
- How your baby’s knees are positioned
Vaginal Breech Birth and Other Options
If an ECV is not successful, you still have options. Your doctor will discuss delivery with you, the pros and cons of having a vaginal breech delivery or cesarean delivery (c-section birth), and repeating the ECV closer to your due date.
Natural Methods
Although not backed up by much scientific evidence, natural methods have been known to help encourage your baby to turn on its own. These methods include different exercise positions, certain stimulants, and alternative medicine. Here are a few you could try at home.
Breech or Pelvic Tilt
Lie on the floor with your legs bent and your feet flat on the ground. Raise your pelvis into a bridge position, and hold the position for 10 to 20 minutes. You can try this three times a day, and it may help to try it when your baby is incredibly active and moving around.
Inversion
You can use gravity to help turn your baby by resting in the child’s pose for 10 to 15 minutes. You can also rock back and forth on your hands and knees, making circles with your pelvis to promote activity.
Music
Certain sounds may appeal to and excite your baby! Place headphones or a speaker at the bottom of your stomach to try to encourage them to turn heads down on their own.
Temperature
Much like music, your baby may have a preference for different temperatures. Try placing something cold at the top of your stomach where the baby’s head is. Then place something warm—not hot—near the bottom of your uterus.
Webster technique
This is the chiropractic approach, meant to align your pelvis and hips and relax the uterus. The goal is to physically encourage your baby to turn its head down on its own.
Acupuncture
This ancient practice in Chinese medicine involves placing very fine needles at specific pressure points to balance your body’s energy. It can help relax your uterus and stimulate your baby’s movement.
When Breech Babies Don’t Turn to a Head Down Position
Turning your baby to a head-down position is not always possible, but it’s not necessarily bad if your baby remains breech. Most babies born breech are born healthy!
Some breech babies can still be safely delivered vaginally, although most doctors perform breech deliveries by cesarean delivery instead. This is due to a slightly elevated risk for complications for breech babies born vaginally.
Some risks associated with delivering your breech baby vaginally include:
- An injury during or after delivery
- An injury where the baby’s hip socket and thigh bone become separated
- Umbilical cord prolapse or complications—it can be flattened during delivery, which can cause brain and nerve damage due to a lack of the baby’s supply of oxygen from the damaged umbilical cord
Remember that breech babies are common and don’t necessarily indicate any serious problems. Consult your doctor and figure out what will work best for you and your baby.
For More Advice on Delivering A Breech Baby + More
Whether you know you’re giving birth to a breech baby, need advice on breastfeeding, or need tips on infant care, we’re here for you!
Our maternal medical care team in the Women and Children’s Pavilion at RMC in Anniston welcomes more than 2,000 newborns each year. We have a team of specially trained OB Nurses, board-certified physicians, and top-of-the-line labor, delivery, and recovery care systems.
For all the pregnancy advice and support you need, contact Regional Medical Center—and check out our maternity blog—today!