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During your pregnancy, around or between weeks 32 and 38 ( ideally the 36th week), the unborn baby will start settling down with his head near your cervix and then facing towards your back. However, there are about 3 to 4 percent of cases where the babies refuse to settle down and have their heads hung up high, continuing with their gymnastic skills. Perhaps, this upward position for the babies is known to be the breech position/breech birth, which may vary across;
(a) Frank breech: where the baby has their bottom down and legs up with their feet near the head,
(b) Complete breech: with their head up sitting in a cross-legged position,
(c) Footling breech: In a footling breech head up with one or two legs down,
(d)Transverse breech: where the baby lies sideways,
(e) Oblique breech: head down but pointed towards your hips.
However, even if the baby is in a breech, it doesn’t mean they would be so at the time of delivery. Most babies turn themselves around when the time comes. But, if they refuse to get out of the breech, it comes really hard for you to give a vaginal breech birth.
Thankfully, there are a few things you and your doctor can do to change their position. To know about it, read further:
What can the doctor do?
If the baby doesn’t naturally turn by the 37th week, the health care provider will most probably attempt an external cephalic version (ECV) also simply known as a version.
Here the practitioner will attempt to turn the baby out of the breech by placing their hands using firm but gentle pressure on the stomach to push the baby into the head-down position. This process isn’t painful but quite uncomfortable for the mother with, fortunately, more than half with positive results. Once that’s done, you’ll be given some medication to relax your uterus
However, in most cases, the baby might turn back to a breech position for which the doctor will attempt to flip the baby, but it gets difficult when you’re closer to the D-Day as there’s less room for the baby to move around. In cases like these, the gynecologist might attempt alternative therapies like:
- They might opt for a few relaxation techniques. These techniques include hypnosis.
- The other way to attempt to get the baby back into the breech position is Moxibustion. Here an acupuncturist burns a herb called mugwort just near the smallest toe to help stimulate the acupuncture point that tends to increase the fetal activity that helps wriggle the baby in a head-down position.
What can you do?
To help your baby out of the breech, you can try a few things. However, there’s no research proven that these methods work, but what’s the harm in trying when they do not hurt? Here’s what you can do:
- Keep your buttocks than your head and rock back and forth gently on your hands and knees.
- Try pelvic tilts for about five minutes several times a day.
- Maintain a good posture even if it means sitting upright on an exercise ball. This will help open up the pelvic area making it easier for the movement of the baby.
- Try having a conversation or let your partner speak near the bottom of your belly. Alternatively, play some music and allow some time for the baby to (hopefully) follow the tune.
- Take a bag of frozen veggies and place it near the top of your stomach. It might be an uncomfortable cold sensation, but experts have said that it sends the baby headed in the other direction.
- Simply, visualize your baby in the head-down position.
But even before we get into these odd ways to help the baby turn from the breech, how do we know if they are in that position in the first place?
Diagnosing a baby in breech presentation
In just a few weeks before the due date, your gynecologist or the midwife will determine the position of the baby. They will do so by simply placing their hands on your stomach and attempt to feel the outside of your abdomen and uterus. In cases of the baby in a breech, their round and firm head will be toward the top of the uterus and the softer to the bottom or lower in your uterus. Furthermore, to confirm they might as well also attempt an ultrasound for confirmation.
Why does the baby get into a breech position?
With no clear answers by the doctors, they have given a few possible reasons for a breech. These are as follows:
(1) The abnormalities in the uterine:
A uterus is normally shaped like an upside-down pear. However, in an abnormality, the woman develops differently that is usually detected via ultrasound before or during the weeks of pregnancy. These are often present from birth or may develop later in life due to scar tissue from a surgery like a C-section or a fibroid that is a tumor growing in the wall of the uterus, or a severe uterine infection. All of this results in less space for the baby to flip.
(2) The location of a placenta :
A placenta is low-lying that covers the cervix or is located up the uterine wall, blocking the space that is near the baby’s head. This will not allow the baby to wiggle into a downward position.
(3) The volume of the amniotic fluid :
If the amniotic fluid is too little or too much, it may result in the breech of the baby as it adds to the difficulty for the baby to “swim” around. And in cases of it being too much, they can flip into between the breech and a head-down position till the time of delivery.
(4) The abnormalities of the fetal :
This is quite a rare position that is based on the problem with the baby’s muscular or central nervous system. Adding on, even a short umbilical cord limits the baby’s movement.
(5) Multiple gestations :
If you have more than one baby, either of the babies might not be able to get into the head-down position due to less space to move around.
What are the risks in a breech position?
Before we get into the pointers, you must understand that even if you meet even one of the following conditions, it doesn’t mean your baby possibly has any of the risk factors. These factors include:
(1) If you had a baby in a breech position in the past :
In cases where the mother most probably has had a baby in the breech, there are changes of the subsequent baby to be in a breech due to similar factors.
(2) A premature birth :
If there are chances of the baby to be born earlier than the due date, there is a high chance of the baby being in a breech position. It could be as early as 28 to 34 weeks with the percentage of the babies in the breech position falling respectively.
(3) If you or your partner was in a breech position :
According to studies, there is a high chance of your baby being in a breech if you or your partner were in a breech position.
(4) Smoking :
Studies have shown that if you smoke while pregnant, there is an increased chance of the baby being in a breech position.
Keeping all of this in mind, what happens if the baby is still in a breech position on the delivery day? Is a vaginal breech birth possible ?
Imagine yourself arriving at the hospital for a scheduled C-section and you are waiting for the health care provider for a version before delivery. But all of a sudden your water breaks and you’re having contractions, which also means it’s too late for a version. Here, irrespective of studies that show about 85 percent of breech babies to be delivered by a C-section, it isn’t possible in this case. Therefore, the doctors would then attempt a vaginal breech delivery. It is only possible if:
1. The baby is in a Frank breech position in its full-term, which means the baby is not too big
2. It is easy for the baby to pass through if the pelvis has enough room for the baby.
3. If you haven’t experienced any pregnancy complications like gestational diabetes or preeclampsia.
4. There are no signs of distress
5. You have twins and one baby is positioned head down while the other is in breech. Here the baby in head down may open up the cervix enough and the other in breech to pass through.
6. If the gynecologist is experienced in vaginal breech births
Note – If the cervix dilates way too slowly and the baby refuses to give vaginal breech delivered vaginally, or there are other problems that arise, your gynecologist will likely opt for a C-section.
That’s all folks! This was all about the baby in a breech position and all are the possibilities and safety measures. Speaking of the D day you might as well like to add the best labor and delivery gown to your registry. View and explore Parenthood bliss’s top picks now!
Irrespective of the many complications and the sense of disappointment, you might feel keeping in mind the things that didn’t turn out how you envisioned, you’ll for sure have your heart melt once you meet the little one after their safe entry into the world. So, stay strong, trust the doctor, and be optimistic with the happiness of the much-awaited event of it all! Stay safe, stay healthy!