What does breech even mean?
Babies tend to turn head down by sometime around 36-37 weeks. After this time, a baby is considered “breech” if the baby‘s bum or feet are closest to the exit [i.e. your cervix]. This happens in 3-4% of all deliveries.
So, why exactly does this happen? What causes a baby to cradle in that way as opposed to head down?
It can happen if:
too little amniotic fluid
too much amniotic fluid
uterus has an abnormal shape
fibroids in your uterus
placenta previa
What does this mean for the birther?
The main impact is on your delivery. An ECV (external phalic version) may be offered by your provider via externally turning your baby. This is successful about 50% of the time. The options if ECV doesn’t work or isn’t wanted are to deliver breech baby vaginally or schedule a planned c-section.
What does it mean for your baby?
Your baby’s heart rate may be heard higher on your belly than your provider would expect.
What is actually going on in my body to cause baby too not be head down?
Something like imbalanced muscles can cause baby to not find the optimal head down position. Also, fibroids in the uterus can be rather large and get in the way of baby changing positions easily. Another possible reason with too little/too much amniotic fluid can cause baby to either not have room to move or to have way too much room to move around and thus doesn’t remain in a head down position.
What can you try?
Daily balancing exercises from spinningbabies.com
prenatal yoga classes (live or virtual)
you can try your own “turn day” where if your provider approves, you can try the 3 Sisters of Balance found on spinningbabies.com
ECV : on or after 37 weeks , usually 2 providers work together to manually turn your baby from the outside.
moxibustion
accupuncture (call and ask locals if they treat breech pregnancies)
Chiropractic work by a Webster certified provider.
Remember. Breech babies CANbe born vaginally. The hardest part about this is finding a provider willing and skilled to help you birth. The key with a breech birth is “hands off the baby”. Some midwives are trained in breech delivery and occasionally other providers are skilled in these deliveries. Many hospitals don’t allow breech deliveries per their policies.
A provider may tell you “it is an increased danger to your baby”, but the risk of perinatal death is 2 per 1000 births compared to your head down birth losses which is 1 per 1000.
A vaginal breech birth does seem to increase risk of am initial low APGAR score (the score providers assign to a baby based on color after birth, crying, etc...) but the findings are that these babies quickly recover. The main reason for this seems to be a slightly longer cord compression right at delivery.
What can you expect in an vaginal breech birth?
Optimal positioning for the birthed is upright in a breech birth and many midwives believe the “all-fours” position can be helpful.
A provider should avoid breaking your water to help avoid cord prolapse. (Cord coming out ahead of baby).
Your provider should allow passive decent before any active pushing. Pushing should be avoided before the presenting part of your baby is visible.
Significant cord compression is common once baby’s bum has passed the perineum. This is quickly followed by the spontaneous birth of your baby’s belly/limbs that should not be pulled on as your baby needs to have their chin tucked in to birth.
I really hope all these tools and descriptions of what to expect when you hear the words “breech presentation” will help you educate yourself on what is best for you and your sweet baby And what to discuss with your provider. Feel free to reach out with any questions! I am really proud of you for learning more about your birth and options.
Love,
Alissa