By the end of pregnancy, at 37 weeks, a small percentage of babies are found to still be breech – bottom down into the pelvis and heads up. The different types of breech positions are:
Footling breech - feet first
Complete breech - baby sitting on heels (Buddha style)
Extended/Frank breech - bottom first, with feet up by head
And the very rare
‘Kneeling breech’ where the baby is in a kneeling position.
There may be a breech clinic in your hospital where a scan is taken to assess the size and position of the baby, and the amount of fluid around the baby. An “external cephalic version” ECV will then be attempted. This is where the baby is encouraged to move by the doctor placing her hands on your abdomen and moving the baby through a somersault, and into place. It is usually attempted after 37 weeks but cannot be done if the breech is already “engaged” (down in the pelvis). It is usually easier for the obstetrician to turn the baby of a veteran mum because the muscle tone is less firm. The success rate is around 50%, though some doctors have a higher success rate.
As ECV can be quite uncomfortable women will often try natural methods including self-turning techniques, acupuncture and homeopathy before going the medical route.
Acupuncture and moxibustion (burning moxa cones or sticks on a point on the little toes) have been shown to be particularly effective. Moxa sticks (dried mugworth herb) are held a couple of centimetres away from the skin, so that there is sensation of warmth. You may be able to do this at home, once you are shown how.
Before attempting moxibustion it is important to ensure that you do not have any other complications. It is also vital that the position of the baby is checked before you begin the treatment to ensure he has not turned already.
Many obstetricians dismiss the value of moxibustion, saying that many babies will turn themselves if left alone. However, studies now suggest that moxibustion—when combined with either acupuncture or postural techniques—is safe and increases your chances of turning a breech baby.
- Do your optimal foetal positioning exercises (see blog entry in our TIps for Bumps)
Encourage your baby into a head-down position by spending time with your hips raised about 30 cms off the floor using firm pillows or cushions.
- Spend time in the knee-chest position. To do this, kneel on your bed with your bottom in the air and your hips flexed at slightly more than 90 degrees (don't let your thighs press against your bump). Try to keep your head, shoulders, and upper chest flat on your mattress. Maintain this position for 15 minutes every two waking hours for five consecutive days.
- Or, if you don’t have back or pelvic pain, try lying on your back with your hips slightly elevated and your hips and knees flexed. Gently roll from side to side for 10 minutes and repeat this manoeuvre three times a day.
- For lots more tips and suggestions, including turning techniques you can try at home including how to administer moxibustion we have a separate page dedicated to breech babies http://www.bumptobirthtobaby.com/breech-babies/
Breech vaginal births are possible, particularly with experienced and supportive carers, but many caregivers still prefer to deliver by C-Section. However, if it is not your first baby, and the breech is well down into the pelvis it may be worth giving labour a go as the cervix should dilate quickly and you will have a quicker recovery than after a C-Section.