Abnormal Position And Presentation of The Fetus – How To Turn a Breech Baby?
For a successful delivery of a child, everything should go smoothly right from the day 1 of pregnancy till the childbirth. Sometimes the pregnancy seems to be getting through all the phases normally and at the end, some unwanted things create problems in the delivery room. One such condition is when the child represents abnormal position during delivery, also known as breech position.
A breech baby is often a term used for a baby who is not in the head down or vertex position. Typically, this means the head and feet of the baby before the delivery is positioned opposite i.e. head up and feet down towards the birth canal. As head is the largest part of a baby, when it comes first, the rest of the body slips right out easily.
Most babies will naturally come into normal position before birth i.e. head down position. But this is opposite in the case of breech position. This could create challenges for both mother and the baby. According to an estimate, 3-4 percent or 1 out of 15 cases will result in baby being breech.
What causes a breech pregnancy?
Breech position can be divided into various types including frank, footling and complete breech, depending on the position of the baby in the uterus. In all these types, baby’s bottom will be towards the birth canal. What causes a baby to go in these poses is exactly unknown. But according to American Pregnancy Association, there are some factors why a baby might position itself in the wrong way. These are:
- Childbirth several times before
- Carrying multiple babies
- Abnormalities in the uterus
- History of premature birth
- Abnormalities in the baby
- Low lying placenta (placenta previa)
- Too much amniotic fluid (polyhydramnios)
- Little amniotic fluid (Oligohydramnios) to move around
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How is breech position diagnosed?
How will I know the baby is in breech position? This would be the question in mind. A baby is not considered in a breech position before a couple of weeks of the mature term (37 weeks). Before this term, it's normal for a baby to be in any position. After this term as the baby start getting bigger and runs out of space in the womb, it becomes difficult for the baby to turn or get into the correct position.
The doctor will first physically examine this by placing hands on the lower abdomen. If the doctor suspects the baby might be in a breech position, he would use an ultrasound to confirm it.
Are there any complications of breech position?
Normally, breach pregnancies are not harmful until the time of delivery has reached. And when the delivery date is near, there is a risk of baby getting stuck in the birth canal. The oxygen supply coming from the umbilical cord can also break up.
Are vaginal deliveries safe when baby is breeched?
In this situation, the most important thing is to how safe the child can be delivered? Before cesarean deliveries became common, the midwives were trained to handle breech deliveries safely. Factor that might make vaginal delivery successful is the baby weighing between 2 to 3.8 kgs. Another factor that is considered positive is the baby being in frank breech position (feet straight up).
However, breech vaginal deliveries do have complications. So the best bet is to deliver the child via c-section.
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Can a breech position corrected?
While most of the pregnant women will be scheduling a c-section, there are ways to turn the baby. Success rates may vary but as long it is tried safely, there is no harm. Here are some methods:
External Cephalic Version
This procedure is generally performed around 37 weeks in the hospital. You must have an adequate amount of amniotic fluid to be a candidate of this procedure. The team of two doctors or nurses will try to manipulate the baby with their hands. During the procedure, the baby will be continuously monitored via ultrasound and medications to relax the uterus. The success rate of EV is 50 percent, as per American College of Obstetricians and Gynecologists.
Inversion or Tilt position
In this method, the body of the woman is inverted to encourage the baby to flip position. Women try various methods such as tilt position; lying on their hands with feet on sofa or bed and different yoga poses. The theory behind this is that it helps elevate the pelvis. The baby’s head would then disengage from the pelvis and turn down. Some women might face dizziness, so always consult a trained nurse or doctor before trying this method.
Some also try essential oils such as peppermint oil on the stomach to stimulate the baby to turn on its own. As always the case, check with your doctor before using any kind of oils as some may be not safe for pregnant women. Some other uses light music directly on the pubic bone to encourage the baby to turn position. Many women have tried this and reported success as it doesn’t have any side effect.
Many pregnant women also try alternative methods. These include homeopathic plant called pulsatilla, acupuncture technique moxibustion and also chiropractic technique called as Webster technique. Speak to the respective practitioners before trying these procedures.
Treatment - Is cesarean the last resort in case of breech position?
In most of the cases and if the baby is near the due date, the only option left is to go for a cesarean. However, in rare cases such as when breech labor progresses too quickly, vaginal birth might be the only option in hand.
Every labor and delivery will be unique. So your doctor will be the only one that would let you know the best possible solution in this case. If you are close to 37 weeks of pregnancy, have a word with the gynecologist and know the risks and benefits of both vaginal and cesarean delivery.