Most babies move into a head-down position in the womb before labor begins. However, if a baby’s buttocks or feet are in position to come out first, the baby is in a breech position. There are three types of breech presentations:
- Frank breech—the baby’s buttocks are down and the legs extend straight up in front of the body with the feet up near the head
- Complete breech—the baby’s buttocks are down with the legs bent at the knees and the feet near the buttocks
- Footling breech—one or both of the baby’s feet are down
Because more complications can occur in a breech delivery, almost all breech babies are delivered by cesarean section]]> . If your baby is in a breech position as you near the end of your pregnancy, you and your doctor can talk about trying to change the position of the baby (external version) or cesarean section delivery.
Complete Breech Birth Position
Causes and Risk Factors
The reasons that a baby ends up in a breech position are not fully understood. However, breech presentations are more common when:
- A woman has had more than one pregnancy
- There are two babies or more in the uterus
- The uterus has too much or too little amniotic fluid (the fluid surrounding the baby in the uterus)
- The uterus has an abnormal shape or has abnormal growths such as ]]>fibroids]]>
- The placenta partly or fully covers the opening of the uterus (known as ]]>placenta previa]]> )
- The baby is premature
- The baby has a condition such as ]]>hydrocephalus]]> (increased fluid around the brain) that makes it difficult for it to turn in the uterus
There are no particular symptoms to indicate that a baby is breech. Some women feel kicking low in the abdomen or even hiccups above the belly-button when a baby is in a breech position. But because babies change positions often, it can be very hard to tell which way your baby is lying.
A few weeks before your due date, your doctor will try to determine your baby’s position. This is usually done through a physical exam, where your doctor feels the baby’s position through the wall of your abdomen. Placing his/her hands in different places, the doctor will try to determine the position of the baby’s head, back, and buttocks.
The doctor may also listen for the position of your baby’s heartbeat or use an ultrasound]]> to determine your baby’s position.
If your baby is still in the breech position in the last weeks of pregnancy, talk with your doctor about the best treatment plan for you. Treatment options include the following:
External version is a nonsurgical procedure in which the doctor tries to turn the baby from the breech to the head-down position by gently pushing on the mother’s abdomen. External version is usually performed 3-8 weeks before the due date. The procedure is successful more than 50% of the time, but sometimes a baby will turn back to the breech position before delivery.
Two nonmedical exercises done during the last eight weeks of pregnancy may help encourage a baby to turn head-downward. These exercises are usually done two or three times a day for 10-15 minutes each.
- Tilt position—Lie on your back with knees bent, feet flat on the floor and with several good-sized pillows under your bottom.
- Knee-chest position—Kneeling on the floor, you lean forward until your head rests on your folded arms, making your head lower than your bottom.
Moxibustion is a Chinese remedy that involves burning a herb, Moxa, close to the skin. When attempting to turn a breech baby, Moxa is burned close to the acupuncture point which is at the tip of the fifth toe. Some studies have found moxibustion to be effective in stimulating breech babies to turn. This treatment is still being studied. However since it may help you avoid a surgical delivery if effective, you may consider talking to your doctor about it if your baby is breech.
Cesarean Section (or C-section)
Surgical delivery of the baby is the most common way of delivering a breech baby.
American Academy of Family Physicians
American College of Obstetricians and Gynecologists
The Canadian Women's Health Network
The Society of Obstetricians and Gynaecologists of Canada
Breech babies: what can I do if my baby is breech? American Academy of Family Physicians website. Available at: http://familydoctor.org/310.xml . Accessed on August 9, 2005.
Breech birth. CHC Wausau Hospital Medical Library and Patient Education website. Available at: http://www.chclibrary.org/micromed/00040740.html . Accessed August 10, 2005.
Breech births. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/labornbirth/breechpresentation.html . Accessed August 10, 2005.
Eisenber A, Murkoff HE, Hathaway SE. What to Expect When You’re Expecting . 2nd ed. New York: Workman Publishing; 2002.
If your baby is breech. American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/from_home/websiteBenefits/patient.htm . Accessed August 9, 2005.
Korte D, Scaer R. A Good Birth, A Safe Birth: Choosing and Having the Childbirth Experience You Want . Boston, MA: Harvard Common Press; 1992.
Shennan A, Bewley S. How to manage term breech deliveries. British Medical Journal website. Available at: http://www.bmjjournals.com . Accessed August 10, 2005.
Last reviewed November 2008 by ]]>Jeff Andrews, MD, FRCSC, FACOG]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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