Where to turn when your baby is breech?

When babies are positioned so that their buttocks or feet will be born first, we call them breech. Approximately 3-4% of all deliveries will be of breech presentation babies. The percentage of breech deliveries is higher with premature babies at 22% prior to 28 weeks' gestation, 7% at 32 weeks' gestation, and just 1-3% at term. That's roughly 1 out of every 25 full term babies breech. So, what causes babies to be breech and what can you do if you find yourself with a breech baby?

​While it isn't known what causes babies to be breech, we do know what factors increase the likelihood of you having a baby present breech. You're more likely to have a breech baby:

• In subsequent pregnancies
• In pregnancies of multiples
• When there is history of premature delivery
• When the uterus has too much or too little amniotic fluid
• When there is an abnormal shaped uterus or a uterus with abnormal growths, such as fibroids
• With women who have placenta previa
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Better Birth offers some more possibilities: 

• History of breech babies either with previous pregnancies or within your family
• Maternal age
• The umbilical cord is very short or tangled
• Issues with the amniotic sac
• Baby has immature hips
• First pregnancy as first babies are more likely to be breech
• Studies show breech is more common in women who are caucasian
• Diabetes 
• Sedentary lifestyles
• Smoking during pregnancy
• Stressful lifestyle

*You can see Better Birth on social media for more information during #breechweek 2017, Nov 5th-11th.*
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Understanding the Implications:

There are different kinds of breech presentation: 

• Complete breech: This is when the buttocks are pointing downward with the legs folded at the knees and feet near the buttocks.
• Frank breech: When the baby’s buttocks are aimed at the birth canal with its legs sticking straight up in front of his or her body and the feet near the head.
• Footling breech: This is when one or both of the baby’s feet point downward and will deliver before the rest of the body.

​When attempting a vaginal breech birth, it's crucial that baby be in the frank breech position. Other factors that are favorable to vaginal breech birth include: baby is full-term, baby does not show signs of distress, process of labor is smooth and steady, a large baby is not expected, anesthesia is available and cesarean delivery possible on short notice. 

Finding a provider who is trained and comfortable with vaginal breech birth will be the larger problem, however, as it's a disappearing knowledge. OBGYNs are simply not being trained to handle breech births with anything other than a cesarean. Dr. Berlin of Informed Pregnancy helped produce a fantastic documentary called "Head's Up: The Disappearing Art of Vaginal Breech Birth."  It's a highly informative (and short!) documentary I recommend you rent and watch if you're even slightly interested in learning more about vaginal breech birth. 
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My baby is breech, what now?:

So now that we know a little bit about what may (or may not) cause breech presentation, what can you do if you find yourself with a breech baby? 

While I would love to outline every single option for you in this blog post, it would simply be too long. So, here are some of my favorite places to get more information on breech presentation, in no particular order. I offer these in hopes to help you make your informed decisions regarding how to proceed with your breech baby. 

• Breech 101 on Informed Pregnancy Podcast
• Better Birth Blog
• Spinning Babies
• Evidence Based Birth: Breech Version
• When Breech Doesn't Flip - Birthful Podcast
  
  

Talk to your health care provider about trying different exercises from sources like Spinning Babies or chiropractic and Chinese medicine techniques as suggested in Breech 101. Ask them about the benefits and risks of external cephalic version (ECV) and read up about it on Evidence Based Birth. Search out the experience of other's and ask them about their breech birth experiences, vaginal or cesarean.

Finally, realize that the options are there, but the support and resources may be minimal. We need more doctors and midwives trained to handle vaginal breech birth. It's a knowledge we once had more abundantly but are losing in favor of a surgery that comes with it's own risks. As always, do your own research and make your own decisions! 

*This post is to participate in #breechweek 2017 in the effort to raise more awareness about this disappearing art.*

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Breech isn't the only mal-presentation for birth. For tips on how to sit, stand and move to help promote favorable positioning for birth in general, download my free PDF on Optimal Fetal Positioning (button below).

OFP - PDF