Breech Baby – everything you need to know

What is Breech?

Babies lying bottom first or feet first in the uterus (womb) instead of in the usual head first position are called breech babies. At term only 3 to 4 out of 10 babies are found to be in breech position.

Why is your baby breech?

In most cases it is only a matter of chance that a baby does not turn and remains in the breech (bottom down) position. In a few situations, certain factors make it difficult for a baby to turn during pregnancy. These might include the amount of fluid in the womb (either too much or too little), the position of the placenta or the presence of more than one baby. Most breech babies are born healthy.

Causes of breech presentation 

• Grand multipara (has had more than 3 children before)
• if a woman is pregnant with multiples
• if a woman has placenta previa
• if the uterus contains either too little or too much amniotic fluid
• if the woman’s uterus has an abnormal shape or other problems such as fibroids

Breech baby positions 

• Extended or Frank Breech- the baby is with the bottom first with the thighs against its chest and feet up by its ears
• Flexed breech –the baby is with its bottom first with its feet right next to its bottom
• Footling breech – when one or both of baby’s feet are below its bottom

Turning a breech baby: is it possible? 

If there is a case of a breech presentation, you can try to turn the baby. ECV is usually performed after 36 or 37 weeks of pregnancy. However, it can be performed right up until you are in early labour. You should discuss all the options with your obstetrician and follow their recommendations.

Medical technique

External Cephalic version (ECV): This is a non-surgical method of turning a breech baby in the uterus.  During the procedure, your gynaecologist will give you medicine to help your uterus relax. Before the ECV you will have a bedside ultrasound to check baby’s heart beat and position and after the ECV it will be done again to check if the baby has turned with head down position. The success rate is around 40% to 50% and depends on the skills of your obstetrician.

ECV can be uncomfortable and painful at times. Your obstetrician will stop if you are experiencing pain. Procedure usually last for few minutes. Fetal heart is monitored for an hour after procedure and you will be advised to go home with follow up plan.

If your blood type is Rhesus D negative- you will be advised to take anti D injection.

Natural techniques

There is no scientific evidence, but one may try this technique.

The breech tilt: While lying on your back, use large, firm pillows to raise your hips about a foot off the floor. Do these three times every day for 10–15 minutes. You can do this technique when the baby is active and on an empty stomach.

Vaginal breech delivery vs. Caesarean breech birth 

If your baby remains breech towards the end of pregnancy, you should be given the option of a caesarean section. Research has shown that planned caesarean section is safer for your baby than a vaginal breech.

Your gynaecologist may attempt breech vaginal delivery after discussion with you it in the following situations:

• Your baby is in frank breech position and is full term
• Your gynaecologist has been monitoring your baby’s heart rate, and there are no signs of distress
• The labour proceeds smoothly and steadily with the cervical opening widening with the descent of the baby
• The baby isn’t too big, or the woman’s pelvis is too narrow for the baby to pass safely through the birth canal
• Anaesthesia and the possibility for caesarean section are available on short notice

While a successful vaginal birth carries the least risks for you, it carries a small increased risk of your baby dying around the time of delivery. A vaginal breech birth may also cause serious short-term complications for your baby. However, these complications do not seem to have any long-term effects on your baby. Your individual risks should be discussed with you by your gynaecologist.

Consult Dr. Deepika Aggarwal, best obstetrician and gynaecologist at the CK Birla Hospital in Gurgaon to learn more about this condition and discuss your individual risks. Book your appointment today!