Breech babies are too often approached by care providers as a complication for which parents are offered very limited options when preparing for the birth. However, many experienced midwives would prefer to describe breech presentations as a variation of normal and advocate for more choices to be available.
In this post, I'm sharing 10 things every Mama should know about Breech babies.
This is an invitation to get curious and to ask more questions about your options if your baby is settling in comfortably head up at the end of your pregnancy... because the key to ANY positive birth experience is to feel in control of your birth choices, WHATEVER they are.
1. Breech babies are rare.
Fewer than 4 in every 100 babies are in a breech presentation at term (37 weeks).
If you are reading this at 30 weeks and have been told that your baby is breech, please reframe it as; "my baby simply hasn’t turned yet".
You can read a previous post I wrote about things that you can do to help baby move into a more optimal position during the third trimester here.
2. External cephalic version (ECV).
If your baby is breech at 36 weeks of pregnancy, your healthcare professional will discuss the option of trying to turn your baby into a head-first position by external cephalic version (ECV). An ECV involves applying pressure on your abdomen to help baby turn and move into a head-first position. The success rate of ECVs is about 50%. As for every intervention, please make sure that you’re given all the benefits and risks before making a decision.
3. Other options to help Breech babies turn
The Webster technique (Chiropractic care), Biomechanics for pregnancy and birth techniques (Spinning Babies), Hypnotherapy, Moxibustion (Traditional Chinese medicine therapy) and Acupuncture can also help babies turn.
However, some babies have good reasons to settle into a Breech position so it’s important that you tune in and listen to your intuition before trying anything. Also, who knows, your baby might still rotate into a more optimal position by themselves during the birth itself!
4. With Breech births, less is more...
Epidural anaesthesia and interventions such as labour augmentation with synthetic oxytocin should be avoided in breech vaginal births.
Equally, as the baby is born, care providers may support the body, but should avoid interfering or using traction.
5. Women should always follow their instinct and move freely during birth however...
‘All fours’ is recommended as the easiest and safest position to birth a breech baby vaginally.
6. This is still 'Your baby, Your birth, Your choice!'
The decision on how and where to have your baby rests ENTIRELY with you. Your midwife or obstetrician SHOULD discuss the implications of a breech presentation in depth with you, and give you CLEAR OPTIONS for care, but although they may advise you to follow a certain path, these decisions are YOURS.
7. A variation of normal
Many experienced midwives would approach a breech presentation as a variation of normal labour and not an abnormal situation or a complication. If you feel that the care you are receiving is not reflecting that, you can ask to be supported by a more senior care provider with physiological breech birth experience. If this is not available in your trust, then maybe an independent midwife would be able to offer the support you need.
8. A first breech baby doesn't mean that your second will also make a breech grand entry.
Statistically less than 10% of women who have a previous breech birth will have a subsequent breech baby.
9. There are 4 types of breech presentations:
A frank breech: baby's legs are up next to its abdomen, with its knees straight and its feet next to its ears. This is the most common type of breech.
A complete breech: baby appears as though it is sitting cross-legged with its legs bent at the hips and knees.
A footling breech: one or both of baby's feet are born first instead of the pelvis. This is more common in babies born prematurely.
A kneeling breech: baby is born knees first.
10. Cord Prolapse. What are the odds?
The risk of umbilical cord prolapse - when the umbilical cord drops down the birth canal and become compressed reducing oxygen supply to baby - increases with breech babies. Data shows that cord prolapse remains quite rare for frank breech babies. However, incidence increases considerably with other breech presentations. Among full-term, head-down babies, cord prolapse occurs in 0.4 percent of birth. Among frank breech babies the incidence is 0.5 percent, among complete breeches 5 percent, and among footling breeches 15 percent.
“Breech is a variation of normal. My birth was mesmerizing, far from normal!”
-words by Mama @_kiana.nicole
If you are looking to learn more about breech birth, the midwifery.org.uk website is a great source of information. It includes precious notes from independent midwife Mary Cronk who has written a lot on this subject. The AIMS website is also another fantastic platform to find information about birth and get free individualised support.
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