Breech babies and what to do about it

Breech position baby

What is a Breech position and what you can do about it?

To understand the situation of a breech baby and breech delivery, you have to fully understand what the term implies and what are the options that you have. So, what is the breech baby? Usually during the latter weeks of your third trimester the baby assumes the head down position towards the birthing canal and stays that way for the impending birth. Contrary to this, a breech baby is one who is lying with the head touching the diaphragm and the legs pointing to the birth canal. Your baby moves around a lot during the pregnancy, but by the eighth month, your baby will normally settle down in a heads-down position. However, some babies end up positioned in a bottom-down position. This happens to about 3-4% of the babies and these are termed as Breech babies.

Techniques to turn a breech baby

If, by the time it is to deliver, your baby is still in breech position, your doctor may try to bring it in heads down position manually. This is called external cephalic version (ECV), and can be done only after completing 36 weeks. You doctor will perform ECV by placing her hands on your abdomen. She applies firm pressure to the abdomen such that the baby rolls into a feet-up position. Two medical professionals are needed to perform an ECV. Ultrasounds are used to help guide the turning and to monitor the baby. ECV is done near the operating room so if a problem occurs or if the baby goes into distress, a c-section can be performed right away.

This process is painful as it is done manually by your doctor. Also, usually it is done only to mothers who have delivered previously because it is easier in such cases. However sometimes a baby may rotate back to a breech position even after ECV.

Complications that can occur due to a breech position

In a breech position of the baby, the body comes out first, which leaves the baby’s head to be delivered later. Additionally, the baby’s head which usually stretches the cervix and allows the head to come easily is up and thus dilation of the cervix does not happen the same way. There is the risk also that the baby’s shoulders could become wedged in the mother’s pelvis. Another problem that could happen in a normal breech delivery is a prolapsed umbilical cord. This means that the cord could slip into the birth canal even before the baby is delivered.This could lead to the cord becoming pinched, which in turn will lead to a decreased flow of blood and oxygen through the cord to the baby.

Is C-section necessary if my baby is in the breech position even at the time of delivery?

It is completely possible to deliver normally even if your baby is in the breech position. After all for centuries, women didn’t even have the choice of c-sections and doctors were trained to deliver breech babies. However, in India, breech babies are normally delivered via caesarean section as it is considered safer to do so. But with experienced doctors and strict guidelines, it is possible to have a safe normal delivery for a breech baby.

Your doctor will consider your wish to have a vaginal birth only if:

  • You have delivered vaginally before
  • An anesthetist is available in event of epidural or assisted birth.
  • Facilities for the C section are available in the same hospital

Talk to your doctor on the risks and benefits of either delivery techniques and make a decision based on what is the best for your baby and for you.