The story of my breech baby

Close to the end of my second pregnancy, I learned that my baby was breech. She was in a Frank breech position – her bum was down, and her legs were straight up – instead of being in the usual head down position. This knowledge put me on a path that was 180° different from the one I had hoped and planned for this baby’s birth.

For my first baby, I had had an unmedicated birth with a midwife at a birthing centre, and it was an empowering experience! This time around, I was hoping for a vaginal unmedicated birth with a midwife. But the breech position my baby had adopted created a different journey for both of us.

In the weeks leading up to the birth, I tried many different flipping methods to invite my baby to turn head down. I then shifted between actively inviting her to rotate, to fully relaxing into the situation of her being breech and accepting that she was in the position she needed to be.

Knowing that there is a big part of birth that I had no control over, I realized that this maybe was the best way for her to birth. Many mothers had been in this situation before me and I wasn’t going to be the last. I found courage knowing this.

I gathered all the information and support that I could to better understand the different techniques and options that I had to choose from. This informed decision-making process greatly helped me navigate this new situation. The last few weeks of my second pregnancy turned out to be such an empowering time for me!

What is a breech position?

Most babies are positioned head down around the 36^th or 37^th week of pregnancy. Sometimes, however, the baby is positioned so their feet or their bottom would come out first during childbirth! This is called a breech presentation. Breech births occur in approximately 1 out of 25 full-term births.

There is often no clear reason why a baby settles into a breech position and a breech birth usually doesn’t affect your baby’s long-term health.

At your prenatal visits around week 32 of your pregnancy, your caregiver will palpate your abdomen or listen to the fetal heart rate to understand the position of the baby’s head, back, and bottom. Ultrasound will sometimes be used to confirm their position too.

There are five types of breech positions:

• Frank breech is the most common breech position in which baby’s bottom is down with legs pointing upward and the feet near the head.
• Complete breech is when baby’s head is up, the buttocks are down, and baby is sitting cross-legged.
• Footling breech is when baby is head-up with one or both feet hanging down.
• Transverse breech is when baby is lying sideways instead of lying vertically in your uterus.
• Oblique breech is when baby’s head is down but pointed sideways toward one of Mom’s hips.

Breech birth time line

Many babies are breech on and off throughout pregnancy without causing any concern. But after 32 weeks, it’s a good idea to try and invite baby to turn head-down. It is still fairly common for a baby to be in a breech position before 35-36 weeks as some babies turn in the last month of pregnancy and sometimes even during labor. In most hospital settings, however, if baby hasn’t turned by 37 weeks, your medical caregiver will probably want to schedule a cesarean.

Some reasons why baby is breech

Often it is unclear why a baby remains in a breech position, however, some of the common reasons include:

• Too much or too little amniotic fluid around the baby
• A shorter umbilical cord that doesn’t allow baby to turn
• Multiple pregnancy – often one twin will be in a head down position and the other in a breech position
• Uterine fibroids that prevent baby from turning
• An irregular size or shape of the mother’s uterus

Flipping a breech baby

The closer you get to your due date, the less likely it is for your baby to turn head down as baby is getting bigger and there’s just not enough room to turn head down.

These methods work on creating more space in your uterus for baby to turn:

• Rock back and forth gently on your hands and knees with your buttocks higher than your head.
• Crawl backwards on your hands and knees.
• Do five minutes of pelvic tilts several times a day.
• When sitting, maintain an upright posture. You can use an exercise ball for both comfort and mobility.
• Use Spinning Babies techniques 
• See a chiropractor trained in the “Webster” technique, a gentle chiropractic adjustment to the pelvis and sacrum that reduces uterine twisting and balances the pelvic muscles so that the baby can move into a more optimal position for birth.
• See an Osteopath who will use gentle techniques to give more space and freedom to the uterus which will allow baby to turn more easily.

These methods work on creating gentle movement to invite baby to flip head down:

• Between 33 and 35 weeks, acupuncture point stimulation, by needle or moxibustion (the acupuncturist burns mug wort herb near your smallest toe to stimulate the acupuncture point with heat) changes the mom’s hormonal levels, which in turn gets baby moving and hopefully turning.
• Use the homeopathic remedy Pulsatilla which stimulates the uterus to settle baby headfirst.

More methods you can try on your own:

• Talk to your baby and invite them to move to a head down position.
• Visualize your baby in the head-down position. Create a calm environment for your visualisation by finding a time where you can feel relaxed. Take a few deep breaths (I know at this point in your pregnancy deep breathing takes on a completely different meaning as baby is still high and is pressing on your diaphragm which can be uncomfortable)! Find an ease in your deep breaths. Imagine your baby turning head down.
• Place a bag of frozen veggies or ice near the top of your stomach (some experts and moms think the uncomfortable cold sensation sends baby headed in the other direction!)
• Place a flashlight by the pubis, the front joint of your pelvis. Coax your baby to move towards the light!
• Play music or have your partner speak or sing near the bottom of your belly and wait for your baby to (hopefully) follow the tune.

We often suggest trying various methods – you never know what will work for your baby!

ECV, or external cephalic version

If your baby is still breech at your 36-week appointment, your doctor or midwife may suggest an ECV, or external cephalic version, at 37 weeks.

At the ECV, while you’re lying down, you will have an ultrasound to verify baby’s position and levels of amniotic fluid. You might be offered a drug to relax your uterus. The doctor or midwife lifts the baby’s body with one hand and places their opposite hand on the baby’s head. They then push down into the mother’s body, and rotate baby to encourage a somersault.

It’s like a deep abdominal massage. 

According to the American College of Obstetricians and Gynecologists, the average success rate is 58 percent. This is why it’s strongly encouraged to try the version first rather than go directly to a cesarean.

What happens if your baby stays breech?

Vaginal Breech Birth

In Canada, the majority of breech babies are born by a planned cesarean birth. Why? Because most of today’s caregivers are not trained to deliver breech babies – as they once were only a few decades ago! But thankfully the training is coming back into our medical schools.

Some women do choose to have vaginal breech birth – if they can find a caregiver to help them deliver this way – as there are many health benefits to having a vaginal birth, such as a quicker recovery, less pain, more chance of having subsequent vaginal deliveries and less complications in future pregnancies.

As there are some additional risks in a breech birth, vaginal breech births take place in the OR and caregivers strongly suggest taking an epidural, in case you need to have an emergency cesarean during your birth.

There are also some criteria that must be in place when having a vaginal breech birth, such as:

• baby being in frank or complete breech position
• you are 37 weeks or more
• baby is a normal weight for this stage
• your placenta is far enough from the cervix
• you’re only having one baby
• you’re pregnant with twins and the first baby is head down
• both you and baby are in good health

What I learned from having had a breech baby

My daughter taught me that birth is a gate to life. It requires taking the time to gain knowledge, to mentally and emotionally prepare for any scenario. It was truly helpful for me to embrace the way my baby’s birth was unfolding. Knowing my choices. And having non-judgmental empathetic support. These were all key for me in having such a positive cesarean or as I like to refer to it, my belly birth experience.

If your baby is in a breech position and you’d like support during this time, let me know! I’d love to help.

Mika 

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