Understanding breech births

Published by Baby Bunting on Sunday, January 27, 2019

Most babies that are born via the vaginal canal will be born head first. They usually settle into this position in the final four to five weeks of pregnancy as room gets tighter in the uterus. However, around 3% of babies that carry full-term settle into the breech position in the days leading up to their expected birth.

What is the breech position?

The breech position describes when a baby’s head is upright in the womb and their feet or bottom are positioned down towards the cervix.

How is the breech position detected?

In the weeks leading up to your due date, your specialist will see whether your baby has turned. At first they will use their hands by pressing them against your belly to determine the baby’s position. If they suspect that your baby might be in the breech position they can use an ultrasound or a special X-ray for confirmation.

Can breech-positioned babies be turned?

This depends on how early the position is picked up. Usually babies must be turned between weeks 32 and 37 if a turn will be successful. This manual process is called an external cephalic version (ECV).

However, this is not always possible and your specialist will discuss your options.

What happens if a breech baby can’t be turned?

If a breech baby can’t be turned, your doctor might discuss the option of having a caesarean.

Depending on the circumstances, it might be possible for the baby to be delivered vaginally. This can sometimes be the case if:

  • The delivery team has experience in delivering breech births.
  • There are no other known complications that could endanger you or the baby, such as the placenta blocking the baby’s passage.
  • The hospital is prepared to deliver an emergency caesarean.

How does a breech birth work and what are the risks?

The process for a vaginal birth when the baby is delivered head first is made easier by the baby’s head opening the passage for the rest of the body to follow.

Because this is reversed in the breech position, delivery is more difficult. Usually it is assisted by a breech birth-experienced midwife or doctor, and sometimes delivery can involve the mother adopting a kneeling or hands and knees position.

Anaesthesia will be available and forceps may be used to assist the baby’s passage. A cardiotocograph will also be used to monitor the baby’s heart beat – breech births risk a squeezed umbilical cord, limiting blood and oxygen supply to the baby.

If the baby’s progress slows or there are any signs of complications, an emergency caesarean will likely be recommended.

You should discuss what to do in the event of a breech birth as part of your birth plan with your specialist. Although there is an increased risk to you and the baby with breech-positioned babies and breech births, it can sometimes be managed with proper specialist care.

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