One of my biggest fears when I was pregnant with both my children was whether they would be in the breech position. And for a time, my first one was.
Is your baby breech? If you want a natural childbirth, a baby in a breech position will add complications. Fortunately, there are plenty of options for you and your baby.
What is a Breech Position?
Generally speaking, most babies prefer a head down position. In fact, well over 90 percent of all babies will favor this presentation at the time of birth.
A breech position is when baby is not head down. Instead, baby is butt or feet down. According to the American College of Obstetricians and Gynecologists (ACOG), 3 to 4 percent of babies are in breech position when they are full-term.
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Breech Baby Presentations
When a baby is in the breech position, there are four basic presentations:
1. Frank breech
Baby’s bottom comes first; legs are flexed with knees near the ears. Nearly 65-70 percent of breech babies are in this position. Some doctors and/or midwives will deliver these babies vaginally.
2. Complete breech
Baby is in a cross-legged position, with feet near their bottom. Some doctors and/or midwives will deliver these babies vaginally.
3. Footling breech (Single or Double)
Feet first; almost a standing like position where one (single) or both feet (double) come first. This is rare and most common with premature babies or deliveries. Cesarean sections are usually mandatory for footling breech babies.
4. Kneeling Breech
Baby is kneeling with one or both legs extended at the hips with knees bent. This is extremely rare and often not even classified as a category.
5. Footling – Frank
This is where one foot is bent like in a complete breech, and the other foot is flexed like a Frank breech.
Images from the U.S. National Library of Medicine.
While not necessarily a breech position, transverse babies lay in the womb like a hammock. This can be common in early pregnancy when baby has more room. It is rare that a first-time mom would have a baby presenting transverse at 40 weeks due to the tight fit. This is more common in moms who have had multiple babies. It is a mandatory cesarean if baby won’t descend into the pelvis.
Is Baby Breech? How to Tell If Baby Is In a Breech Position?
Hopefully, your midwife or practitioner will be palpating your belly from 30-34 weeks on to determine your baby’s position and whether you may be dealing with a baby in a breech position. While this certainly isn’t a fail-proof process, it can be quite accurate and a nice alternative to those wanting to reduce or eliminate ultrasounds.
Palpating involves your practitioner firmly pressing certain spots on your belly looking for the baby’s back, butt, and head. It will also include using a fetoscope (or less preferred, a doppler) listening for the baby’s heartbeat, which will also inform your practitioner on baby’s position. Of course, if you and your birth team still aren’t sure what baby’s position is, you can also do an ultrasound to confirm. (source)
Some mamas intuitively know the position of their babies and can feel the hardness of the head pressing against their rib cage or pelvis, whichever the case may be. Also, the biggest kicks will be where ever the feet are so that’s another indication of baby’s position. If you’re feeling a lot of kicks on your ribs, baby is likely head down, if you are feeling them in your pelvis you may be dealing with baby breech positioning.
Some mamas like to take things into their own hands and practice belly mapping. Belly mapping is not a term you will likely hear about from you’re OB/GYN or even midwives, but it’s a technique that helps empower mamas with awareness of baby’s presentation.
Starting in the 2nd trimester, baby’s wiggles can start to map a picture. Keep in mind that baby still moves around a lot at this point, so use this time to only practice the technique, by getting to know baby’s movements. Most babies settle into their “home” position, the one they will start birthing from around 32-36 weeks gestation, so belly mapping should be done during the 3rd trimester for the most effective results.
If mapping or information reveals baby is in a breech position, you might want to consider how to turn a breech baby. See this article of mine to learn how to belly map.
What Causes a Breech Position?
Breech babies can be a result of many different factors. Some of these conditions are totally out of our control. Breech babies are more common:
- In subsequent pregnancies
- In pregnancies of multiples
- When there is history of premature delivery
- If previous cesareans were preformed
- When the uterus has too much or too little amniotic fluid
- When there is an abnormal shaped uterus or a uterus with abnormal growths, such as fibroids.
- With women who have placenta previa
Why Are So Many Babies Breech?
The answer: our lifestyles. Since we lead a more sedentary and stressful life than our ancestors did, we’re seeing increased rates of babies in a breech position. Luckily, most women can still experience a natural, vaginal birth. There are many supportive techniques to turn a breech baby head down, if necessary.
Tips to Avoid Having a Breech Baby
It’s best to start from day one. Keeping baby head down is much easier than turning him. Empower yourself, as there are many daily activities you can do that will initially help support baby towards a head down position. Of course, always check with your midwife or physician before starting any activity, however, these are gentle, self-caring activities that most women can do.
Brisk walking stretches the psoas (“so-as”) muscles; this maintains flexibility, better fetal descent, as well as positioning. Walking is a great exercise that promotes great health. Start slow. Work up to a brisk pace. Walk every day. Gravity is your friend.
Sitting the wrong way is one of the biggest reasons a baby gets in a breech position. Be sure to follow these guidelines when siting.
- Sit with your back straight and the weight on your hamstrings rather than your tailbone.
- Keep your knees lower than the hips.
- Keep a nice curve in the lower back (don’t round it out).
- Sit so your belly is lower than your hips. Let your belly “hammock” your baby.
- Avoid overly soft and comfy seats; they are terrible for posture. Try a Swedish chair or an exercise ball for a straight back; belly will naturally mimic a hammock position for baby.
The spine and the abdominal wall work in harmony. They create a whole tension-compression system, rather than separate parts. The natural shape of the female pelvic wall creates an “L” shape, which wraps underneath the body and holds up the organs, which is especially important during pregnancy. As you stand and walk, let your lower back sway forward. This supports good posture and helps gravity encourage baby to move head down.
Proper sleeping positions during lie-downs or while sleeping can also be implemented during labor. Make a little pillow nest underneath your belly to lean into, which is comfortable for baby to settle into. It’s so comfy for both of you. If you want to lie on either side, make sure one hip is directly over the other at a right angle. Change sides frequently to help keep the uterus a little more symmetrically balanced.
Exercising and stretching
Optimal baby positioning exercises are the best, cheapest, easiest, and most readily available technique to help ensure baby’s head down position. It’s important to keep your body and muscles flexible and loose. Stretching helps with this, as well as circulation, metabolism, comfort, and posture, which all help create an optimal space for baby to move head down when ready.
Strengthening the pelvic wall muscles is important for any pregnant woman. It’s especially important for women who have had more than one pregnancy. As the uterus stretches and expands with each pregnancy, the risks of a baby in a breech position increases. There simply becomes more space for baby to move around and become breech. By keeping the pelvic muscles strong and tight, mama can help keep future deliveries as optimal and natural as possible.
Check out our 7 Easy Exercises for an Optimal Pregnancy & Labor for step-by-step instruction on these techniques.
My Baby is in a Breech Position. Now What?
Is your baby in a breech position? If your provider has confirmed baby is in a breech position, your provider may offer ECV (studies suggest this is a relatively safe way to turn a baby in a breech position). You can also try some natural and safe techniques for turning a breech baby. Many women have successfully turned their breech baby this way.
What If My Baby Won’t Turn Out of a Breech Position?
You have options. Though many doctors in the U.S. won’t let you deliver a breech baby vaginally, that doesn’t mean you can’t. Do your research and make sure you know what all of your options are so you can make the best choice for you and your baby.
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