Breech birth - Pregnancy and Baby Guide

Most babies move the head-down position in the mother's uterus a few weeks before birth. But if this doesn't happen, the baby's buttocks, or buttocks and feet, will be in place to come out first during birth. This position is called breech presentation, and it occurs in about 1-25 full-term births.

The causes of breech presentation are not completely clear. However, breech presentation is more common when certain other conditions are present:

·  The mother has had more than one pregnancy.

·  There is more than one fetus in the uterus.

·  The uterus contains too much or too little amniotic fluid.

·  The uterus is abnormally shaped or has abnormal growths, such as fibroid.

·  Placenta previa has occurred.

There are three main types of breech presentation:

1. Frank breech- The fetus’s buttocks are directed toward the birth canal and the legs extend straight up in front of the body, with the feet near the head.

2. Complete breech- The buttocks are down, with the legs folded at the knees and the feet neat the buttocks.

3. Footling breech-One or both of the fetus’s feet are pointing down and will come out first.

Although most breech babies are born healthy, they do have higher risk for certain problems than babies in the normal position. Preterm babies (those born 3 or more weeks early and weighing less than 5 pounds) are more likely to be breech. Birth defects are also more common in breech babies and may account for why they have not turned into the proper position before delivery Your doctor may advise cesarean birth or may attempt vaginal delivery after carefully assessing a number of factors, such as the stage of pregnancy, the size of the baby and the mother’s pelvis, and the type of breech position.

In some cases, the baby’s position can be changed by a method called external version. This technique consists of manually moving or turning the baby into the head-down position. It does not involve surgery. The doctor places his or her hands at certain key points on your lover abdomen. He or she then gently pushes the baby into the head-down position, as if the baby were doing a slow-motion somersault.  Often a drug is given to the mother first to relax her uterus, and the turning is done while the fetus is viewed with ultrasound.

An ultrasound exam done in advance allows the doctor to better check the condition and position of the baby, the location of the placenta, and the amount of amniotic fluid in the uterus. Before during, and after external version, your baby’s heartbeat will be checked closely. If any problems arise, efforts to turn the baby will be stopped immediately. Most attempts at external version succeed, but some babies will shift back into a breech presentation. If that happens, your doctor may try again, but external version tends to be harder to perform as the time of delivery grows closer. The best time for trying external version is several weeks before your due date.