Turn a breech baby
The breech position is common in early pregnancy, with most babies turning into the head-down position by 37 weeks. But if your baby is still breech, here’s what you can do to turn him
Ababy who is in a breech position means that your baby is lying with his bum first (or down) or feet first (or down) in your uterus, instead of in the usual head first (cephalic) position. The position of the breech can vary, depending on the flexion of the limbs.
COMPLETE BREECH
In this breech position, your baby has his feet tucked in besides his buttocks, his knees and arms close to his body. This and frank breech are the most common types of breech presentation.
FRANK BREECH
Your baby sits bottom down, but with legs extended. The thighs are flexed on the abdomen, and the lower legs are extended upwards (the legs are straight and not bent at the knee). These babies are almost impossible to turn.
FOOTLING BREECH
In this presentation your baby sits bottom down, with one leg dangling below his bottom. This is quite a rare breech position.
KNEELING BREECH
In this presentation one knee is extended from the hip and the other may be flexed, or both legs are extended from the hip and the knees are bent – as in a kneeling position.
TIPS FOR TURNING A BREECH BABY
VISUALISE your baby moving down with the head very deep in your pelvis, several times a day; especially in conjunction with positions and exercises below. Begin at 32 to 35 weeks’ gestation, and do this exercise three times daily for 10 to 15 minutes each time, when you have an empty stomach, and the baby is active. Prop one end of an ironing board securely on a couch or chair about 30cm high. Lie down, bend your knees, but keep your feet flat on the board. Relax, breathe deeply, and avoid tensing. You may also use pillows on a flat surface to raise your hips above your shoulders. Gravity pushes the baby’s head into the fundus, tucks it, and baby can then do a somersault to a cephalic (head down) position. FLASHLIGHT Try moving a torch slowly down from the top of the uterus toward your pubic bone while you’re in a breech tilt position (above). Use an amber or red light. SWIM as often as possible. This keeps your body and pelvis loose and relaxed. Try doing a headstand in the pool – but only if you have help. MASSAGE Start with your left hand at the bottom of the abdomen and your right hand just above it. Move your hands clockwise around the right side of your tummy. As your right hand reaches the top of your abdomen, slide the left one over your right and move it down the left side of your tummy. Your left hand should lead as you come full circle, continuing clockwise. Massage for 10 minutes or more several times each day. CLOTHING PIN Place a clothing pin on the small toe of each foot at the outside corner of the toenail. Attach it sideways so that the toenail and toe pad are stimulated for 30 minutes per day. This is a “moving down” acupressure point. You can also do this with just finger pressure. Do it as often as you remember to do it. GLASS OF ORANGE OR OTHER JUICE Follow this drink with a side-lying position with your hips positioned higher than your feet. Babies move more after a sugar high! PELVIC TILT Place an ice pack on the top of your belly, on an empty stomach, for 10 minutes twice a day. Do this while lying on your back on the floor with knees flexed and feet on the floor with three large pillows placed under your buttocks. Try this in conjunction with visualisation. CAT STRETCH Start on all fours, then lay your head and chest flat on the floor with your buttocks in the air, as you round your back and return to all fours. CRAWLING AND KNEECHEST POSITION Kneel on all fours with your hips flexed slightly more than 90 degrees, but with thighs not pressing against your tummy and your head, shoulders and upper chest are flat on a mattress for 15 minutes every two waking hours for five days. Alternate with crawling. There’s no absolute evidence to support this technique, but you have nothing to lose by trying. EXTERNAL CEPHALIC VERSION (ECV), means “turning the baby’s head from the outside”. It’s a procedure used to turn a foetus from a breech position into a head down (cephalic) position before labour begins, usually around 37 weeks, but depending on your situation, ECV can be done right up until you give birth. Gentle massage and pressure is applied on your abdomen to encourage your baby to tuck his chin under and follow his nose as if doing a somersault in the womb to lie head first. ECV may be carried out in your doctor’s rooms or the labour ward – don’t do it yourself. Ultrasound may be used to identify the position of your baby and your placenta. You may be given medication to relax the muscles of your uterus. This medication won’t affect the baby. You’ll be asked to empty your bladder, which will give more room to move baby and be more comfortable for you. You can help by relaxing your abdominal (tummy) muscles. You’ll need to rest for about an hour after the procedure, during which time checks will be carried out on your baby’s heart rate and to make sure you have no fluids leaking from your vagina. Most babies turned this way are likely to stay in that position, but some will revert back to breech.