Baby Breech

Babies change positions in the uterus many times during the first 36 weeks of pregnancy. In the last few weeks, they will move less as there is less room. By three to four weeks prior to the due date, most babies will position themselves so their head is near the birth canal. If a baby does not move into this position and the baby’s feet, buttocks, or both are positioned to come out first, this is called a breech position. This occurs in about three percent of full-term births. Most breech babies are healthy, but they have a higher risk for certain problems.

Breech position is more common when:

• The woman has had more than one pregnancy.
• There is more than one fetus in the uterus.
• The uterus has too much or too little amniotic fluid.
• The uterus is not normal in shape or has abnormal growths like fibroids.
• The placenta partly or fully covers the opening of the cervix.
• The baby is preterm.

Finding the Baby’s Position

Your health care provider can determine the baby’s position by placing their hands at certain points on the abdomen to feel the baby’s head, back, and buttocks. Because babies may change position up until delivery, they may not be able to tell for sure if the baby has settled into a breech position.

Ultrasound may also be used to confirm the baby’s position.

Can a Breech Presentation be Changed?

Your health care provider may try to turn the baby into a head-down position using a technique called an external cephalic version. This may be attempted if you are at least 36 weeks along.

Your health care provider will use an ultrasound exam to determine the placement of the baby and view the baby during the turning. To perform a version, the health care provider will place their hands at certain points on your abdomen and then push the baby into a head-down position. At all times, your baby’s heartbeat will be closely monitored. If any problems arise during the version, it will be stopped right away. More than half of the attempts are successful.

Risks of a version include:

• Rupture of membranes.
• Problems with the baby’s heart rate.
• Labor may begin.
• Placental abruption.

Talk with your health care provider to determine if a version is an option for you.

Delivery

Vaginal delivery of a breech baby carries more risk. Because the head is the largest and firmest part of the baby, and during a breech birth it comes out last, it may be harder to ease through the birth canal. There is also an increased risk of a prolapsed cord, where the umbilical cord slips through the cervix and enters the birth canal before the baby. This can stop the flow of blood through the cord.

Cesarean delivery may pose less risk but is still difficult. Cesarean delivery is major surgery that carries its own risks, including:

• Infection.
• Heavy bleeding.
• Problems from the pain medication.

Cesarean deliveries are the best option for most women if the baby is breech.

Finally…

Most breech babies are born healthy. Talk with your health care provider about your options for delivery if your baby is in the breech position as your due date approaches.