Options and evidence for turning a breech baby by Baby Hints and Tips’ midwife Caroline May.
Frequently during pregnancy the baby will present in the breech position, but the majority will adopt the head down position by 37 weeks. Approximately 4-5% of babies are in the breech position at term and this percentage increases significantly with premature births. There is some debate about whether a vaginal birth or an elective caesarean is better for mother and baby and I will discuss this another month, but there is no doubt head first is the preferred way of birthing. If you are in the last few weeks of your pregnancy and your baby is breech here are some tips for trying to turn it.
Moxibustion is a form of traditional chinese medicine which involves burning moxa sticks next to the acupuncture point bladder 67 on the outside edge of the little toes. There is some evidence that this works and there do not seem to be any serious side effects reported, but they do smell! It is best to see an acupuncturist or experienced midwife and be taught how to use these correctly before attempting it yourself.
Acupuncture can also be used in conjunction with moxibustion and again there is some evidence that this works but nothing conclusive.
Chiropractic care may also be beneficial in helping a baby turn. You need to find someone who is skilled in the use of the Webster Technique. This is thought to help align the pelvis and release any undue tension on the uterus from the round ligaments giving the baby the room to turn. There is little evidence to support this technique but anecdotally women and chiropractors report good results.
External Cephalic Version (ECV)
You may be offered an external Cephalic Version or ECV. This is a medical procedure usually performed by an obstetrician after 36 weeks gestation where the Doctor manually tries to turn your baby from the outside. Usually a muscle relaxant will be given to help make this easier. This procedure does carry the risk of an immediate caesarean should the baby become distressed and can be quite uncomfortable for the mother, but it does increase your chance of having a vaginal birth if it is successful.
There are plenty of other techniques which can be tried and though there is little or no actual evidence that they work, many women report success and in theory they may be a good idea. Laying with your bottom higher than your head is one of these. This can be achieved by either kneeling and leaning forward adopting a head down, bottom up position or by laying on an ironing board propped up, a pile of pillows or something similar with your head at the lowest point. It is also believed that diving down in a deep pool may help by inducing weightlessness in the mother and baby thus allowing the baby to flip.
Other things you may wish to consider include reflexology, talking to the baby or playing music near the bottom of the uterus where you want the baby’s head to be, or shining a torch there, wearing a bell or something jangly on a belt around your hips and hypnotherapy or visualising your baby in a head down position. There is no evidence that these work but they also are highly unlikely to do any harm.
Some babies still just refuse to turn and there may be a very good reason for this such as a tight cord or little space to move in the uterus. If that is the case there is not much you can do apart from weigh up your options of vaginal birth versus caesarean but more on that another time. Good luck!
Caroline May qualified as a Midwife in 1999 and has worked in both community and hospital settings around Australia and in the UK. Currently residing in Perth with her partner and two young children, Caroline is particularly interested in home and waterbirth and is passionate about enabling women to make an informed decision and play an active role in their care. You can find all her articles here.