Turning a Breech Baby: Safe and Effective Techniques for a Natural Birth

Discovering your baby is breech can be concerning, especially when you’re hoping for a vaginal birth. A breech presentation means your baby is positioned with their buttocks or feet down instead of the head. While a Cesarean section might be recommended in some cases, there are various methods, both medical and natural, you can explore to encourage your baby to turn head-down. This comprehensive guide delves into these techniques, providing detailed steps and instructions for each, empowering you to make informed decisions about your pregnancy and birth.

Understanding Breech Presentation

Before we dive into methods for turning a breech baby, let’s understand the different types of breech positions and the factors that might contribute to them:

• Frank Breech: The baby’s buttocks are presenting, with the legs extended upwards towards the head.
• Complete Breech: The baby’s buttocks are presenting, with the knees bent and feet tucked close to the buttocks.
• Footling Breech: One or both of the baby’s feet are presenting first.

While the exact cause of breech presentation is often unknown, some factors are believed to increase the likelihood, such as:

• Multiple pregnancies: There may be less room in the uterus.
• Too much or too little amniotic fluid: Affecting the baby’s ability to move freely.
• Uterine abnormalities: Irregular shapes of the uterus can hinder optimal positioning.
• Placenta previa: The placenta is located low in the uterus, potentially affecting the baby’s position.
• Prematurity: Preterm babies are more likely to be breech due to their smaller size and less developed muscle tone.

When to Start Considering Turning Techniques

It’s common for babies to move around frequently in the early and mid-stages of pregnancy. Often, babies naturally settle into a head-down (vertex) position by around 36 weeks. If your baby is still breech at this stage, it’s a good idea to start exploring options for encouraging them to turn. Consult with your healthcare provider to discuss the risks and benefits of each approach, taking into account your specific medical history and the baby’s health.

Medical Options for Turning a Breech Baby

External Cephalic Version (ECV)

ECV is a medical procedure performed by a skilled obstetrician or midwife to manually turn the baby from the outside of the abdomen. It’s generally considered safe, but like any procedure, it carries some risks. Here’s what to expect:

1. Preparation: You’ll have an ultrasound to confirm the baby’s position and assess amniotic fluid levels and the placenta’s location. You’ll likely be given an IV to hydrate and possibly medication to relax the uterine muscles. The baby’s heart rate will be monitored throughout the procedure.
2. The Procedure: The provider will gently manipulate your abdomen with their hands to guide the baby into a head-down position. This is usually a relatively quick process, typically lasting just a few minutes. It is normal to feel some pressure during the procedure and possibly mild discomfort.
3. After the ECV: You’ll be monitored for a short time to ensure both you and your baby are stable. You may experience some mild cramping afterwards. A follow-up ultrasound will be done to confirm the baby’s position.

Success Rates and Risks of ECV:
ECV has a success rate of about 50-70% in turning a breech baby. Factors that may increase the success rate include having a woman’s uterus relaxed, normal amniotic fluid volume, and having given birth before. Risks, although rare, may include premature labor, placental abruption, or fetal distress, leading to an emergency C-section. This is why ECV is usually performed in a hospital setting with readily available surgical resources if needed.

Contraindications to ECV:
ECV is not recommended if you have certain conditions, such as a low-lying placenta, vaginal bleeding, multiple pregnancies, or a history of uterine surgery.

Natural Techniques for Encouraging a Breech Baby to Turn

Before considering or in conjunction with medical intervention, there are several natural methods you can try to encourage your baby to turn. These techniques are gentle, safe, and can be done at home.

1. The Spinning Babies Approach

Spinning Babies® is an approach based on the understanding that a baby’s position is heavily influenced by the tension in the mother’s soft tissues – muscles, ligaments, and fascia. It focuses on balancing these soft tissues to create space for the baby to move into an optimal position. Here are some key techniques from Spinning Babies®:

a) Forward-Leaning Inversion:

This position creates space in the lower uterus, encouraging the baby to lift out of the pelvis.

Instructions:

1. Start on your hands and knees, with your hands shoulder-width apart and knees hip-width apart.
2. Lower your forearms to the floor, forming a triangle with your elbows and hands.
3. Keeping your knees bent, allow your head to lower towards the floor, tucking your chin slightly.
4. Maintain this position for 30-60 seconds, or as long as comfortable. Don’t feel you must do it for the full time. Even 20 seconds a few times a day can be beneficial.
5. Slowly return to hands and knees and rest before slowly sitting up.

Precautions: Don’t try this with high blood pressure. Do not do if you are dizzy, nauseous or have any pain during the inversion. If you have reflux you may need to do it on a cushion or use another method.

b) Breech Tilt:

This position uses gravity to create more space and encourage the baby’s head to engage in the pelvis.

Instructions:

1. Lie on your back with a few pillows or a cushion under your hips, creating a tilt so that your hips are higher than your head.
2. Keep your knees bent and feet flat on the bed or floor.
3. Relax in this position for 10-20 minutes a couple of times a day.

c) The Open Knee Chest Position:

This is another way to create space in your lower uterus.

Instructions:

1. Start on your hands and knees.
2. Begin to bring your chest towards the ground with your arms outstretched in front.
3. Widen your knees out to the sides and allow the hips to drop down.
4. Allow yourself to go as far as is comfortable for you.
5. Hold for 1 minute and repeat as often as comfortable.

d) Sidelying Release:
This technique helps to release tension in your pelvic floor muscles.

Instructions:

1. Lie on your side, either on a firm bed, floor or yoga mat.
2. Place one hand underneath the hip of the leg that is on top and rest your lower leg on the floor or mattress.
3. As you breathe out allow the top leg to gently fall towards the ground.
4. You should feel a gentle stretch through your glutes.
5. Allow the hip to relax completely and hold for 3-5 minutes and repeat on the other side.

e) Rebozo Sifting:

Using a rebozo (a long shawl or scarf), gentle sifting motions can help release tension in your abdomen and pelvis. If you don’t have a rebozo, use a long sheet, scarf, or even a large bath towel. Make sure it is cotton or breathable and not a synthetic fibre.

Instructions:

1. Have a partner place the rebozo around your abdomen, just above your pubic bone.
2. While you relax, your partner should gently rock and sway the rebozo back and forth.
3. The movement should be soft and rhythmic, never jarring.
4. Repeat for 5-10 minutes or as tolerated.

2. Moxibustion

Moxibustion is a traditional Chinese medicine technique that involves burning the herb mugwort near specific acupuncture points. In the case of breech presentation, it’s used on the acupuncture point BL67 on the outer corner of the fifth toe. This point is thought to stimulate fetal movement and promote the baby turning. Although this has shown very good results, not everyone can use this treatment.

Instructions:

1. Purchase moxa sticks, commonly available online and at Chinese herbal medicine stores.
2. Ideally you need a partner to assist you, or a qualified practitioner for best results.
3. Sit comfortably, and have your partner light the end of the moxa stick.
4. Hold the lit moxa stick about 1-2 cm away from the acupuncture point on the outer corner of your pinky toe.
5. You will feel a warm, but comfortable sensation. Move the moxa stick slightly if it feels too hot.
6. Continue for 15-20 minutes on each foot, or as advised by your practitioner.
7. Perform this once or twice daily for several days, usually at 34-36 weeks.

Precautions: Moxibustion should only be performed under the guidance of a qualified practitioner. It’s not suitable for all pregnancies. Discuss this technique with your doctor or midwife before trying it. Contraindications include a history of preterm labor or hypertension.

3. Acupuncture

Acupuncture, involving the insertion of very thin needles at specific points on the body, is another treatment of Chinese Medicine that can help to turn a breech baby. It often works best in combination with moxibustion. As mentioned above, it can be a useful alternative to moxibustion for those who can not have that particular treatment.

Instructions:

1. Seek a qualified and experienced acupuncturist who specializes in prenatal care.
2. They will use different acupuncture points based on your individual needs, but often include the acupuncture point mentioned above, BL67.
3. Treatment sessions may last 30-60 minutes and can be repeated one or more times per week as advised by your practitioner.

4. Chiropractic Care

Chiropractors who specialize in prenatal care may be able to assist in helping to turn a breech baby using techniques such as the Webster Technique. The Webster Technique is a specific analysis and adjustment that helps to balance the pelvic structures which often help to create space for a baby to turn.

Instructions:

1. Seek out a qualified chiropractor who specializes in prenatal care and the Webster Technique.
2. The chiropractor will assess your spine and pelvis and use gentle techniques to encourage optimal alignment.
3. They can also give advice on some of the Spinning Babies techniques mentioned above.
4. Treatment sessions may last 15-30 minutes.

5. Posture and Movement

Your daily posture and movement patterns can influence your baby’s position. Incorporating these simple adjustments may encourage your baby to turn:

a) Pelvic Tilts:

Pelvic tilts help to increase space in the pelvis. These can be done by lying on your back with knees bent, and tilting your pelvis up and down.

Instructions:

1. Start on your hands and knees, or lying on your back with knees bent.
2. As you breathe in, gently arch your back, lifting your head and tailbone (as if sticking your bottom out).
3. As you breathe out, gently round your back, tucking your chin to your chest and tailbone under.
4. Repeat for 10-15 repetitions several times daily.

b) Swimming:

The weightlessness and movement of swimming can be a great way to allow baby to turn, while being gentle on your body. Try different swimming styles, including breaststroke, or just gently floating in the water.

Instructions:

1. Start in a swimming pool, warm if possible as cold water may cause you to tense up.
2. Choose a stroke that you find comfortable, breaststroke is often recommended.
3. Enjoy swimming for 20-30 minutes.

c) Walking:

Gentle walking can encourage a baby to move by opening up the pelvic outlet. Make sure you are walking at a comfortable pace for you, and not pushing yourself too hard.

Instructions:

1. Choose a comfortable pace and a safe place to walk.
2. Take regular breaks when needed and drink plenty of water.
3. Walk for 20-30 minutes at a time, most days of the week.

6. Visualization and Gentle Communication

Your mind-body connection can play a crucial role. Visualize your baby turning head-down, gently encouraging them through positive affirmations and dialogue. Talk to your baby, telling them how much you’d like them to move head down, and that they have plenty of space to do so.

When Natural Techniques Might Not Be Enough

While natural techniques can be very effective for some, they might not work for everyone. If your baby remains breech, and ECV is not an option or you would prefer not to have it, your healthcare provider will discuss other birthing options. Some hospitals have experience delivering breech babies vaginally, which can be a valid option for those who meet the criteria. Otherwise, a planned Cesarean delivery may be the safest choice for both you and your baby. Always have open communication with your healthcare team. They can support you in making an informed decision based on your circumstances.

Conclusion

Discovering your baby is breech can be stressful, but you have several options available. From the medical procedure of External Cephalic Version to the gentler natural methods like Spinning Babies techniques, moxibustion, acupuncture, chiropractic care, and postural changes, there’s a range of approaches to explore. Be informed, discuss your options with your healthcare provider, and choose the techniques that feel right for you and your baby. Remember, your body is designed for birth, and with patience and support, you can work towards achieving a safe and fulfilling birthing experience.