Turning Your Breech Baby

Turning Your Breech Baby – A D.I.Y Approach

By Elizabeth Orr for www.natural-birth.com

It was half past eleven at night when the young registrar I had been demanding to see finally came to my hospital room. I was not feeling my best to say the least - on my own a long way from home, admitted against my will, decked out in a blue hospital gown and 37 weeks into a pregnancy which was spiralling out of control after a diagnosis of toxaemia.

My planned homebirth in a small New Zealand seaside town was ready to proceed with my husband, trusted midwife, her birthing pool, acupuncture needles and herbs. However my plans were shattered following an examination by a woman I had never met. Oblivious to the impact her words would have on my long anticipated arrival she announced. “Your baby is breech - you will be delivered by caesarean section”.

In fact my baby was not breech and I managed to convince staff in the following days to perform an ultrasound, confirming this belief. However it was not the presentation of a breech baby itself that frightened me, but rather the long term issues following caesarean section I had witnessed within my practice.

There are very few health professionals now who will support women to birth a breech baby vaginally, due to the perceived risks involved. Hospital policy most often means that breech babies are born by caesarean – a procedure which itself holds many risks. In making an informed choice regarding the birth of a breech baby it is of utmost importance that parents are given accurate information and encouraged to make a decision that best meets the needs of the mother and her unborn child..

What is breech positioning?

As a pregnancy progresses and the anticipated day of delivery draws near a baby will typically turn so that his/her head presents against the mother’s cervix, nestling into her pelvic brim. However in the case of a breech presentation the opposite occurs with the baby’s bottom descending, while the head remains upward (this often resulting in pain under the mother’s ribcage).

There are differing forms of breech presentation, with ‘complete’ meaning that the baby is in a cross-legged position, ‘frank’ describing the legs out straight and held flat against the baby’s body, ‘footling’ (rare) considering the feet first and ‘kneeling’ (rarer still) describing a kneeling position.

All these forms of breech presentation refer to the part of the baby which is ‘presenting’ against the cervix. Obviously the weight and size of a baby’s head provides a greater amount of pressure on the cervix than say a foot and for this reason (though there may be others) complication may arise during labour.

There is really no need for concern until a few weeks from delivery as at twenty eight weeks it is estimated that there is a 25% chance of a breech position. This percentage of course diminishes until at full-term there is only a 3-4% chance. Rare, yet we all know of mothers who have faced their last few weeks of pregnancy with a ‘breech’ label and all the weight that this carries.


What causes breech positioning?

There are many reasons why a baby may choose to sit in a breech position and these alone decide how much can be done conservatively to change the presentation.

Premature birth is a common cause as the baby has not yet turned; a septum (a wall of tissue dividing the uterus) may often block the baby turning; a growth (tumour or fibroid) may also do the same. As well there is the chance of placenta praevia, baby abnormality, excessive amniotic fluid, an unusual pelvic shape, or very tight/ weak abdominal musculature. On the other hand the baby and mother may be healthy and well – the baby simply preferring to lie this way!

If you are nearing the end of your pregnancy with a baby in breech presentation, it may be useful to examine via ultrasound the factor/s which have contributed to this. Consultation with your health professional will provide information as to the viability of attempting to turn your baby. This in itself will empower you as a mother and enable you to make ‘choices’ pertaining to your birth.

For instance if an anatomical factor is present blocking the pathway of the baby then the method described below will be fruitless and cause further frustration. On the other hand, if there seems no good reason why rotation of the baby has not occurred then approach your local midwife on different positioning techniques as well as your homeopath on appropriate remedies. You may also like to utilise the age-old technique of acupuncture as described in this article.

Acupuncture – a ‘do-it-yourself’ guide

Your experiences of acupuncture may be varied and range from miraculous results to those of no effect. Regardless, history itself (with acupuncture having existed before scientific explanation) demands that certain traditions are continued, and this is certainly correct when looking at the Chinese therapy for breech presentation.
A small acupuncture point located at the outer edge of the little toe (‘Bladder 67’) is traditionally known as the point to stimulate when requiring your baby to turn. As a Western Acupuncturist I struggle with the scientific reasoning as to why this point is used in particular. Perhaps it is because it is supplied by a level of nerves which also stimulate the lower back (relaxing the uterine wall). Or perhaps it is because of the known release of neuro-peptides in the body when acupuncture occurs. There are many theories and debate yet such discussion detracts from the majority of midwives and mothers who have stimulated this particular point and had positive results.

The joy of this technique is that is not painful (does not use needles), costs very little and requires no therapist to assist. What is required is a ‘moxa stick’. These should be readily available at either your local Asian food store or acupuncture clinic. They look like a cigar and are made of up herbs which smell fairly strong when burnt.

Once you have one of these the easiest position is to sit in a chair with your feet up on a table, or (if that tummy is too big) ask a friend to assist and then semi-recline with your feet up. This position not only allows you access to your little toe, but will assist in encouraging the baby’s bottom to move up and out of the pelvic brim.
Next, light the end of the moxa stick and then hold it a couple of millimetres away from the outer edge of your little toe until you feel its warmth *. When the temperature gets too warm (avoid burns) take the stick away until the temperature has settled again. In this pattern, keep the area heated for ten minutes before repeating on the other foot.

In total you need to be stimulating for twenty minutes and should start to feel movements happening soon after this is completed. Repeat this procedure morning and night along with other positional exercises prescribed by your health professional. This process can be continued up to the birth or until the baby has turned.

*If you for any reason lack an ability to perceive temperature in your feet, then refrain from this technique.

References:

Palmer, Jane (2000): http://www.pregnancy.com.au/breech_babies.htm

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15280133&query_hl=5&itool=pubmed_docsum

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=2125868&query_hl=5&itool=pubmed_docsum

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15846688&query_hl=1&itool=pubmed_docsum