Pregnancy What Ifs // What If My Baby Is Breech?
Pregnancy What Ifs. What If My Baby Is Breech?
This week in my pregnancy yoga class here in York a ladies baby at 36 weeks is in a breech position, not ideal for a vaginal birth but we spoke about some things she might do to encourage baby into the more favourable head-down position. So I thought I’d write a blog post to share with you about breech babies and what you might do and what your options are if you find yourself in this position later in your pregnancy.
If a baby is breech it means that instead of being head down, they are bottom or feet down in your pelvis, and their head is in your upwards in your ribs. In the earlier stages of pregnancy babies spend most of their time in utero with their heads up by the mother’s heart. But as the baby gets heavier and prepares to be born, it turns upside down to prepare for head-first delivery. If you are in the later stages of the third trimester and you find your baby is breech you are probably a bit worried, but I there are lots of proactive things you can do – so please don’t bury your head in the sand or feel like a rabbit in the headlights.
First of all – how pregnant are you?
If you are less than 34 weeks then there is every possibility that baby will flip into the more favourable head-down position and is still just enjoying swimming around in there. Only around 3 to 4 % of breech babies are still in the breech position at term.
There are also active methods that women can undertake in pregnancy to encourage baby in a favourable position. That’s called optimal foetal positioning, and I’ll talk about that in another blog post very soon.
Past 34 weeks pregnant?
There is still a lot you can do to help baby turn:
· Try some of the resources on the Spinning babies website. These involve moving into various physical positions to use gravity and your own body to encourage baby to move. https://spinningbabies.com/
· Place warmth (like a hot water bottle) where you want baby to move towards. You can also try playing music or using Dads voice to encourage baby to move in a certain direction. Or is you are feeling a little more ruthless, place a cold object (like a bag of frozen peas) where you want baby to move away from!
· Moxibustion. This is an acupuncture technique that although it sounds rather bizarre it has good results. A small stick of dried herbs (called mugwort) is lit so it smokes and then is help over acupuncture points. You often get some to take home so you can do it again at home. Its non-invasive and doesn’t hurt – so it worth a try. I know brilliant local practitioners I can recommend to you.
· Pregnancy massage can also help with an experienced practitioner, who can relax you and the muscles surrounding baby so give them some space to turn. Other alternative therapies such as osteopaths may also help you. Again let me know if you’d like to know a wonderful local pregnancy massage practitioner who can help you with this.
· Swimming and spending some time on all fours (especially with head below hips), some pregnancy yoga on all fours (I can tell you good poses to do) can help give baby some space and keep them from settling in your pelvis in the breech position.
· Having a word with baby or using self hypnosis. This is said to be about 80% effective. It may be difficult to accept that talking is more effective than ‘doing something’, but research shows this to be the case. It is very effective if a mother simply talks to her baby herself. After all hypnotherapy is only words. She strokes her bump gently from the top, going down the left hand side to the bottom, at the same time gently talking to her baby, suggesting that it might like to turn, that it’s easy to turn, that many babies are easily born head down, that she acknowledges it could be in the very best position for him/her.
I can send you a recorded hyponsis track for helping to encourage a baby to turn if you would like to give this a try.
· Visualise. Get into a relaxed state and visualise baby turning into the correct position. From a practical point of view the more we want something and visualise it and feel how we will feel when it happens, we are more propelled to take the action needed. I have an MP3 I can send you with a lovely visualisation on.
· Relax, about it. The more pressure you put on yourself the more tension you create in your bod and the less likely your baby is to turn.
· Using a rebozo can also help, again find an experiences local practitioner.
Past 36 weeks pregnant and baby still breech?
You may at this point be offered an ECV (External Cephalic Version) procedure, which is done by an obstetrician in the hospital usually between 37 weeks and term. You are given a muscle relaxant drug and then the doctor tries to externally turn baby into a head down position. ECV has about at 50% success rate, but it does vary widely between practitioners so it’s worth asking about an individual doctor and ‘shopping around’. ECV carries a small risk of causing complications (1 on 200) such as placental bleeding or changes to baby’s heart rate, which would result in you needing an immediate caesarean birth.
Some babies are supposed to be breech, according to the brilliant midwife Mary Kronk ‘breech is another version of normal’. So some babies are not meant to be turned at all, they are supposed to come out ‘upside down’.
There is a brilliant AIMS booklet on Breech birth full of evidence based information you may want to read up on.
If you baby flips
If your ECV or other technique you try is successful in persuading your baby to turn head down then please just don’t slump back onto the sofa in relief! You now need to keep active (brisk daily walking is good) to get babys head to settle in your pelvis. Maybe some squats would be good too (again I can show you some pregnancy yoga to help you with this). As long as baby stays head down there is no reason why you should not have a straightforward vaginal birth in the setting of your choice.
If nothing works to turn your baby
At this point the options can seem pretty crappy. But information is power, as always, and you DO have choices.
You are likely to be offered a caesarean birth at this point. And you may be wondering what exactly women did before this option was readily available or before scans came along to tell baby’s position accurately. The answer is that they had their babies vaginally, and their midwives knew how to help a woman safely birth a breech baby. Breech birth requires highly specialised midwifery skills, but in recent years these skills have been lost as caesarean birth has taken over from breech vaginal delivery. (This is because of a piece of research called the Hannah Report. Which has since been called into question). So because caesarean section has become default, midwives have had little or no experience of vaginal breech birth and the specialist skills have been lost. But there are midwives who DO have these skills, and locally both Leeds and Sheffield hospitals will deliver a breech baby vaginally.
So really you have two options in your course of action now.
1. Choose a vaginal breech birth and go Birthzilla in your hunt for information. Explore hospitals in your area and see what they offer. You can birth in ANY hospital you choose, not just the nearest one to you. Talk to people in local birth groups and use the pool of knowledge on social media in groups like Breech Birth UK on Facebook https://www.facebook.com/groups/371624862918154/ Speak to local birth professionals like Doulas and Independent Midwives to pick their brains and see how they can help you get the information you need.
2. Choose a caesarean birth and really take the time to write some birth preferences for this. Make it the best most women-centred experience you can, and do what you need to do to make peace with that. Research ‘gentle caesarean’, and I can send you a birth preferences template that you may want to use. As this is planned (not an emergency) caesarean there are so may brilliant and positive choices you can make, such a delayed cord clamping, immediate skin to skin, your own music in theatre, lowering of the screen to see baby being born. Also fill up on positive caesarean birth stories and videos – again I can help you with that just email me. Discuss this with your care providers before the birth and have it all agreed so you can go into your birth feeling positive and confident and excited to meet your baby.
As always with pregnancy and birth, do your research and make the right choice for you and your baby. We can think about how we would like to be, but we can’t control what our babies do and so making positive choices with good evidence based information is the key to a positive birth experience – however you birth your baby.
For more information on resources I can send you to help a breech baby, from pregnancy yoga and from hypnobirthing then do drop me an email firstname.lastname@example.org. And I can also put you in touch with local birth and pregnancy specialists in York who can help you including acupuncture, moxibustion and pregnancy massage.
Breech Birth Resources:
AIMS book on breech birth. "Breech Birth – What are my options?" by Jane Evans
One of the most experienced midwives in assisting women to give birth to their breech babies has written this informative and empowering book to inform women about the choices they have and help them decide what is right for them.
Buy it here - https://www.aims.org.uk/shop/item/breech-birth-what-are-my-options
Breech Birth: A guide to Breech Pregnancy and Birth by Benna Waites
This book on breech births is for for parents, obstetricians, midwives and all who come into contact with women carrying breech babies. It addresses the whole experience of breech from causes to turning techniques to the options for birth. It engages with the controversial debate on caesarean versus vaginal breech birth and provides a powerful critique of recent evidence which has led to an increase in caesarean section.
Buy it here - https://www.amazon.co.uk/Breech-Birth-Guide-Pregnancy/dp/1853435635
Contact me for positive breech birth stories and breech birth videos too.
The information in this blog post has been gathered from the Better Birth Blog and Positive Birth Book by Milli Hill. Thanks to them.