Breech Baby

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Most babies will settle into a position for birth during the last 4 weeks of pregnancy and, for most, it’s a head-down position. About 3-4% of babies choose a breech position. This means that the baby is in a position where their bottom, legs or feet are in your pelvis instead of head first.

You may not know your baby is breech, but this can be confirmed with a scan. Your options and choices can then be discussed. This may be an unexpected discovery at the end of your pregnancy, but if you’re expecting one baby and your pregnancy has been uncomplicated, there are 3 main options that will be offered to you.

Breech Positions

Complete Breech

Incomplete Breech

Frank Breech

An intravenous drip in the back of your hand will keep you hydrated and give any medications needed. You will also have a catheter, which is a small tube, placed in your bladder. This keeps your bladder empty for surgery. Once surgery has begun, the birth of your baby is quite quick – about 10 minutes. In most instances, the baby is placed skin-to-skin with you or your partner while you wait for the operation to finish.

Turning Your Baby

Your doctor can offer to turn your baby for you, and the term you may hear is ‘external cephalic version’ (ECV). This happens in a hospital. A doctor who is experienced in ECV will apply gentle but firm pressure on your stomach to encourage your baby to turn to the head down position. You and your baby will be checked before and after to ensure all is well. It’s common to be given a muscle relaxant before the procedure as this increases the chance of being able to turn your baby. Approximately 50% of babies will turn to the head down position with this procedure but percentages vary. You can ask your maternity team what the local success rates are.

Birthing Your Baby Vaginally

In an uncomplicated pregnancy, the option of a vaginal birth will be offered to you. There are some factors that may mean this may not be the safest option for you, such as:

  • If your baby’s feet are below their bottom (picture of baby’s feet at bottom)
  • If your baby is estimated as either small or large on a scan
  • If the position of your baby may make birth more difficult, for example, if their head is tipped backwards
  • If you have a low-lying placenta
  • If you have been diagnosed with a condition called pre-eclampsia

Vaginal breech birth does carry more risk than a baby being born head first, and it is important you discuss these potential complications with your maternity team before you decide how you wish to birth your baby.

A successful vaginal birth carries the least risks for you, but it carries a small increased risk of your baby dying around the time of birth.
A vaginal breech birth may also cause serious short-term complications for your baby. But these complications do not seem to have any long-term effects on your baby.

Risks are individual and should be discussed with you by your healthcare team.

Birthing Your Baby by Planned Caesarean Birth

As there are some risks involved with a vaginal breech delivery, you will be offered a planned caesarean birth. This is to reduce the potential risks for the baby but does have greater implications for your recovery. If this is the option you choose, the birth would be planned for between 39 and 40 weeks. Should you go into labour before the planned caesarean, an assessment would be made when you arrive at the hospital to see if it would be safer to proceed to a caesarean birth or continue with your labour and have a vaginal birth.

Your maternity team will support you to make a plan for your birth if your baby remains breech at the end of your pregnancy. If you are ever unsure about the choices available, please ask your maternity team to discuss them with you further.

Explanation Point

ScanUltrasound scans use sound waves to build a picture of the baby in the womb.A person who carries out a scan of your baby is called a sonographer.
Muscle relaxantA drug given via an injection to relax muscles, making turning your baby easier with less restriction.
Low-lying placentaAs your pregnancy progresses, your womb expands and this affects the placenta's position. The area where the placenta is attached usually stretches upwards, away from your cervix. If the placenta stays low in your womb, near to or covering your cervix, it may block the baby's way out.
Pre-eclampsiaA condition that affects some pregnant women, usually during the second half of pregnancy (from 20 weeks) or soon after their baby is delivered. Early signs of pre-eclampsia include high blood pressure (hypertension) and protein in your wee (proteinuria).
Caesarean birthAn operation to deliver your baby through a cut made in your tummy and womb. The cut is usually made across your tummy, just below your bikini line.
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