Breech Babies

Ideally, in the final weeks of pregnancy, baby will move into the vertex position (his head facing downwards toward the cervix) to prepare for birth.

Approximately 3% of babies settle into a breech position, with head up high, and feet or bottom down low in the pelvis.

The standard treatment for breech babies in the United States is cesarean section. Most physicians do not have training or experience doing vaginal delivery of breech babies. (More info.)

Thus, many moms want to know: is there anything they can do to encourage baby to turn head down?

Before 33 weeks, don’t worry too much about baby’s position.

But, at 33 – 35 weeks, if baby is still head-up, that’s when we want to get to work, as it is easiest to get a baby to turn head-down before 36 weeks of pregnancy. Check with your caregiver before trying any of these methods.

Non-Invasive Ways to Encourage Baby to Turn

Positions You Can Try:

Breech tilt with pillows: Lay on your back with your knees bent, and your feet flat on the floor. Raise your pelvis up, and slide in enough pillows to raise your bottom up 10 – 15 inches higher than your head. Or lay on your back with your feet high on a wall, push with your feet to lift your hips, then place pillows underneath your back/bottom. There is an illustration on this page: www.home4birth.com/pregnancy/special-circumstances/breech/what-you-can-do/

Breech tilt with ironing board: Lay an ironing board or other board so it’s at a 40-45 degree angle. Lay on your back, with feet up and head down. Bend your knees. See illustration at http://www.spinningbabies.com/techniques

Note: if you feel really uncomfortable lying on your back in pregnancy due to supine hypotension, you may find the two breech tilt positions too uncomfortable, so the open knee-chest may be better for you.

Open knee – chest position: Get on your hands and knees first, then lower down to your elbows and knees, so your chest is resting on the ground. The best picture I’ve found is at http://www.betterbirthpartners.com/optimalfetalpositioning.html

Do any of these positions three times a day for 10-20 minutes at a time. (If you feel dizzy while doing them, stop right away.) It’s best to do it when baby is awake and active.

Music or voice: Playing music down near the bottom of your belly (put headphones or a walkman down near the pubic bone), or having your partner talk to the bottom of the belly may encourage your child to rotate his head down to there. If desired, combine this with the positions mentioned above. (Note, the research done on this actually used an unpleasant loud buzzing noise at the top of the uterus, and the baby turned away from the unpleasant noise.)

Swimming: Spend time in water (in the swimming pool, in the bathtub). Theoretically, this increases your amniotic fluid, which may make it easier for baby to turn. Plus, just reducing the pull of gravity may help free baby up to move. In the pool, do visualizations…

Visualize the baby turning. Talk to your baby, encouraging it to turn… These things can’t hurt, and some people swear by them!

Sifting: Get on your hands and knees, and have your partner or a friend wrap a wide scarf or sheet around your belly. They hold one end of the scarf in each hand, and gently lift till your belly is supported in the fabric. Then they pull one end of the scarf up, and as they lower it they raise the other, rocking her belly (some say it’s like polishing a bowling ball.) Can stay slow, or can start slow and speed up till “jiggling” the belly. Try this a few times a day.

Listen to a public radio story on this technique here; or see video here. (Sifting is also used as a comfort technique in labor, and used to encourage a baby in an occiput posterior position (head down, but facing mom’s belly instead of her back, which is ideally where we’d like baby to be in labor) to turn to occiput anterior.)

Alternative Medicine (These are more invasive options than the home remedies listed above: consult with medical professionals before trying these. All these work best from 34 – 36 weeks.

Homeopathic Measures. Here is an unattributed quote found multiple places on the web: “If your baby is found to be breech close to your due date, try homeopathic Pulsatilla 200c once a day. Repeat one more day if the baby hasn't turned yet. If your baby found to be breech early, Pulsatilla 30c take three to five pellets under the tongue twice daily for two weeks. Or try using homeopathic Pulsatilla 6X one tablet under the tongue four times a day. Take Pulsatilla tablets, then do breech tilt.” [Note, consult with a caregiver trained in homeopathics before following this regimen, to ensure proper choice of homoepathic and dosage.]

Chiropractors: Some chiropractors are trained in something called the Webster technique, which helps the ligaments of the pelvis soften and relax, which may give baby enough room to turn. You may need multiple treatments to see the effect. The technique is described at www.icpa4kids.com/webster_technique.htm. Information on efficacy is here. To find a chiropractor trained in this technique, go to here: www.icpa4kids.com/find_pediatric_chiropractor.htm

Acupuncture/Moxibustion. Acupuncture may be effective at turning the baby, especially if it is supplemented with a light electrical current. During the treatment, needles are placed at the bladder 67 acupuncture points, on the outsides of each pinkie toe.

Moxibustion is a needle-free technique, which involves putting a burning herb near these same acupuncture points. This may also help baby to turn. This video of moxibustion shows how moxibustion is done, but it is best to go to a trained practitioner. Call your local acupuncture providers, and ask if they have experience with these techniques. Information on efficacy is here and here. One site says “Studies suggest that heating this point for 10-15 minutes daily for 7-14 days increases fetal movements and encourages babies to turn to head first (Cardini and Huang, 1998). Success rates of 53.6% -81% have been reported in studies.”

Most Invasive.

External version. This obstetric technique is used at 37 weeks, under careful monitoring, as it may cause labor to begin. Ultrasound is used to verify baby’s position, then the mother is given medication to relax her uterus. The doctor then places his hands on her belly, and pushes and presses on the baby to turn it. More details: http://familydoctor.org/handouts/310.html

The procedure is very uncomfortable, so some women use pain medication for the procedure, or have a doula attend the procedure with them. Definitely at least plan to bring a support person along! Version succeeds approximately 50 – 65% of the time.

For research data on these techniques, and for care providers in the Seattle area, click here.