When I was expecting my third baby I found out my little one was breech. I was planning a natural home birth, so it became a high priority to get baby to rotate. Even though I was at 32 weeks, I technically still had plenty of time for baby to flip.
I thought I might be done with breech births, but it turns out babies number 4 and 5 had different plans! I ended up with several breech pregnancies, a successful flip, and my last two babies were breech deliveries
Here’s what may cause a breech baby, what to look for, and what to do about it. As a mom of 6 and a doula, I’ve had plenty of experience here!
What Is a Breech Baby?
In an ideal world baby is in a head-down position for birth with their face towards your back. This is called a vertex presentation. Little ones twist, wriggle, and kick around until they settle into a good fetal position (usually). The position of your baby isn’t always ideal though.
If your baby’s position is feet first or bottom first then they have a breech presentation. This means instead of a head-first position during delivery, their bottom or foot is closest to the birth canal. During the first few weeks of pregnancy, baby has plenty of room to do backflips and summersaults. It’s not until the end of pregnancy that a breech presentation poses more of a problem.
Here are the different breech presentations:
- Frank breech – The most common type of breech position, baby’s butt is poised to enter the world first. Their legs are straight up with their feet near their head.
- Complete breech – With this position, instead of having their feet by their head the knees are bent and the feet are tucked near their bottom.
- Footling breech – One or both legs are stretched out and the baby’s feet extend past the baby’s butt.
- Transverse lay – In this case baby is sideways in your uterus. While healthcare experts don’t technically consider this a breech presentation, baby isn’t head down where they’re supposed to be.
What Causes A Breech Baby?
Most babies stay head down after 36 weeks, but about 3-4% of full-term babies don’t. We don’t really know what causes a breech baby, but there are some common factors. According to the American College of Obstetricians and Gynecologists (ACOG), You could be at a higher risk of breech presentation if:
- This isn’t your first baby.
- You’re having multiples
- There’s too much or not enough amniotic fluid
- Your uterus is abnormally shaped or has fibroids and other abnormal growths.
- You have placenta previa and baby’s head can’t comfortably fit by the birth canal
- The baby is preterm and didn’t have time to turn head down
- Baby has a neurological issue that makes it difficult for them to turn head down (this only accounts for 10% of breech babies)
The breech experts over at Spinning Babies also add:
- Mom has low thyroid function or metabolic disorders
- The placenta is near the fallopian tubs and makes it harder for baby to turn
- The cord is wrapped around the baby.
- Mom’s muscles and ligaments are too loose or too tight
None of these guarantee you’ll have a breech baby, but they might increase your risk.
Can I Deliver a Breech Baby Without a C-Section?
It depends. You may be able to get baby to flip before delivery, or baby may decide to come feet/bottom first. Most conventional healthcare professionals recommend a Cesarean section for breech babies. A Cesarean delivery doesn’t have to be your only option though.
If the placenta isn’t low-lying and blocking the vaginal canal and baby’s heart rate is strong, some obstetrics providers are okay with a vaginal delivery. There are several factors to consider here. These include your personal health history, exactly how baby is presenting, and most importantly how skilled your healthcare provider is with vaginal breech deliveries.
Many doctors and hospital policies go straight to a C-section because they see it as the less risky option. Midwives often have more training and experience helping mamas deliver breech babies. This is something to discuss with your trusted healthcare provider to create your own birth plan.
Breech Birth Complications
C-sections are major abdominal surgery and come with their own risks. These include side effects from the drugs used, infections, blood loss, and future pregnancy complications. The maternal death rate is 11 times higher with a C-section than with a vaginal delivery. That said, sometimes it’s the safest option for both mom and baby.
With my third baby I had an emergency C-section. As much as I was hoping and planning for a natural vaginal delivery, I knew that C-section saved both our lives. I was still able to have a natural vaginal birth for my other babies, even though there were a few breech babies in the mix.
Trying A Vaginal Breech Birth
Several large, multi-country studies followed over 10,000 women and their breech babies. The researchers found no significant differences in safety and outcomes when it came to a planned C-section versus a vaginal breech birth. In other words, a vaginal breech birth can be just as safe as a C-section delivery. Moms and providers also have to weigh future risks. According to PhD Rixa Freeze:
“Between 2001-2005, 8,500 women in the Netherlands had a planned CS for breech. This … saved an estimated 19 babies, but it also led to 4 direct maternal deaths, 9 additional babies dying in future pregnancies due to the uterine scar, and 140 additional life-threatening maternal complications in future pregnancies.”
If your healthcare provider has cleared you for a vaginal delivery there are a few things to watch for. Some of the biggest risks include cord prolapse and umbilical cord problems. The umbilical cord could possibly wrap around the baby and cause injury or oxygen deprivation. A skilled provider will know how to rotate a breech baby if they become stuck.
My Personal Experience With Vaginal Breech Delivery
Since you’re pushing out more of baby’s body first, it can cause more pressure during delivery. I figured out that it’s important to wait until I’m completely dilated before pushing. This helps reduce tearing. Even when I started to feel the urge to push, I focused on calm breathing.
I felt a lot of pressure during my last breech birth. So much so that it felt like my pubic bone would snap in half and my hips were being pushed out of their sockets!
It’s also recommended for the assisting healthcare provider to take more of a hands off approach. Touching the baby during breech deliveries could startle the baby and trigger them to raise their hands before they emerge.
How To Turn a Breech Baby
The moment you’ve finally been waiting for! (or maybe you just skipped to this section and that’s ok too). Here are tried and true methods for helping flip a breech baby.
Our bodies are all individual (nothing like pregnancy to remind you of that!) and what worked for me might not work for others. Consult with your own doctor to see which approach makes sense for you.
External Cephalic Version (ECV)
This is the most commonly offered option in the conventional medical world. Your provider will manually turn baby into the right position by pressing on your stomach. There are some risks and I chose to try other methods first (and thankfully didn’t need to attempt ECV for my baby).
Risks of ECV include:
- Premature labor
- Vaginal bleeding and blood loss (for you or baby)
- The amniotic membrane may break too early
- Emergency C-section.
- Baby may go back to a breech position.
The idea is to invert your body to trigger baby to flip. To do this I sat upside upside down on the stairs with my arms and head about three steps lower than my legs and butt. Sound ridiculous? You have no idea! The good news is this can help adjust pelvic ligaments to turn a breech baby.
Similarly, I also took up doing handstands. There’s nothing quite like putting on a bathing suit in the third trimester and standing on your head for an hour at the gym pool. I swam and did handstands in the water as much as possible.
Almost as fun as inversion… I put one side of the ironing board on the couch and the other side on the ground, creating an angle. I then positioned myself with my head on the low end and legs/butt up. I held this position for 20 minutes, three times a day.
If you have an inversion table that’s a much simpler way to do it. I don’t find this one so bad, at least since I found out that the alternative is doing a full handstand for 20 minutes a day. Can Olympic gymnasts even do that?
This was perhaps my favorite. As much as possible during the day, I walked around on my hands and feet. Basically, I created an acute angle with my bottom straight up in the air. My kids (toddlers at the time) thought it was hilarious and they’d chase me around the house while I did it.
Webster Chiropractic Technique
A good chiropractor can be a lifesaver for any pregnant mom. The Webster chiropractic technique though is specifically designed to release certain tight trigger points near the uterus. This doesn’t manually move the baby down, but sets the stage so a breech baby can flip themselves.
The Webster technique allows the ligaments, muscles, and vertebrae to be in the best position so baby has the space to flip. One small study showed an 82% success rate when it came to using the Webster technique for flipping a breech baby. It also relieves hip tension and lower back pain for Mom.
You can search for a Webster certified chiropractor near you at the ICPA site.
Spinning Babies Exercises
The Spinning Babies website is also a great resource with good information on turning your breech baby. They also have a lot of facts on the safest way to deliver if baby does stay breech. Positions like hands and knees help baby as they move and twist down the birth canal.
You can find specific exercises to do daily/weekly that help encourage baby to flip. Similar to the Webster technique, these work by releasing tension and opening up space for baby to move. If baby isn’t head down by 34 weeks, you can also find a Spinning Babies aware practitioner there.
Acupuncture and Moxibustion
A 2010 review found that acupuncture could help a breech baby turn head down. A 2021 review and meta-analysis however found acupuncture on its own didn’t work that well. The researchers concluded that acupuncture combined with moxibustion was much more likely to be effective.
So what is moxibustion? This heat therapy involves burning Artemesia herb next to a trigger point on the little toe. It’s most effective at week 34, but pregnant moms can also see benefits as late as week 38 or 39. Moxibustion can help babies become more active so they can turn.
Does It Work? My Breech Baby Story
These techniques did work, and baby number 3 successfully flipped. Unfortunately, we found out the reason he was breech when I hemorrhaged at 35 weeks because of an undetected placenta previa.
In this condition, the placenta is in the lower part of the uterus and covers the cervix. Not only can it make it difficult for baby’s head to settle in place, but it can block the vaginal canal. Hence my need for a C-section.
For babies 5 and 6 though I was able to have successful breech deliveries. For years I struggled with Hashimoto’s and low thyroid function, so maybe that played a role in why my babies were breech. The interesting thing about pregnancy is that they’re all different and what may work for one mama may not for another.
For anyone interested in the whole story, check out my full birth saga (of all the kids) here.
Ever had a pregnancy where the baby was breech? What did you do to help baby turn?