Breech Birth: What do you need to know?

Breech birth is a common presentation of a baby at birth. It is estimated that 1 in 25 babies (3-5%) present bottom or feet first when labor begins. Vaginal delivery of breech babies had been the norm until the 20th-century when medical interventions and technology became widespread and cesarean sections became common. While many care providers only deliver breech babies via c-section, there are many obstetricians and midwives who are experienced in breech birth and will attempt a safe vaginal delivery.

What Are the Different Types of Breech Presentations?

In a frank breech presentation the butt is pointed down with the legs straight up in front of the face or at the ears. This is the most common breech presentation and generally thought to be the safest for a vaginal delivery because the baby's bottom and head are roughly the same size.

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A complete or partial breech presentation is where one or both of the legs are folded with the knees up and the feet near the baby’s bottom.  Also considered by many care providers to be a safe position for vaginal birth.

complete breech

A footling breech presentation is the rarest of the breech positions and is almost always delivered via c-section because there is significant risk to the baby if the feet are able to slip into the birth canal before the cervix is fully dilated.

footling breech

Can I Have a Vaginal Breech Birth? Are There Risks?

While delivery of breech babies through c-section is most common, there are circumstances in which a vaginal delivery may be attempted by a willing and experienced OB or midwife. According to The American Pregnancy Association there are several criteria a breech birth must meed in order to considered safe to attempt. These are: 

  • Full term and frank breech (although some care providers will also consider a complete/incomplete breech)
  • Baby is not in distress
  • Smooth labor and widening cervix
  • Baby is deemed an appropriate size for the mother's pelvis
  • Anesthesia and cesarean delivery are possible on short notice 
  • Labor begins on its own with normal, non-augmented progression

Your care provider may have additional  or different qualifications to consider a vaginal breech delivery.  

Even if you meet these qualifications, a vaginal breech delivery is not without certain risks.  Possible complications include:

  • Cord prolapse
  • Forceps delivery
  • Trauma to head 

How Can I Turn My Baby?

While most babies will turn head down by 34 weeks (and some will even turn just before birth!), if you know for sure that your baby is still presenting bottom down you may want to attempt to turn your baby. There are many gentle, non-invasive ways that you can attempt to turn your baby. *Always remember to discuss turning your baby with your OB or midwife before attempting.*

The Breech Tilt, recommended by the American Pregnancy Association is a risk-free way to attempt to flip your baby.

  • Using large, firm pillows, raise the hips 12″ or 30cm off the floor for 10-15 minutes, three times a day. It is best to do this on an empty stomach when your baby is active. In this technique, try to concentrate on the baby without tensing your body, especially in the abdominal area

I have a breech baby and would like to attempt a vaginal birth. Where can I find support?

If you have a breech baby, the safest and best thing to do is to talk directly with your care provider and other members of your support team to express your wish to attempt a vaginal delivery and to discuss your options.  Your doula or childbirth instructor can help point you towards additional resources and care providers to help turn your baby or get a second opinion. 

There are several Washington D.C. area hospitals with OBs and midwives who will attempt to deliver breech babies vaginally.  There are also many home birth midwives and birth centers who support vaginal breech births. The two hospitals listed below are well-known in the DC metro area for attempting breech birth, especially through their midwife programs.

George Washington University Hospital

Virginia Hospital Center

Consider hiring a birth doula for support during your pregnancy and birth

The birth doulas of Balanced Birth Support are experienced and equipped to help you find and understand your birthing options for a breech presentation. We will support you regardless of how you choose to birth your breech baby. Our doulas are committed to helping you communicate with your care providers so that your birthing experience has an emotionally and physically healthy outcome.

Sources & Additional Information

American Pregnancy Association

Spinning Babies

Mama Natural

Images from:

A.D.A.M.http://adam.com

https://godlessnurse.wordpress.com/tag/footling-breech/

Was your baby breech in the late weeks of pregnancy?

Were you able to turn your baby? Any additional tips for turning breech babies? Did you have a vaginal breech birth? Were you unable to have a vaginal birth and had a c-section? Contact us or leave a note in the comments and tell us about it!

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