Breech Baby

A breech baby is when the baby is in a bottom-first or feet-first position in the womb. This is different from the usual head-first position. About 3-4% of babies are in this position by the time they are ready to be born.

There are different breech positions, each with its own challenges. Knowing about the causes, diagnosis, and management of breech babies is key. This knowledge helps both parents and healthcare providers to ensure the best outcome for the baby and mother.

In this guide, we’ll look at what breech presentation is, its types, and why some babies are in this position. We’ll also talk about the risks of breech delivery. And we’ll cover the options for managing a breech pregnancy, like cesarean section, vaginal breech delivery, and external cephalic version (ECV).

What is a Breech Baby?

A breech baby is a term for a baby in the womb with its buttocks or feet near the birth canal. This is called a breech presentation. It happens in about 3-4% of pregnancies at term.

In a normal birth, the baby’s head goes first. But with a breech baby, the baby’s buttocks or feet lead the way. This can make delivery more complicated.

Definition of Breech Presentation

Breech presentation means the baby’s buttocks or feet are first to enter the birth canal. This can be tricky because the baby’s head is the largest part. It may find it hard to pass through the birth canal last.

Types of Breech Positions

There are three main breech positions:

1. Frank Breech: The baby’s buttocks are near the birth canal, with legs straight up and feet near the face. This is the most common breech position.

2. Complete Breech: The baby sits cross-legged, with buttocks down and feet beside them.

3. Footling Breech: This is rare, where the baby’s feet lead, with buttocks above them.

Knowing your baby’s breech position helps plan the best delivery method. This could be a cesarean section or a vaginal breech delivery, depending on the situation.

Causes of Breech Presentation

Many things can cause a baby to be in a breech position during pregnancy. Knowing these can help moms and doctors get ready for and handle breech babies. Let’s look at the reasons why a baby might be in a breech position.

Maternal Factors

Some things about the mom can make a baby more likely to be in a breech position. These include:

Fetal Factors

Things about the baby can also affect if it’s in a breech position. Some of these include:

• Multiple gestations (twins or more)
• Premature birth
• Low birth weight
• Congenital abnormalities

Uterine Abnormalities

Uterine shape or structure issues can also affect the baby’s position. Some issues include:

• Uterine fibroids
• Bicornuate uterus (heart-shaped uterus)
• Placenta previa (low-lying placenta)
• Polyhydramnios (excess amniotic fluid)

Often, the exact reason for a breech baby is not known. Regular prenatal visits and talking with your doctor can help manage breech presentation. This ensures the best outcome for both mom and baby.

Diagnosing a Breech Baby

Knowing if a baby is in breech position is key for a safe delivery. Doctors use physical checks and ultrasound to find out. This helps keep both mom and baby safe.

Physical Examination

At prenatal visits, doctors check the baby’s position. They feel the mom’s belly to find the baby’s head, bottom, and back. If the baby is breech, they might feel the head up high and the bottom or feet down low.

Ultrasound Imaging

Ultrasound is a great way to confirm a breech baby. It uses sound waves to show the baby’s shape and position. This lets doctors see if the baby is breech.

Ultrasound scans are done at different times. They help check the baby’s growth and position.

If a breech is suspected, more ultrasound scans might be needed. They help watch the baby’s position. This decides if a vaginal delivery is safe or if a cesarean is needed.

Risks Associated with Breech Delivery

Babies in a breech position at delivery time come with risks. These risks affect both mom and baby. It’s important to know these risks when thinking about how to deliver.

Breech delivery can lead to birth injuries. The baby’s position increases the chance of getting stuck in the birth canal. This can cause problems like:

• Umbilical cord prolapse
• Head entrapment
• Brachial plexus injuries
• Fractures or dislocations

Babies in breech position face health issues more often than head-down babies. Here are some risks they might face:

For moms, breech delivery can lead to longer labor, more tears, and bleeding after birth. Doctors often suggest a cesarean section for breech babies to avoid these risks.

It’s key for expectant parents to talk about breech delivery risks with their doctor. Knowing these risks and options like cesarean section helps parents make informed decisions. This ensures the best outcomes for mom and baby.

Breech Baby: Delivery Options

When a baby is in a breech position, it’s important to think about delivery options. These options include cesarean section, vaginal breech delivery, and external cephalic version (ECV). The right choice depends on the breech type, gestational age, and the mother’s health history.

Cesarean Section

A cesarean section is often chosen for breech babies. It involves making an incision in the mother’s abdomen and uterus to deliver the baby. This method is recommended when vaginal delivery risks are higher.

Factors that might lead to a cesarean include:

• Type of breech position (e.g., footling breech)
• Presence of uterine abnormalities or placental issues
• Large baby size or multiple fetuses
• Previous cesarean section delivery

Vaginal Breech Delivery

In some cases, a vaginal breech delivery is attempted. This is more likely to succeed if the baby is full-term and the breech position is frank or complete. The mother’s pelvis size also matters.

But, vaginal breech deliveries are riskier than cesarean sections. Risks include cord prolapse, head entrapment, and birth injuries.

External Cephalic Version (ECV)

External cephalic version tries to turn the baby from a breech to a head-down position before labor. It’s done after 36 weeks and has a 50-60% success rate. The procedure involves applying gentle pressure to the mother’s abdomen.

ECV is more likely to work if:

• The baby has enough amniotic fluid
• The mother’s uterus is relaxed
• The baby is not engaged in the pelvis
• There are no complications, such as placental issues or fetal abnormalities

If ECV is successful, the mother might try a vaginal delivery. But, if it fails or isn’t recommended, a cesarean section might be needed.

Preparing for a Breech Delivery

Learning you’re having a breech baby can be stressful. But being informed and prepared can help. Talk to your doctor and make a birth plan to get ready for your baby’s arrival.

Discussing Options with Your Healthcare Provider

Find out your baby’s breech position and talk to your doctor. They’ll look at your health and the baby’s age. They’ll explain the risks and benefits of each delivery method, like cesarean section, vaginal breech delivery, and external cephalic version (ECV).

You’ll decide together what’s safest for you and your baby.

Creating a Birth Plan

After choosing a delivery method, make a birth plan. It should cover your wishes for labor and delivery, like pain relief and who to have with you. For a breech delivery, include special needs and your hopes for skin-to-skin contact and breastfeeding.

Share your plan with your doctor and support team. This way, everyone knows what to expect and can help you.

Vaginal Birth After Cesarean (VBAC) and Breech Babies

Women who have had a cesarean section might think about a vaginal birth after cesarean (VBAC) if they have a breech baby. Trying a VBAC with a breech baby depends on many things. It’s important to talk about it with a healthcare provider.

When thinking about a VBAC with a breech baby, several things are considered:

• The type of uterine incision used in the previous cesarean section
• The mother’s overall health and obstetric history
• The size and position of the baby
• The availability of a skilled healthcare team experienced in managing vaginal breech deliveries

A VBAC can be safe for many women. But, a breech baby might make vaginal delivery riskier. Risks include cord prolapse, head entrapment, and fetal distress. So, each case needs a careful look to decide the best way to deliver.

In some cases, trying to turn the baby with an external cephalic version (ECV) might help. This could make a VBAC more likely. But, if ECV doesn’t work or isn’t right, a planned cesarean might be the safest choice for a breech baby.

The choice to try a VBAC with a breech baby should be made together. The mother and her healthcare provider should discuss the risks and benefits. This way, they can make a choice that’s best for both the mother and the baby.

Emotional Aspects of Having a Breech Baby

Learning your baby is breech can be tough for parents. You might feel worried, stressed, and scared. But, remember, you’re not alone, and there are ways to handle these feelings.

Coping with Anxiety and Stress

Getting news of a breech baby can make you anxious and stressed. Here are some tips to help:

• Educate yourself about breech babies and the available delivery options
• Practice relaxation techniques such as deep breathing, meditation, or prenatal yoga
• Engage in regular physical activity, as approved by your healthcare provider
• Join a support group for parents expecting a breech baby
• Communicate openly with your partner about your concerns and feelings

Seeking Support from Family and Friends

Having a strong support system is key during this time. Don’t be shy to ask for help from family and friends. Here are some ways to get support:

• Share your feelings and concerns with loved ones
• Ask for practical assistance, such as help with household chores or childcare
• Attend prenatal classes or workshops with your partner or a supportive friend
• Seek guidance from other parents who have experienced a breech baby

Having a breech baby doesn’t mean you’re not a good parent. Focus on your emotional health and ask for help when you need it. This way, you can face this journey with more strength and confidence.

Long-Term Outcomes for Breech Babies

Parents of breech babies often wonder about the long-term effects. Most breech babies grow up normally. But, it’s good to know about possible developmental milestones and health issues.

Developmental Milestones

Breech babies usually hit developmental milestones at the same time as others. This includes:

Regular visits to the pediatrician are key. They help track your breech baby’s growth and address any issues.

Potential Health Concerns

Though rare, breech babies might face higher risks of certain health problems. These include:

• Hip dysplasia
• Torticollis (twisted neck)
• Foot deformities

These issues can often be treated with early intervention. This might include physical therapy or special exercises. In some cases, breech babies might have underlying conditions that affect their health long-term. Yet, most breech babies grow up to be healthy.

If you’re worried about your breech baby’s development or health, talk to your pediatrician. Early action can lead to the best outcomes for your child.

Preventing Breech Presentation

It’s not always possible to prevent breech presentation. But, expectant mothers can take steps to lower the risk. A healthy lifestyle, including regular exercise and a balanced diet, can help. Exercises like pelvic tilts and forward-leaning inversions might encourage the baby to turn head-down.

Medical interventions can also help. One method is external cephalic version (ECV). A healthcare provider applies gentle pressure to the mother’s abdomen to encourage the baby to turn. This is usually done after 36 weeks and has a success rate of 50-70%.

Not all breech presentations can be prevented. Some factors, like uterine abnormalities or multiple gestations, can increase the risk. Regular prenatal check-ups and talking openly with your healthcare provider are key. They can help identify and address any concerns related to breech presentation.