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What is a breech birth?
A breech birth is when your baby is lying with their bottom, or feet towards your pelvis, rather than their head. Around 3-4% of babies are found to be in the breech position before labour. It's more common for babies to be in the breech position before full term, which is defined as before 37 weeks, but this isn't a problem as babies often turn themselves around into a head first position before 37 weeks. Breech births are more complicated than births where babies are in the correct birth position, as they can make vaginal delivery difficult, and pose a greater risk to the baby.
What causes babies to be in breech?
There is no clear cause for some babies not turning themselves around so their head points towards the birth canal, but there are some factors that can make it more likely for your baby to be in breech position. These include your baby being smaller than average (this is often the case with premature babies or multiple births), having an unusually shaped uterus, having fibroids, and having too much or too little amniotic fluid. Having a low lying placenta also increases your chance of having a breech baby. If you have had one baby in the breech position at full term, you're more likely to have breech babies in future pregnancies.
What happens if my baby is in breech?
During your pregnancy check-ups, your midwife will feel your stomach to check the position of your baby. Your midwife will be able to tell which way up your baby is by feeling for their head, and bottom, which will feel softer. The position of your baby's heartbeat can also indicate which way up they are lying.
If your baby is found to be in breech after 37 weeks, there is a small chance they may turn themselves around in time for labour. However, most babies won't turn around after 37 weeks so your health practitioner will talk to you about what options are available to you. If your pregnancy is healthy and low-risk, after 37 weeks you will be offered an external cephalic version (EVC). This is where a doctor tries to turn your baby around manually by placing their hands on your stomach and guiding the baby into the normal birth position. This is successful in round 50% of cases, although 2.5% of babies turn back into the breech position. It may feel uncomfortable when your baby is being turned around, but it shouldn't be particularly painful. Sometimes medicine is given to help the womb relax. Your baby's heartbeat will be monitored during and after EVC.
If EVC doesn't work, your options are to have a breech delivery, or a caesarean section. Your doctor will discuss which is the safest option for you, but generally a caesarean is recommended for breech babies as studies have found that it is the safest option for the baby. One instance where you may be advised to have a breech vaginal birth rather than a caesarean is if your labour has started and your baby is very close to being born. Instances where it could be dangerous to opt for a breech vaginal birth include if your baby is excessively large or small, having a small uterus, if your baby is positioned feet first(known as the 'footling' position), if your baby is 'stargazing' (where his head is tilted back), or if you have pre-eclampsia.
Are there anything I can do to get my baby to turn around?
Many midwives recommend doing simple exercises to encourage your baby to turn its head. Try rocking backwards and forwards on your hands and knees with your knees slightly apart, arching your back. Some studies have shown that doing this for 15 minutes every 2 hours during the day can be very beneficial in persuading your baby to turn around.