By Fidelia Asogwa
With every passing day of your pregnancy, your baby grows, develops and moves inside your womb preparing itself for labour and birthing. So as you near your expected delivery date, your baby would position and align itself along the birth canal in such a way that its head would be facing down placed in the pelvis area of the mother. Your baby takes this position a few weeks before the delivery to gear up for a natural birthing.
As in the process of natural birthing, the head of the baby comes out first marking the grand entry into the world.
However, in some cases, this natural positioning does not happen as expected and the baby’s buttocks or feet will be positioned to be delivered first. This situation is referred to as “breech presentation”. In most cases, this position gives rise to delivery complications resulting to delivery through caesarian section.
What are different types of breech presentation?
- Frank breech: In this position, the baby’s buttocks are aimed at the birth canal with its legs sticking straight up in front of his or her body and the feet near the head.
- Complete breech: Here, the buttocks are pointing downwards with the legs folded at the knees and feet near buttocks.
- Footling breech: In this position, one or both of the baby’s feet point towards the birth canal.
What are the causes of breech presentation?
- Location of the placenta: If your placenta is low-lying, covers the cervix or is located up near the top of your uterine wall and as well blocking the space near your baby’s head, the baby may not be able to wiggle her way into a downward position.
- Volume of amniotic fluid: Too little or too much amniotic fluid can also cause a baby to be in a breech position. Not having enough fluid makes it more difficult for your baby to ‘swim’ around, while having too much means the baby may swim too much and end up in a breech presentation.
- Pregnancies of multiples such as twins, triplets etc can result to breech presentation sometimes because the babies would be fighting for space thereby moving totally away from the normal position.
- Premature delivery can cause breech presentation.
- Pregnancy with abnormal growth in the uterus such as fibroid can make a baby to be in a breech position.
How is a breech presentation diagnosed?
A few weeks prior to the due date, the health care provider will place his /her hand on the mother’s lower abdomen to locate the baby’s head, back, and buttocks. If it appears that the baby might be in a breech position, they can use ultrasound to confirm the position. Special x-ray, can also be used to determine the position and the size of the pelvis to know if a vaginal delivery of a breech baby can be safely attempted.
Can a breech presentation be changed?
It is preferable to try to turn a breech baby between the 32nd and 37 weeks of pregnancy. The methods of turning a baby vary and the success rate for each method also vary depending on the type of breech presentation and the expertise of health care provider involved.
Here are some of the methods through which babies in breech position can be turned:
Medical Techniques: Here we have two forms
- External Version: External version is a non-surgical technique to move the baby in the uterus. In this procedure, a medication is given to help relax the uterus. There might also be use of ultrasound to determine the position of the baby, the location of the placenta and the amount of amniotic fluid in the uterus. Gentle pushing on the lower abdomen can turn the baby into the head down position. Throughout the external version, the baby’s heartbeat should be closely monitored so that if a problem develops, the health care provider will immediately stop the procedure. External version has a high success rate. However, this procedure becomes more difficult as the due date gets closer.
- Chiropractice care: Larry Webster, D.C. of the International Chiropractice Pediatric Association, developed a technique that enabled chiropractors to reduce stress on the pregnant woman’s pelvis leading to the relaxation of the uterus and surrounding ligaments. A more relaxed uterus makes it easier for a breach baby to turn naturally. This technique is called Webster Breech Technique. This technique is preferably performed in the 8th month of pregnancy.
- For emphasis, a Chiropractor is a health care practitioner who specializes in chiropractice, the hand-held instrumental movement of the bone structure of the body to improve the f unction of the joints or nervous system. While Chropractice is a system of health care involving manipulation of the spinal column and other body structures, for the purposes of alleviating neural dysfunction.
The following risk-free techniques can be tried by pregnant women whose babies are in breech position
The Breech Tilt: Using large firm pillows raise the hips 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.
Using Music: We know that babies can hear sounds outside the womb. Consequently, many women have used music or taped recordings of their voice to try to get their babies to move toward the sound. Placing headphones on the lower part of your abdomen and playing either music or sounds of your voice can encourage your baby to move towards the sounds and out of breech position.
Walking: This is the most easy and convenient exercise that you can indulge in during pregnancy. Walking at least twice a day during the last trimester of your pregnancy for 20-30 minutes increases your chances of turning your breech baby into the natural position. This is because while you walk, your baby’s head that is the heaviest part of the body will gravitate downward and fix at the bottom of the pelvis of the mother. So going for a walk is the least you can do to ensure that both you and your baby enjoy a birthing that is natural and with less medical intervention
Crawling: Crawling is very important when you notice that your baby is in a breech position. Crawling like a baby for about 10 minutes every day can help your baby move inside your womb and change the breech position to normal. Bend down on your knees and support your upper body with your palms resting on the floor, keeping your back straight. Know that even your full-term belly would not be touching the ground as you craw. This exercise will help your baby move and reposition itself correctly to initiate a natural birthing process.
Sleeping towards the left hand side: Sleeping for at least 8 hours a day plays an important role during pregnancy. And sleeping position also has a lot to do with your baby’s movements and positioning ability. During the last few months of your pregnancy, make sure that you sleep on your left side supporting your belly with a pillow beneath it. Even when you are sitting, sit on large seat leaning on the left side. This position will encourage baby movements inside the womb and help your baby get into the natural position before the onset of labour.
It is important to know that some expert health care providers can turn breech babies for vaginal delivery instead of resorting to Cesarean section.
The following conditions are considered necessary in order to attempt a vaginal birth for a breech baby.
The baby does not show signs of distress while its heart rate is closely monitored.
The process of labour is smooth and steady with the cervix widening as the baby descends. The health care provider estimates that the baby is not too big or the mother’s pelvis too narrow for the baby to pass safely through the birth canal.
What are the risks and complications of a vaginal delivery of breech baby?
In a breech birth, the baby’s head is the last part of its body to emerge making it more difficult to ease it through the birth canal. Sometimes, forceps are used to guide the baby’s head out of the birth canal.
Another potential problem is cord prolapse. In this situation, the umbilical cord is squeezed as the baby moves toward the birth canal, thus slowing the baby’s supply of oxygen and blood. In a vaginal breech delivery, electronic fetal monitoring should be used to monitor the baby’s heartbeat throughout the course of labour. A caesarian delivery should be performed immediately if signs develop that the baby is in distress or that there are other complications. It is advisable that pregnant women go to experts instead of going to quacks where they either loss their babies or their lives on the course of delivery.
Seek for help: Seek for medical help for adequate treatment if you experience bed wetting. It is treated once the root cause is ascertained. But if after conducting all the tests and the treatment administered yet the problem persists, seek for spiritual help. There have been cases where people were actually afflicted with such problem spiritually. So once you’ve utilized all other options and nothing happened, seek for God’s intervention.