Babies positioned feet or bottom first in the uterus are called breech babies instead of the usual headfirst position. During the early stages of pregnancy, it is common for foetuses to be in a breech presentation. However, when they reach 36-37 weeks of gestation, most foetuses naturally turn to a cephalic or headfirst position. Only 3-4% of babies are in breech position by the end of gestation.
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It could be a coincidence that your baby hasn’t yet turned into the headfirst position. However, specific factors can make it harder for the baby to turn during pregnancy, increasing the likelihood of them remaining in the breech position.
These include:
A caesarean section is generally the preferred and recommended option if your baby remains breech towards the end of pregnancy.
Studies indicate that a planned C-section is a safer option than a vaginal delivery for a breech baby.
Giving birth through a Caesarean section entails a slightly higher risk than vaginal delivery. However, the complications are minimal when done in the best of hands.
Planned vaginal breech delivery is not the recommended option in terms of safety of the baby. While vaginal birth is generally considered safe, it is essential to note that there is a slightly increased risk of infant mortality around delivery. In addition, a vaginal breech birth can present potentially severe short-term complications for your baby. Therefore, this option is offered only after individualized risk assessment of patients.
ECV involves applying gentle but firm pressure on your tummy to help your baby turn in the uterus to lie in a headfirst or head-down position.
Medication is given by injection before ECV to relax uterine muscles and improve the chances of turning your baby safely. The drug is safe for both mother and baby.
Before undergoing an ECV, an ultrasound is done to ensure your baby is in the breech position. Additionally, your pulse and blood pressure are monitored. Another ultrasound is performed following the procedure to check if your baby has shifted positions. The foetal heart rate is closely monitored before and after the procedure. ECV is typically done after 36 or 37 weeks of pregnancy. While ECV can cause discomfort and occasional pain, your healthcare provider will stop if you experience pain. The procedure usually lasts for a few minutes.
However, it is associated with a few risks to the baby, like the risk of bleeding or the baby’s heartbeat suddenly going down after the procedure requiring an Emergency Caesarean Section. Therefore, this procedure is not available to all patients with a breech pregnancy. This option is again individualized after a detailed case risk assessment.
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Throughout pregnancy, the baby will keep moving and changing positions. A breech baby can change position even when labour starts. A breech position, once labour sets in, is not very safe. To avoid unnecessary complications that can endanger the mother, or baby, or both, doctors opt for a caesarean delivery.
Sleeping on your side with a pillow between your bent knees is the best position to sleep in when the baby is in a breech position. This gives room for the baby to turn around. There are other positions to increase the chances of the baby turning head down from the breech position. It is advisable to consult your doctor and follow their advice.
It is not possible to always avoid the breech position successfully. While you cannot predict when the baby will change positions, doing some pregnancy-safe stretches, exercises, and maintaining a good posture can help babies turn if they are in a breech position.
A fetus keeps moving and changing position throughout pregnancy. Some common reasons for a baby to move into a breech position include an abnormally shaped uterus, the presence of more than one baby in the womb, the position of the placenta, and preterm delivery.
