We say that babies are “presenting breech” when baby’s head is up (you may feel it under your ribs!) and bottom is down. There are different types of breech presentations, depending on whether baby’s bottom, feet or sometimes even knees are lowest in your pelvis. What is a Breech Baby? We say that babies are “presenting breech” when baby’s head is up (you may feel it under your ribs!) and bottom is down. There are different types of breech presentations, depending on whether baby’s bottom, feet or sometimes even knees are lowest in your pelvis.
Many babies are breech during pregnancy, but most turn head-down at some point, and only about 3 - 4 % of them remain breech.
Most of the times the breech positioning occurs by accident, for example baby simply ran out of room to flip on his or her own, or your particular pelvic type invites breech babies - they can run in families!
Your Obstetrician or Midwife will advise you if certain choices are not appropriate in your individual situation. However, for the majority of women we offer the following:
External Cephalic Version – This is a technique to turn the baby in the womb. If successful, you would return to your original birth plans.
Planned Caesarean Section – This is planned from 39 weeks. This timing is considered ideal to strike a balance between waiting for your baby to reach full maturity, while it is still likely the surgery will occur before you go in to labour, when it is safest.
Planned Vaginal Breech Delivery – If the baby remains breech you would come in early in labour, and you would be looked after by a midwife. A doctor will oversee your care and will be present for the birth. Labour would be on delivery suite. Your baby’s heartrate will be monitored on the CTG throughout. We now have telemetry monitoring in every room, which enables you to be mobile and adopt any position you wish for the birth.
Although approximately 60% of spontaneous breech births progress without intervention, occasionally, manoeuvre may be required at the time of birth. In some cases progress may be slow or there may be concerns with the baby’s heart tracing. In these cases an Obstetrician will discuss this with you and may recommend a caesarean.
External Cephalic Version (ECV) is a simple technique for turning your baby head-down in the womb. Prior to the procedure, a muscle relaxant is given to relax the uterus, as research shows this can increase the success rate. While you are lying on a bed, a doctor or midwife will apply pressure to your abdomen to encourage your baby to somersault into a head-first position. Ultrasound is used to monitor your baby throughout the procedure, which should take no longer than ten minutes.
ECV is generally safe and does not cause labour to begin. Your baby’s heart will be monitored before and after the ECV. Like any medical procedure, complications can sometimes occur. About one in 200 babies need to be delivered by emergency caesarean section immediately after an ECV. Therefore, ECV’s take place on Delivery Suite so that this can happen as quickly as possible if necessary.
During an ECV, a small amount of baby’s blood can be transferred to the mother. If you are Rhesus negative you will be offered an anti-D injection to prevent problems in future pregnancies.
Some situations may make ECV inappropriate, or more complicated. If any of these apply to you, your obstetrician or midwife will advise you.
ECV can be uncomfortable, but can be stopped at any time if you wish. Please tell your obstetrician or midwife if you are experiencing pain so they can move their hands or stop.
On arrival at delivery suite, you will be shown to a room and greeted by the Breech Clinic team.
Your options and birth preferences will be discussed and the position of the baby will be confirmed on scan.
If you would like a planned caesarean, this can be booked the same day and you will be given the date.
If you would like an ECV, your baby will be monitored and if suitable, an ECV will be performed. Your baby will then be monitored again following the procedure. If you are rhesus negative, blood will be taken and you will return the following day for an Anti D injection.
If your baby remains breech, your choices are:
• planned caesarean section
• planned vaginal breech birth.
There are benefits and risks associated with both caesarean section and vaginal breech birth, these will be discussed with you by a consultant Obstetrician so that you can choose what is best for you and your baby.
