I have heard women talking about a breech baby and breech births. Just in case you weren’t aware, a breech birth is one where the bottom-first or feet-first position appears first, unlike in normal cases where the baby’s head comes first as that is how they are normally positioned in a mother’s uterus. Babies born after the entire gestational period usually bear the headfirst position. But those babies being born early are more likely to breech. Excess amniotic fluid or more than one baby in the uterus can cause breeching.If your doctor can advise from the ultrasound as you near the due date as to whether yours will be a breech birth, then you might want to read through the following:
- Types of breech positions:
First let’s understand the four types of breech positions.
- Frank-Breech: The legs of the baby stretch out towards the baby’s abdomen.
- Footling: In this position the baby seems to be sitting on the pelvic tunnel with one or both the feet coming together in the pelvis while the bottom is above the brim. At around the 37th week, the baby may be able to bend its knees to make it seem like a sitting position.
- Kneeling: The baby has its feet coming together and folded behind the thighs.
- Complete Breech: The feet are behind the buttocks in this position.
However, if the baby is transversely or diagonally positioned, it’s not supposed to be in the breech position.
- Whether breech babies can be delivered normally?
You might obviously be thinking whether breech birth can occur vaginally or if it needs a C-section. One thing to bear in mind is that the headfirst babies are most easily delivered vaginally unlike a breech baby that may require a Cesarean. Few breech babies can be normally delivered, though. The risks involved are an injury to the baby or birth defects that might cause separate hip socket and thigh bone of the baby. Moreover, if the umbilical cord is pressed during delivery, it’s likely it can cause brain and nerve damage due to low oxygen levels.
Whether there are any techniques to spin and turn the baby?
Regular visits to the doctor will help you stay tuned to the movements of your baby. If it is a breech baby, the doctor may advise on few exercises that will help the baby to stay headfirst. However, there is also a procedure called external cephalic version whereby the doctor will turn the baby headfirst from outside of the abdomen using his or her hands. If the baby is brought to the headfirst position, then you can expect a normal delivery. The external cephalic version is performed after 37th gestational week.
- How is the external cephalic version performed?
Once the ultrasound confirms that the baby is breech, and a nonstress test is performed, the doctor will administer an injection to relax the uterine muscles. While you are lying down, he will use his hands from outside the abdomen to turn the baby to the headfirst position. An anaesthetic will be informed before the procedure is carried out just in case there’s a need for an emergency Cesarean. The injection administered is safe to both you and your baby.
- Whether external cephalic version has any disadvantages?
Some risks, although with low incidence, involved here are going into premature labor, an emergency Cesarean delivery due to fetal distress, minute blood loss for the mother or the baby, premature membrane disruption, and above all, the baby coming back to the breech position once again.
- What to expect after the external cephalic version is performed?
The doctor will advise you for a nonstress test, which if turns out good, you are free to go home. Else you might have to go through the external cephalic version once again, or there are chances the doctor will immediately set you for a C-section or try for a vaginal delivery.
- Who can expect external cephalic version recommended to them?
If you are scanned with abnormally small baby, membranes disrupt prematurely, have a nonreactive non-stress test, abnormal fetal heart, or if you have vaginal bleeding or have multiple pregnancies, then the procedure could be recommended.
- The success rate of external cephalic version:
The success rate is 65 percent. The major determiners for the success rate are the amniotic fluid levels, placental position, baby weight, and if you are nearing the due date.
It’s important to identify if your baby is in the breech position. Regular visits to the doctor will help you assess that. However, it’s also important to gauge if your doctor and his team are adept at breech birth techniques. Else you might want to look for a medical facility that will help you for a smooth birthing.
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