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Health Information

Breech Presentation

Definition

Most babies move into a head-down position in the uterus before labor begins. If a baby’s buttocks or feet are in position to come out first, the baby is in a breech position. There are three types of breech presentations:

  • Frank breech—the baby’s buttocks are down and the legs extend straight up in front of the body with the feet up near the head
  • Complete breech—the baby’s buttocks are down with the legs bent at the knees and the feet near the buttocks
  • Footling or incomplete breech—one or both of the baby’s feet are down

More complications can occur in a breech delivery. Almost all breech babies are delivered by cesarean section . If your baby is in a breech position as you near the end of your pregnancy, talk to your doctor about trying to change the position of the baby, or a cesarean section delivery.

Complete Breech Birth Position
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Causes

Certain factors can make it difficult for the baby to move but the exact cause is not fully understood.

Risk Factors

Factors that may increase the chance of breech presentations include:

  • A woman has had more than one pregnancy
  • There are two babies or more in the uterus
  • Too much or too little amniotic fluid
  • Abnormal shape or abnormal growths of the uterus, such as fibroids
  • Placenta previa , when the placenta partly or fully covers the opening of the uterus
  • Premature birth
  • Hydrocephalus , an increase in fluid around the baby's brain, makes it difficult for it to turn in the uterus

Symptoms

There are no symptoms that indicate a baby is breech. Some women feel kicking low in the abdomen when a baby is in a breech position. Others feel hiccups above the belly button. Babies change positions often. It can be hard to tell which way your baby is lying.

Diagnosis

A few weeks before your due date, your doctor will try to determine your baby’s position. This is usually done through a physical exam. Your doctor will feel the baby’s position through the wall of your abdomen. Placing his hands in different places, the doctor will try to determine the position of the baby’s head, back, and buttocks.

The doctor may listen for the position of your baby’s heartbeat. An ultrasound may also be used to determine your baby’s position.

Treatment

If your baby is still in the breech position in the last weeks of pregnancy, talk with your doctor about the best treatment plan for you. Treatment options include the following:

External Version

External version is a nonsurgical procedure. The doctor will try to move the baby's head into a downward position by gently pushing on the mother’s abdomen. External version is usually performed 3-4 weeks before the due date. The procedure is successful more than 50% of the time. But, sometimes a baby will turn back to the breech position before delivery.

There are some rare, but serious complications that may occur after an external version, such as preterm labor.

Exercises

Two nonmedical exercises done during the last eight weeks of pregnancy may be tried to help encourage a baby to turn head-downward. These exercises are usually done two or three times a day for 10-15 minutes each.

  • Tilt position—Lie on your back with knees bent, feet flat on the floor and with several good-sized pillows under your bottom.
  • Knee-chest position—Kneeling on the floor, you lean forward until your head rests on your folded arms, making your head lower than your bottom.

Moxibustion

Moxibustion is a Chinese remedy that involves burning an herb, Moxa, close to the skin. When attempting to turn a breech baby, Moxa is burned close to the acupuncture point at the tip of the fifth toe. Some studies have found moxibustion to be effective in stimulating breech babies to turn. This treatment is still being studied. Because it may help you avoid a surgical delivery, you may consider talking to your doctor about it.

Cesarean Section

Surgical delivery of the baby is the most common way of delivering a breech baby.

Prevention

There is no way to prevent a baby from moving into a breech position at the end of a pregnancy.

Revision Information

  • American Academy of Family Physicians

    http://familydoctor.org

  • The American Congress of Obstetricians and Gynecologists

    http://www.acog.org

  • The Canadian Women's Health Network

    http://www.cwhn.ca

  • The Society of Obstetricians and Gynaecologists of Canada

    http://www.sogc.org

  • Breech babies: what can I do if my baby is breech? American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/pregnancy-newborns/labor-childbirth/breech-babies-what-can-i-do-if-my-baby-is-breech.html . Updated August 2010. Accessed June 5, 2013.

  • Breech births. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/labornbirth/breechpresentation.html . Updated May 2007. Accessed June 5, 2013.

  • Breech delivery. EBSCO DynaMed website. Available at: http://dynamed.ebscohost.com/about/about-us . Updated May 1, 2012. Accessed June 5, 2013.

  • If your baby is breech. American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/For%20Patients/faq079.pdf?dmc=1&ts=20121218T1009018242 . Accessed June 5, 2013.