Question
At 36 weeks, I'm wondering how a baby in breech position can be turned?
Answer
Breech presentations occur in about 3 percent to 4 percent of all pregnancies. Usually babies settle into a headfirst (cephalic) position by 34 to 36 weeks gestation; however, it is possible for them to turn from breech to cephalic up until delivery. Although today's typical medical management for delivery of a breech
baby is a cesarean, there are strategies you can try prior to
birth to encourage the
baby to turn to a cephalic position. Be sure to discuss these with your health care provider.
* Maternal positioning. Assume an inverted position with your head down and hips and feet elevated. This will help the
baby move back out of your pelvis so he has more room to turn. A simple way to achieve this position is to place an ironing board on an angle from a sofa to the floor; you then lie inverted on the board for about 10 minutes three times a day. This will be more comfortable if your bladder and stomach are empty. This technique is worth a tryit's been estimated to work 50 percent of the time.
* Sound stimulation. Some women have found success in getting their breech babies to turn by placing earphones from a tape or CD player just above the pubic bone and playing music for the
baby during his active periods. Because the
baby can hear sounds while in the uterus, it is thought that he might move his head down in the uterus to hear the music better and thus turn his body.
* External abdominal massage. This deep abdominal manipulation, performed by a physician with the assistance of ultrasound, is called external cephalic version (ECV). The physician uses her hands on the mother's abdomen to rotate the
baby by using deep, massage-like movements. Once turned, the
baby usually remains in this position for
birth, although it is possible for him to revert back to the breech position.
If these strategies are not successful in turning your breech
baby, you do have the option of a vaginal or cesarean
birth. Some physicians are willing to give you a trial of labor to attempt a vaginal
birth, if all other factors regarding your
pregnancy are normal. However, many physicians are not willing to consider vaginal
birth for a breech because of the potential risks involved. Since the breech (baby's bottom) is not as large as the head, a woman's cervix is not likely to dilate to 10 centimeters during labor as it would normally. The delivery of the baby's body through a cervix that has not completely dilated can cause the head to be trapped. Therefore, most physicians today recommend a cesarean
birth for delivery of a
baby in a breech presentation.
