One of the more common reasons a woman is given for “needing” a C-section is that her baby is breech–that is, the head is near the top of the uterus, instead of at the cervix. Prior to the 1970s, doctors were trained how to matter-of-factly handle breech births. At the time, C-sections were much riskier than they are today, so they were reserved for truly necessary situations. Most doctors nowadays do not have the knowledge or skill necessary to attend a vaginal breech birth–they were taught how to perform surgery instead of attending breech births. If you have been told that you must have a C-section because your baby is breech, you need to know your rights, as well as the risks to you and your baby from either a C-section or a vaginal birth. I would suggest reading Henci Goer’s book The Thinking Woman’s Guide to a Better Birth for a fuller explanation of the risks and benefits.
There are many studies on breeches; but unfortunately, most of them are too small to draw firm conclusions. One study I recently read said that there are some definite factors that increase the risk of vaginal breech birth; but in the absence of these factors, vaginal breech birth is safe.
However, the best thing you can probably do is to try to get your baby to turn head-down. A few years ago, I combed through the internet looking for different ways to turn a breech baby, and I’ve compiled them in one file (see below). The reasons for the baby being breech in the first place probably has a lot to do with the success rate. The main reason a baby is breech is unknown; other contributing factors include too much or too little amniotic fluid, twins, placenta previa, abnormally-shaped uterus, fetal abnormalities, prematurity (only 3-4% of term babies are still breech once labor starts), cord problems and entanglements, and maternal tension. This list by no means takes the place of medical advice. Most of the “techniques” I’ve listed have not been formally studied, and some are more or less anecdotal.
o Many times maternal fears lead to tense muscles (including those of the uterus), making the breech position the most comfortable one for baby, or the one in which it was stuck, and is then unable to move to vertex because of the confines of the uterus
o Necessary for other turning attempts to work—no amount of turning will get the baby out of breech if the uterine muscles are just too tense
· External Cephalic Version
o Basically, someone manually turns the baby head-down by pressing and pushing on the mom’s stomach
o This is typically done at 36+ weeks, and can be done during labor
o There is the possibility of cord compression or some other cause of fetal distress, so it’s typically done in the hospital, in case a quick C-section needs to be done
o Some other countries tend to do ECVs earlier (31 weeks or so); this tends to make it easier, because the baby is smaller, so there is more room in the uterus, but there is a higher possibility of the baby turning back breech in the intervening weeks
· Webster technique
o A chiropractic technique in which the body is manipulated to release stress on the mom’s pelvis and relax the uterus and ligaments
· “Breech tilt”
o Mom lays on something like an ironing board (or several large pillows) with one end on the floor and the other end propped up on a couch, with her head on the floor side
o Done three times a day for 10-15 minutes at a time
o Best done on an empty stomach and when baby is active
o Play nice relaxing music near your pelvis to induce baby to come closer to hear better
o Or play loud raucous music near your fundus so baby will move away
· Shine a light near your pelvis, or even between your legs
· Have the father talk to the baby, low on the belly, and tell him/her to move
· Hypnotherapy (helps to relax)
· Lots and lots and lots of pelvic rocking
· Elephant walking (walking on hands and feet, to get your rear-end up as high as possible)
· Swimming—diving into pool, doing somersaults, or walking on your hands in the water
· Drink plenty of fluids
o This may help especially if low amniotic fluid is making not enough room for baby to move freely enough to turn
o Keep your belly open by keeping spine straight and tall
o Sit “Indian style”, leaning slightly forward
o Watch out for “bucket seats,” recliners, and other types of seats that tip you slightly back
· Moxibustion (a Chinese herb that is rolled into a stick, then the end is lit and put on various acupressure points of your body)
· Various herbs
· An ice pack or frozen bag of peas where the baby’s head is, to encourage it to move
Update: please click here to read a second post about breech babies, including why some babies may be breech.