A Facebook group that I am an Admin for (along with 2 amazing women, Jen Hazi and Amelia Parkinson) has ‘Lives’ on pregnancy and birth topics every Monday evening (click HERE for details of the group!). Last Monday, Amelia and Jen discussed options for a Breech Pregnancy and this blog is a summary of their chat!
So what does 'being breech' mean? A pregnancy is breech when the baby is not head down towards mum's pelvis. There are different types of breech presentation, babies can be lying sideways across the uterus (transverse breech) or be head-up instead of head-down (frank, footling or complete breech). If your baby is breech, the first thing to do is don't panic - babies turn all the time in pregnancy. But if your baby is still breech at around 35-36 weeks, that is the time to start thinking about practical steps to try and encourage baby to turn head down.
image: RANZCOG article on Breech Presentation at the End of Your Pregnancy
Practical Tips for a Breech Pregnancy Samantha Gunn Doula
1. Mind/Body Connection
It is said that 'you learn from the part of the story that you focus on' - so what you think about becomes your reality. The more you think about your baby being breech, the more your baby is likely to stay right where he/she is. The Mind/Body connection is powerful, especially in pregnancy, but it is also an easy tool to utilise in helping your baby to turn. This can be literally as easy as imagining your baby being head head down. Amelia has a beautiful mantra from Wonder Birthing to recite which not only encourages baby head down but also into his/her best position. It's a beautiful and connecting exercise even if your baby is already head down. The exercise is as follows:
Wonder Birthing's Mirror Mantra
Get comfortable, close your eyes and mentally connect to your baby.
Take a few deep breaths.
Repeat the words 'head down, chin to chest, hands to heart, back to belly'
Take another deep breath.
Repeat this sequence a few times, a few times a day.
2. Get an ECV Performed
If you baby is breech at 36 weeks, and you don't have any risk factors associated with your pregnancy, your midwife or doctor may suggest that you consider an ECV (External Cephalic Version) done. This is an external procedure performed around 37 weeks. Your care provider will palpate and manually encourage your baby to turn so that he/she is head down. Baby is then checked via ultrasound to confirm position. The procedure only takes a few minutes from start to finish.
Below is a video of Dr Andrew Bisits from Sydney's RHW in Randwick performing the procedure.
3. Acupuncture/Moxibustion
Moxibustion is a TCM treatment using a Chinese herb called Moxa, commonly known as ‘Mugwort’. The Moxa is compressed and rolled into a stick which is then lit and held over acupuncture points - for turning breech babies, the acupuncture point UB67 is normally used (this point is located on the outer, lower edge of both little toenails). The radiant heat produced has the effect of stimulating the acupuncture point. This is supposed to encourage baby to become more active and lift his/her bottom and wriggle into a head down position.
image: mothernurturing.com
Practical Tips for a Breech Pregnancy Samantha Gunn Doula
Acupuncture and moxibustion is generally believed to be effective in turning a breech presentation. There was a 3 year study performed by the AJCM in 2001 which showed the treatments to have a 92% success rate.
4. Chiropractic Adjustment
I recommend that my clients receive regular chiropractic care during their pregnancy to balance their pelvis and allow for their baby to easily find his/her best position. A chiropractic adjustment called the Webster Technique is a specific adjustment for breech presentations, there have been no studies done to support its effectiveness but there is plenty of anecdotal support for giving it a try to encourage a breech presentation to turn.
image: icpa4kids.org
Practical Tips for a Breech Pregnancy Samantha Gunn Doula
5. Posture and Positioning -
Some people think we're seeing more breech presentations because of modern lifestyle factors. We're generally leading more sedentary lives than we were a few generations ago and we have lovely, comfortable furniture to rest on. It is true that posture impacts our baby's positioning, so be mindful of how you're sitting and maintain your activity levels. Some tips for maintaining good posture while sitting are to keep a rolled up towel or lumbar support behind you, sit on a birthing ball, sit on a hard chair, try and keep your weight evenly distributed and change your position regularly.
As well as being mindful while sitting there are other postures you can try to encourage your baby to turn. Spending time on all 4s utilises gravity to encourage baby to turn. It can also be a good idea while on all 4s to lower your shoulders and have your hips still high, this increases the effectiveness of the posture. Being on all 4s is also a great time to practice some cat-cow yoga stretches. These are also beneficial for providing space a opportunity for baby to move.
image: mothermag.com
Practical Tips for a Breech Pregnancy Samantha Gunn Doula
6. Spinning Babies
It's no secret that I'm a huge fan of Spinning Babies! I've attended 2 courses on their techniques and I often recommend their information to clients or colleagues because I've seen how effective it is. Spinning Babies is a collection of techniques that focuses on posture, exercises and stretches to encourage your body and baby to be as well balanced and well positioned for birth as possible. In general their protocols fall into 2 categories - the Daily Essentials and 3 Sisters of Balance and I highly recommend learning more on their website.
I've had 2 clients whose breech babies turned at 35 weeks after we did some Spinning Babies work. Seeing these practical techniques have such an immediate and tangible outcome was amazing and really cemented my trust in their effectiveness. You can see the specific breech Spinning Babies information HERE.
7. Old Wives' Tales
I have to mention some unusual and traditional bits of advice that you might hear. They generally come from the idea that babies will respond to external stimulus - temperature, light and sound. Now I have no evidence to say that these will work or not but they won't cause any harm and might just be worth a try....
Temperature - put a cold pack (or a bag of frozen peas) on the top of your bump and a warm pack at the bottom. Baby should want to head towards the warmth.
Sound - play music at the base of your bump and cover the top of it. Baby should head towards the sounds
Light - cover the top of your bump and shine a strong flashlight at the bottom. Baby should head towards the light.
8. Find a Willing Care Provider
The reality is that some babies just won't turn head down despite all of our best efforts and intentions. And if that's the case then have a think about how you feel and discuss your options with your care provider. Breech birth is often described as a 'version of normal' and that's exactly what it is, if you are willing and can find a supportive care provider then a physiological birth is still an option if you want it.
At the end of the day pregnancy, like parenting, can be unpredictable, challenging and emotional. Try and stay present and calm, seek good quality and evidence based information and surround yourself with supportive practitioners. Your birth can be beautiful no matter how it unfolds and it is just the beginning of the adventure that is parenting.