Why Babies Go Breech and 5 Things You Can Do About It

Babies are typically head down in the mother’s womb; however, sometimes they flip with their head up and their bum down. There are three different types of breech positions:

Frank: This is when the baby’s bum is facing down towards the woman’s birth canal with the feet sticking straight up by the baby’s head.

Complete: This is where the baby’s bum is facing down towards the woman’s birth canal but the baby’s legs are folded up near the belly and bum.

Footling: This is where one or both of the baby’s feet are almost standing on the cervix pointing down towards the birth canal.

Before the year 2000, breech delivery was not viewed as it is today.

Women were given the choice to deliver breech or delivery via Cesarean. There was a study performed in 2001. This study had some flaws, but due to this study (flaws and all), breech delivery started to disappear.

In fact, training for breech delivery is no longer being taught in medical school. Care providers can’t fully answer why delivering breech is unsafe. In most cases, women are no longer given an option for the type of delivery they desire.

Why Babies Go Breech

Unfortunately, there is no exact known reason or cause as to why babies go breech.

However, there are some studies that show it may be related to things like abnormal shape of the uterus, growths such as fibroids, placenta previa, multiple fetuses, and pelvis injuries, etc.

A blog post written by Rebecca Deckker states that that breech position is present in 3-4% of term pregnancies (Dekker, 2018). Typically when a baby is in a breech position, it is before 28 weeks gestation, but babies still can turn to the breech position after this point.

What can you do to turn a breech baby?

When a baby turns breech, an ECV, or External Cephalic Version should be offered (read more on ECV here).

This is when the provider will manually try and turn the baby from the outside, by placing his or her hands on the mother’s abdomen and manually rotating the baby to a head down position.

This sounds really uncomfortable, and it is.

My son (my VBA2C baby) went breech a few times in pregnancy.

When my provider performed an ECV, I can’t say it was the most comfortable thing I have ever done, but I will tell you it wasn’t as bad as some may describe. I had to breathe through it, but it was 100% manageable and SO worth it.

Not sure how to turn a breech baby? In addition to an ECV, there are things you can do to encourage a breech baby to turn:

• Spinning Babies is a series of movements and positions that you do daily and weekly to get that baby flipping head down.
• Moxibustion is a form of Chinese medicine involving burning an herb close to your fifth toe that shows great promise in encouraging babies to flip.
• The Miles Circuit is a great way to keep that baby head down after it turns as well as encouraging it to turn.
• Chiropractic care by a Webster trained chiropractor has been shown to greatly improve the position of a poorly positioned baby including encouraging a breech baby to turn.

Acupuncture is another form of Chinese medicine that will encourage a baby to turn. Use it in tandem with Moxibustion for the best results.

Is it safe to deliver a breech baby?

In 2018, ACOG, the American College of Obstetricians and Gynecologists, released a new bulletin on this very topic.

They state that the number of skilled providers these days that can deliver breech has gone down.

They go on to say that the trend of C-sections being performed due to breech position has gone up, and they believe that the mode of delivery (delivering breech vaginally or Cesarean) should be considered by the mother’s wishes.

ACOG makes the following recommendations:

1. The decision regarding the mode of delivery should consider patient wishes and the experience of the health care provider.
2. Obstetrician–gynecologists and other obstetric care providers should offer external cephalic version as an alternative to planned cesarean for a woman who has a term singleton breec\h fetus, desires a planned vaginal delivery of a vertex-presentation fetus, and has no contraindications. External cephalic version should be attempted only in settings in which cesarean delivery services are readily available.”
3. Planned vaginal delivery of a term singleton breech fetus may be reasonable under hospital-specific protocol guidelines for eligibility and labor management.
4. If a vaginal breech delivery is planned, a detailed informed consent should be documented—including risks that perinatal or neonatal mortality or short-term serious neonatal morbidity may be higher than if a cesarean delivery is planned.

“There is a trend in the United States to perform cesarean delivery for term singleton fetuses in a breech presentation.” Notice that ACOG uses the word “trend” to define automatically preforming a C-section for breech babies?”

Two studies published in 2022 (since the original version of this article was released) offer similar recommendations – birthing women should be offered information and the ability to make individual decisions when it comes to choosing a cesarean or vaginal birth. Both studies do indicate some difference in maternal complications, potentially a lower risk of maternal mortality for those choosing a planned c-section. Even still, one of these studies goes on to say, “there is no contraindication for vaginal delivery in breech presentation in selected pregnant women and in the presence of experienced health workers.”

Breech Presentation and Hip Dysplasia

DDH (developmental dysplasia of the hip) refers to the infant condition in which the ball of the hip joint doesn’t fit into the socket of the hip due to underdevelopment. According to the International Hip Dysplasia Institute, baby’s position in the womb is a risk factor for DDH and a baby presenting breech at birth has an increased risk of developing it.

DDH is typically diagnosed using a physical exam and / or x-ray at birth or within the first few months, but it is often difficult to diagnose. DDH doesn’t typically cause pain or inhibit a child’s ability to learn to walk. Symptoms to look out for include asymmetry in baby’s bottom creases, hip clicks, limited range of motion during diaper changes or baby-wearing, pain or exaggerated waddling. 

Once diagnosed, DDH is usually treatable with a holding device like a brace or harness, possibly surgery in severe cases. If left untreated, DDH could cause pain and loss of mobility, even arthritis, later in life. 

If your baby has been diagnosed with DDH, we love this list titled “There are things to be thankful for” by the International Hip Dysplasia Institute:

• Hip dysplasia can be successfully treated in most cases. Good results should allow your child to participate in active play and in sports as he or she gets older.

• Hip dysplasia (DDH) isn’t usually painful for babies and young children even when the hip is unstable or dislocated.

• It’s likely that your child’s hip dysplasia has been discovered in time to do something about it.

• Hip dysplasia is a pretty common condition with various degrees of involvement so most doctors are familiar with the problem.

• Hip dysplasia is usually an isolated problem so there’s not much worry that something else might be wrong with your child.

Support for Parents

As with most parts of parenting, navigating a breech delivery along with any accompanying complications like DDH can feel lonely. Here are some great resources to help you feel supported and encouraged along your journey: 

• International Hip Dysplasia Institute – Tips for Parents (and much, much more on this website!!)
• Coalition for Breech Birth Facebook Group
• Hip Dysplasia in Babies Facebook Group
• Infant/Child Hip Dysplasia – USA Facebook Group

Additionally, we have some really great breech-related resources right here at The VBAC Link…

• Episode 4 – “Chelsey’s Breech VBA2C + The Lost Art of Breech Delivery” (Listen on Spotify or Apple Podcasts)
• Episode 38 – “Jenna’s VBAC + Breech Babies” (Listen on Spotify or Apple Podcasts)
• Episode 80 – “Chelsey’s 2VBA2C + Breech Babies” (Listen on Spotify or Apple Podcasts)
• Episode 112 – “Nicole’s VBAC + Breech Babies” (Listen on Spotify or Apple Podcasts)
• Episode 128 – “Grace’s Breech VBA2C” (Listen on Spotify or Apple Podcasts)
• Episode 213 – “Olga Leiser’s Breech VBAC + 2VBAC”  (Listen on Spotify or Apple Podcasts)
• Episode 298 – “Jenny’s VBAC After Baby Was Breech + Intense Travel” (Listen on Spotify or Apple Podcasts)
• Episode 304 – “Aisha’s Surprise Breech HBAC” (Listen on Spotify or Apple Podcasts)
• How to Turn a Breech Baby: 8 Ways to Flip that Baby​
• ECV and VBAC: What you need to know

It is time to take a stand!

Ladies, if you desire to deliver vaginally and your baby has gone breech, be sure that the above options have been discussed/performed, and your options have been given to you.

If your care provider does not deliver breech, don’t be scared to search for one that does. Like the provider states in the “heads up” video/article: we need to take action YESTERDAY! Breech births may not be for everyone, but informed decision making is.​

Did you know? We offer online VBAC preparation classes and VBAC Doula Certification. Click here to learn more and book now!!

 

Updated Sources

https://hipdysplasia.org/developmental-dysplasia-of-the-hip/causes-of-ddh/

https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/aogs.14333

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9284475/