In the final weeks of pregnancy, it is typical for a baby to shift into a position where their head is poised to exit the birth canal first. This positioning is known as vertex presentation. Conversely, a breech presentation occurs when a baby’s buttocks, feet, or both are positioned to come out first, which happens in approximately 3–4% of full-term deliveries.
Types of Breech Presentations
- Complete Breech: In this position, the baby’s buttocks are directed downward, with their legs folded at the knees and feet close to their bottom.
- Frank Breech: Here, the buttocks point toward the birth canal, while the legs are extended straight up in front of the body, with the feet near the head.
- Footling Breech: In this scenario, one or both feet are positioned downward, which means they will deliver before the rest of the body.
Causes of Breech Presentation
The exact reasons for breech presentations remain unclear, but research indicates that certain factors may increase the likelihood, such as:
- Having had previous pregnancies
- Carrying multiple babies
- A history of premature births
- Abnormalities in the uterus, such as fibroids or unusual shapes
- An unusual amount of amniotic fluid, whether too much or too little
- Conditions like placenta previa, where the placenta partially or completely covers the cervix
Diagnosing a Breech Presentation
A healthcare provider will typically assess the baby’s position a few weeks before the due date by palpating the mother’s lower abdomen to identify the baby’s head, back, and buttocks. If a breech position is suspected, they may use an ultrasound or pelvic exam for confirmation. Special x-rays can also help determine the baby’s position and assess the pelvis’s size for the feasibility of a vaginal delivery.
Risks Associated with Breech Presentations
While many breech babies are born healthy, there is a slightly increased risk for certain complications. Birth defects, for instance, are somewhat more prevalent in breech infants, which could be a reason they did not turn into the optimal position prior to delivery.
Can a Breech Presentation be Altered?
It is often preferable to attempt turning a breech baby between the 32nd and 37th weeks of pregnancy. Various methods can be employed to encourage the baby to turn, and success rates may vary. It’s advisable to discuss options with a healthcare provider to determine the best approach.
Medical Techniques: One common procedure is the External Cephalic Version (EVC), which is a non-surgical technique to reposition the baby. During ECV, medication may be administered to relax the uterus, and an ultrasound is often used to monitor the baby’s position, placenta, and amniotic fluid levels. Gentle pressure is then applied to the abdomen to turn the baby head-down. Continuous monitoring of the baby’s heartbeat is essential, and the procedure is typically performed near a delivery room in case a cesarean delivery is needed.
However, ECV is not recommended if you are carrying multiples, if there are health concerns about the fetus, or if the placenta is improperly positioned. Possible complications include rupture of membranes, changes in fetal heart rate, placental abruption, and preterm labor.
Vaginal Delivery vs. Cesarean for Breech Births
Most healthcare providers generally avoid attempting a vaginal delivery for a breech baby. Some may defer making a final decision until labor begins. Conditions that must be met to consider a vaginal birth include:
- The baby being full-term and in a frank breech position
- No signs of fetal distress
- Smooth labor progression with cervical dilation
- Estimations that the baby is not too large compared to the mother’s pelvis
- Availability of anesthesia and immediate access to a cesarean delivery if necessary
Risks and Complications of Vaginal Delivery
In breech births, the baby’s head is the last part to emerge, complicating its passage through the birth canal. Forceps may be used to assist. A potential issue is cord prolapse, where the umbilical cord is compressed as the baby descends, affecting oxygen and blood supply. Continuous electronic fetal monitoring is employed during labor to track the baby’s heartbeat, allowing for timely intervention if distress signals arise.
When considering your journey into parenthood, the decision to pursue alternative routes like at-home insemination could also be explored. Companies like Make a Mom offer innovative solutions, such as the only reusable option for home insemination. Curious about how it works? Check out this guide that outlines the process clearly. Additionally, if you’re looking for sperm donor matching services, Vegas Pregnancy can help you find the perfect fit.
For further insights on fertility and conception, you can explore our blog on creating new traditions in parenthood and enhance your understanding of at-home insemination with resources like WebMD’s overview of IUI success. For a deeper dive into related topics, Modern Family Blog offers excellent perspectives on family building.
In summary, while breech presentations can pose challenges during delivery, options are available to manage the situation effectively. Engaging with healthcare providers to explore all avenues is crucial.