Today, let's talk about what to do when you hear this phrase from your provider.
There are several non-invasive, low risk modalities to encourage a breech to go head down. Experience shows that integration and dedication gives one the best chance to go from breech to head down. Get your providers to talk to each other and work out a plan that fits your needs and lifestyle.
Start working to get your breech baby head down as soon as you find out. Do not wait until 36 or 37 weeks gestation. Often, and especially in this day and age, babies are malpositioned due to stress on the body structure. People spend a large amount of time in flexion, slouched, only using one side of their body, and so many other habits that contribute to soft tissue imbalance in the body. A great way to start at home when you are waiting for an appointment to be available is Spinning Babies. Gail Tully, the Spinning Babies lady, has compiled a series of exercises to do at home, some by yourself, and some need a partner. Continue integrating the Spinning Babies techniques with any other modalities you choose.
Find a modality that works for you
What a great time in herstory to be out of balance! There are so many great practitioners in the world who are masters at their craft. So, which ones are good for helping a breech go head down?
- Acupuncture - find someone experienced with breech.
- Chiropractic - be certain your practitioner is certified in prenatal care.
- Hypnosis - works very well for many people. Hypnobirthing and Hypnobabies have turn your breech tracks.
- Massage - ideally the massage therapist needs to be certified in prenatal care.
- Movement - Keep moving. What ever that looks like for you. If you need something more directed Restorative Exercise is a great choice for alignment.
Everyone has stress, but it seems more so pregnant people. Which birth class do we go to? Are we going to make prenatal yoga everyday? What kind of diapers? Hospital, Home, or Birth Center? Doula or no? (Get a doula!) Shots? Circumcision? Food? And then if you have a breech....Which modality do you choose? Do we try an external cephalic version? (More on that in a moment.) Do we schedule a c-section? Oy vey!!! The decisions are endless!!!! Step back, evaluate what is important to you. Take quiet time for yourself and tune into your intuition.
Talk to your baby. Really. Your baby will tell you what they need. It's a matter of creating space to hear baby.
Next, delegate. Ask for help. Simple things, laundry, meals, cleaning. Those are all things that people in your community can easily do and help with. Go do something fun with your friends! Have a date with your partner! Doing activities that make you happy and boost your oxytocin do the same for baby. When you relax, so do your soft tissues.
External Cephalic Version (ECV)
So, you have tried everything, and baby is still breech. The next step is an ECV. ECV is done by an OB/GYN or midwife in the hospital. You will be put on a monitor, an ultrasound will be done to confirm baby's position, and then you have a few choices. There are medications that can soften the uterine muscle to make the ECV easier. This reduces the uterus' ability to contract. An epidural can be used as well for the same effect. Or you can choose no medication. The provider doing the ECV can tell you the risks and benefits. Make sure you ask! And don't let them tell you there are no risks, there is always risk. Baby is monitored between each attempt by the practitioner. So, what is the practitioner doing? They are trying to turn the baby from breech to head down by pushing on the baby. Is this risky? According to the National Institute of Health, there is a 2% risk that something will go wrong. What is the rate of success? 50% success rate, again according to the National Institute of Health. Those are pretty good odds. Find a practitioner who has LOTS of experience. ECV should be gentle. It should not be painful. It is uncomfortable, but not painful. Now, you may be asking, "But I spent all of that money on the other modalities! Why am I ending up here?" Often, my clients say their ECV went so well, baby turned on the 1st or 2nd try. Practitioners believe this is from the preparation of the soft tissues before the procedure.
Remember, baby has the last word
Sometimes, baby will choose to remain breech. There is usually a pretty good reason for this choice. Please explore the literature, scientific literature, stay off the message boards, to find out common reasons for breech. Today's blog entry explores the soft tissue and bodily restrictions we face day to day. Physiological reasons are a whole other topic.
Vaginal Breech Birth (VBB)
In the United States this is a scarce option. There are few who admit to having the skills and even fewer who will attend. Recent studies, coming out of Brussels, Germany, Australia, England, and Canada, have shown that VBB can be as safe as head down birth. There are many conditions that need to be present for a safe VBB. Many VBB practitioners agree that a Frank Breech is the best candidate for vaginal birth. This where the feet are piked up by the face. But, the baby also needs to be facing the right direction, RSA - Right Sacrum Anterior. (Go to Spinning Babies.com to learn what that means.) The providers attending the breech need to be experienced in breech and trained in what to do if baby needs a little assistance on the way down. In general, and hopefully a majority of the time, all hands off the breech. Hands off the breech has been found to be the best approach across the board in all country's where VBB is practiced. The person giving birth should be allowed to move freely and be in whatever position they find best for them. More often than not, breech parents find themselves on hands and knees to give birth. Breech babies can be born vaginally, safely, and into loving arms.
There are times that cesarean section will be the best choice for mother and baby. Sometimes it is the safest medical route, sometimes it is the best choice for the family, and sometimes the baby will choose cesarean on their own. What ever the reason it is of utmost importance that families who choose c-section for their birth be supported and not shamed. Not questioned endlessly about, "Well, did you try this? Did you try that?" It's not fair to put anyone through that line of questioning. I have heard too many sad stories of parents feeling ashamed and unsupported for their decision to have a c-section. Those parents need as much support, if not more, than families choosing a vaginal delivery. Cesarean birth has become gentler and more family focused in the last year. For this, the natural birth community is grateful. I'm sure the medical community is grateful as well, but I don't dwell there often. Cesarean is birth too.
I hope you find this entry helpful in your breech journey. Best wishes!
Disclaimer: This is not medical advice, not meant to substitute or replace medical advice. All information is shared in the spirit of returning lost knowledge to the people. If one is in doubt as to whether anything here is appropriate, ask a provider.