Most babies are placed in the cephalic position, that is, with the head on the mother’s pelvis, between weeks 28 and 32 of gestation, in order to be able to descend easily through the birth canal. But some continue in another position, breech (sitting on the mother’s pelvis) or transverse, weeks later.
This often creates a lot of stress for the pregnant woman who wonders what to do if my baby is breech or not positioned correctly .
To begin with, it should be noted that it is not something rare or infrequent: between three and four percent of babies are not in the cephalic position at the time of delivery. Also, you have to know that the baby can turn at any time , even very late in pregnancy. Although the bigger it is, the more unlikely it is that it will turn, especially if it is a new mother.
Why is my baby breech?
What factors influence the baby to adopt this position? Many times it is not known why the baby has adopted this position, but there are certain factors that can make it more likely that our baby adopts another position :
- In multiparous mothers who have already had several children and whose uterus is usually more dilated, giving the baby more space to move.
- When there is too much or too little amniotic fluid.
- In cases of placenta previa.
- Multiple pregnancies.
- Malformations of the uterus, when the uterus has an abnormal growth or presents certain abnormalities such as fibroids.
- History of preterm birth.
Breech: three possible positions
Normally, the baby that is not in the cephalic (head-on) position, is in a breech position sitting on the mother’s pelvis. But within the breech presentation there are three variants:
- Full breech: The baby is sitting with the knees bent, and the feet and buttocks are closer to the birth canal.
- Incomplete breech : The baby is sitting with one of his knees bent, and one foot and his buttocks are closer to the birth canal.
- Breech : The baby has the legs stretched out and the feet close to the head. Your buttocks are closer to the birth canal.
Other possible positions, although to a lesser extent, are babies that are in a transverse or oblique position, across the womb, and others in a breech position , where one or both feet are shown.
Will I be able to have a vaginal breech birth?
A breech delivery is always more complicated than a normal one, which is why the most used method in these cases is the cesarean section. Although there are cases that, after having estimated the obstetric conditions of the mother, and there being no unfavorable circumstances or any risk factor, vaginal delivery can be attempted .
There are hospitals that have specific protocols that allow a vaginal delivery in breech presentation to be attempted if the right conditions are met.
What can I do if my baby is breech?
Inverted pelvic posture exercises
Adopt positions in which the law of gravity can help the baby turn. Exercises that disengage the baby from the pelvis so that he or she has more freedom to turn are recommended, such as kneeling on the floor and resting the forearms and hands on the floor, known as the Mohammedan prayer pose .
Nadar a braza
Regular breaststroke swimming is an excellent exercise for your baby to get into a cephalad position as it helps relax the pelvic and abdominal muscles so the baby can turn more easily.
control your posture
For an optimal position of the baby, the ideal is to sit upright with the back slightly tilted forward . It is also better to sleep on your side (the left one is better) than on your back.
Practice yoga
Yoga is a very beneficial practice throughout pregnancy, which helps to increase muscle tone and power, improves body posture, flexibility, favors oxygenation of the fetus and postures (asanas) are practiced that favor the area of the pelvis and hip opening that can help the baby turn.
be calm and relaxed
Above all, be calm and relaxed , it may be the only thing you need for your baby to decide to turn.
What professional help can I seek?
External cephalic version
The WHO sets out its position on this maneuver in a document in which it states that “if adequate precautions are taken, there is a strong rationale for using external cephalic version at term if the benefits of avoiding a breech birth outweigh the risk of process”.
The external cephalic version (ECV) or external version is the best alternative to avoid delivery in the breech position and consists, as its name suggests, in a maneuver to turn the baby from the outside that must be performed by a professional specialized in this technique .
It is advisable to perform it from weeks 36-37 of gestation, at which time the baby is large enough to not turn again. However, it is not always possible to turn the baby to the cephalic position (head down), nor is it certain that if it is successful, it will not turn again.
It is risky? There is a minimal risk of vaginal bleeding, placental abruption, rupture of the amniotic sac, or the umbilical cord wrapping around the baby’s neck, but if performed in the right conditions and by expert hands, the The risk is very low , as are the associated costs, which is why many women decide to try it as long as there are no medical contraindications.
The main drawback is that it can cause labor , which is why it is recommended for full-term babies. The ideal is to support the maneuver with fetal ultrasounds before and after the maneuver to verify the position of the baby, a fetal monitor to perform a stress test before and after the procedure, and the immediate availability of an operating room in the event of any complication. .
It hurt? The pregnant woman feels strong pressure on her belly and the intensity of pain depends on how easy or difficult it is to turn the baby. It is an outpatient procedure that does not require anesthesia (although spinal anesthesia is used in some centers) and lasts a few minutes , since it is not convenient to apply pressure to the uterus for more than five minutes.
As we mentioned before, the maneuver does not always work . There is a 58% chance that the procedure will work and the baby will not roll over again.
What if the baby still doesn’t turn?
If your baby is still in a bad position when the expected date of delivery approaches, your gynecologist should assess whether you are a suitable candidate for a breech delivery or if it is better to opt for a caesarean section to avoid unnecessary risks.
Chances are your baby will turn on time, and if it doesn’t, your doctor will be able to guide you in having the best possible delivery. But it’s always good to know that if your baby is breech, there are plenty of things you can still do .
In Babies and more | The position of the baby in the womb at the time of delivery
