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Definition

Most babies move into a head-down position in the uterus before labor. The baby is in a breech position when its buttocks or feet are in place to come out first. There are 3 types:

  • Frank breech—the baby’s buttocks are down and the legs extend straight up in front of the body with the feet up near the head
  • Complete breech—the baby’s buttocks are down with the legs bent at the knees and the feet near the buttocks
  • Footling or incomplete breech—one or both of the baby’s feet are down

Almost all breech babies are delivered by cesarean section.

Complete Breech Birth Position
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Causes

It is not fully understood why a baby is breech.

Risk Factors

The chances of a breech position are higher for:

  • Having prior pregnancies
  • Women having 2 or more babies
  • Too much or too little amniotic fluid
  • Problems with the uterus or how it works
  • Placenta covers the opening of the uterus—placenta previa
  • Early birth
  • Baby's brain has fluid around it—hydrocephalus

Symptoms

There are no symptoms when a baby is breech. Some women feel kicking in the lower part of the belly. Others feel hiccups above the belly button. Babies move around often. It can be hard to tell which way your baby is lying.

Diagnosis

The baby's position will be checked a few weeks before the due date. This is done with a physical exam. The healthcare provider can feel the position through the belly wall by moving their hands in different places. This helps find the baby's head, back, and buttocks. The baby's heartbeat can also help find its position.

An ultrasound can confirm a breech position.

Treatment

Your baby may still be in a breech position during the last weeks of pregnancy. Your healthcare provider will talk to you about option such as:

External Cephalic Version (ECV)

The doctor will try to move the baby's head into a downward position by gently pushing on the belly. ECV is done about 3 to 4 weeks before the baby is due. It works about half the time, but the baby can revert back to a breech position.

Rarely, early labor can happen after ECV.

Exercise

Exercises done during the last 8 weeks of pregnancy may help a baby turn into the correct position. These exercises are usually done 2 to 3 times a day for 10 to 15 minutes.

  • Tilt position—Lie on your back with knees bent, feet flat on the floor and with several good-sized pillows under your bottom.
  • Knee-chest position—Kneeling on the floor, lean forward until your head rests on your folded arms, making your head lower than your bottom.

Moxibustion

Moxibustion is a form of acupuncture. It involves burning an herb close to the skin at certain acupuncture points on the body. This may help the baby to turn into the right position. Talk to your healthcare provider about this method. It may not work for every woman.

Cesarean Section

A baby cannot always be turned before birth. The most common delivery method is by cesarean section.

Prevention

There is no way to keep a baby from moving into a breech position at the end of a pregnancy.

RESOURCES

Family Doctor—American Academy of Family Physicians  https://familydoctor.org 

The American Congress of Obstetricians and Gynecologists  http://www.acog.org 

CANADIAN RESOURCES

Canadian Women's Health Network  http://www.cwhn.ca 

The Society of Obstetricians and Gynaecologists of Canada  https://sogc.org 

References

American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Obstetrics. Practice Bulletin No. 161: external cephalic version. Obstet Gynecol. 2016;127(2):e54-e61. Reaffirmed 2018.

Breech babies: What can I do if my baby is breech? Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/breech-babies-what-can-i-do-if-my-baby-is-breech. Updated March 13, 2018. Accessed April 24, 2019.

Breech births. American Pregnancy Association website. Available at: https://americanpregnancy.org/labor-and-birth/breech-presentation. Updated August 2015. Accessed April 24, 2019.

Breech delivery. EBSCO Nursing Reference Center website. Available at:  https://www.ebscohost.com/nursing/products/nursing-reference-center . Updated December 22, 2017. Accessed April 24, 2019.

Breech presentation. EBSCO DynaMed website. Available at:  https://www.dynamed.com/topics/dmp~AN~T115087/Breech-presentation . Updated April 13, 2018. Accessed April 24, 2019.

If your baby is breech. The American College of Obstetricians and Gynecologists website. Available at: https://www.acog.org/~/media/For%20Patients/faq079.pdf?dmc=1&ts=20121218T1009018242. Updated January 2019. Accessed April 24, 2019.

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