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The breech baby was once a huge delivery complication that often resulted in the death of both mother and child. Today, it is fairly easy to manage. In the early to middle months of pregnancy, when there is plenty of room in the uterus, most babies will spend at least some time in a breech position - that is, feet first. Most will turn and settle into a head first position in the final weeks. But about 3 - 4% end up as a breech baby.
A breech baby is more likely in a multiple pregnancy (twins or triplets), in a second (or subsequent) pregnancy, when there is too much or too little amniotic fluid, when the uterus is shaped abnormally or has growths such as fibroids, and in women with placenta previa.
Many doctors will try to turn a breech baby using a technique called external cephalic version (ESV). Done during late pregnancy, ECV involves the doctor pushing gently on the lower abdomen. The baby is carefully monitored during ECV and the procedure is stopped if the baby shows any signs of distress. Another procedure, known as the Webster Breech Technique, is done by chiropractors and involves reducing stress on the mother's pelvis. This causes relaxation in the uterus and surrounding ligaments, making it easier for a breech baby to turn naturally.
A safe home technique to try to turn a breech baby involves lying on your back and using large, solid pillows to raise your hips about twelve inches off the floor. Do this three times a day, and make sure you do it on an empty stomach.
A vaginal birth may still be possible even with a breech baby. Much depends on the baby's position. A frank breech, in which the baby's legs are straight up in front of the body with the feet near the face, can sometimes be delivered vaginally. If the baby is in a footling position (one or both feet pointing down) or is a complete breech (legs folded at the knees and the feet near the buttocks - sitting tailor style), a vaginal delivery is usually impossible.
To attempt a vaginal delivery, the breech baby must be full-term, but not too big to fit through your pelvis. The baby will be carefully monitored through labor and must show no signs of distress. If your doctor or midwife determines the baby cannot deliver properly, you will be taken into surgery for a cesarean birth. A c-section might not be the way you envisioned giving birth, but it can ensure both you and your baby survive his or her insistence on coming feet-first.
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