You’re at 34 weeks gestation and your care provider tells you that baby is breech. Chances are, you start to panic. Can I do something to flip the baby? How long do I have to flip the baby? Does this mean I have to have a C-section when I planned on a vaginal birth? Will my labor be longer and more painful, or is baby in any danger?
It is understandable why you might feel overwhelmed or scared. Doctors (especially in the U.S.) routinely tell birth givers they won’t do vaginal breech births and jump straight to scheduling a Cesarean. But before reaching full panic mode, you should educate yourself with all the facts! First of all, there are three kinds of breech positions baby may be in: complete breech, where baby’s butt is in your pelvis and legs are folded in; frank breech, where baby’s butt is in your pelvis, but legs are fully extended in a V-like shape; and footling breech, when one or both of baby’s feet are pointed down in your pelvis.
Secondly, vaginal breech births were once very common among midwives, and they remain safer than a C-section. (You can read about some of the often ignored risks to breech Cesarean here.) But these days, doctors are not trained for vaginal breech birth, and insurance carriers are making it hard for those that do perform vaginal breech births to even offer their services.
Facts and figures aside, breech babies can flip at a moment’s notice. As your due date approaches, we have a few methods we always recommend to pregnant people trying to flip a breech baby.
1. Do the forward leaning inversion as seen on Spinning Babies about five times per day, holding for five breaths each time. Be sure to sit still in an upright position for a full minute afterwards. The first time you try it, do it with a partner for additional support (you are going upside down, after all!). Also be sure to read the full instructions and contraindications before your first try.
2. Set up in a supported bridge pose for as long as is comfortable for you. If you’ve practiced yoga, you likely know what bridge pose looks like—and have been avoiding it in prenatal yoga! But breech babies can benefit from the shift in gravity to get their pelvis out of your pelvis and potentially flip to a head down position. Be sure to use yoga blocks, books, or something similarly stable underneath your sacrum for support.
3. Avoid sitting back on your couch or in bed. Instead, sit on a yoga ball for good posture and be on all fours as much as possible. Sitting on couches, beds and even in cars often leads to poor posture and a cramped baby that is unlikely to flip. Sitting up straight with knees in line with or below the hips gives baby more room to move.
4. Have access to a pool at your gym, community center or apartment building ? Jump in for a swim and do handstands in the pool! The same benefits apply here as with the forward leaning inversion—flipping yourself upside down may lead to flipping baby, too!
5. These next two tips may sound silly, but can actually make a difference. Place ice or frozen peas at the top of your belly to encourage baby to move head away from the cold and toward your pelvis.
6. And along the same line…play music, let partner talk to baby and use flashlight at low belly and pelvis. Like us, babies enjoy nice sounds and warm light, so this may encourage them to move head down.
7. Try acupuncture! It is estimated that about 60% of babies are turned with consistent acupuncture and moxibustion use. Doing your own research and talking to care providers, yoga teachers and doulas can point you toward an acupuncturist with a good record of turning babies.
8. Try the Spinning Babies breech tilt. Yes, it looks like an elaborate set up requiring an ironing board of all things, but this specifically designed technique balances the lower uterine segment and uses gravity to encourage baby to tuck chin and flip head down. Do it one to three times a day if you know baby is breech after 30 weeks.
9. See a chiropractor who specializes in the Webster Technique. This technique is a focused sacral adjustment that can bring balance to the pelvis and uterus. While it’s been used for breech and posterior presentations for some time now, research is also showing it may be beneficial for preventing dystocia as well. Just like with an acupuncturist, talk to your team of care providers to find a chiropractor with a good record of turning babies.
10. Schedule a prenatal abdominal massage. Before 20 weeks gestation abdominal massage is indicated for the upper abdomen only, and can help the liver process the large increase in hormones, the stomach move through difficult constipation and nausea, the diaphragm expand to accommodate easier breathing, and to relax tissue around the esophagus to ease acid reflux. After 20 weeks, abdominal massage on the lower abdomen focuses not specifically on moving the baby, but instead on the ligaments, muscles and circulation surrounding the uterus. The principal is to provide more circulation and space for the uterus to work well, and more room for the baby to move into a comfortable position for you both, which could lead to turning baby.
If none of these work, your care provider will likely schedule an external cephalic version (ECV) to try to manually turn the baby, which you can read more about here on Evidence Based Birth. Do your best to find a provider with a good record of successfully flipping babies.
If you’re eager to give birth vaginally no matter baby’s position, there are still a few places that welcome vaginal breech births, including The Farm in Tennessee. Reach out to Love Child for a list of vaginal breech-friendly care providers local to the New York and New Jersey area.