Breech Baby: Techniques in Preparation for Delivery

Parenthood is exciting, but pregnancies come with unexpected twists!

During my second pregnancy, everything seemed fine—until my doctor casually mentioned my baby was in a breech position. Instead of being head down, my baby was feet first, throwing off my birth plans and leaving me anxious.

With the right guidance and a few proven techniques, I found ways to help my baby turn. If you're facing the same uncertainty, you're not alone.

Here’s everything you need to know about breech babies and safe techniques to prepare for delivery.

As the due date gets closer, a baby is normally positioned head down and is ready for delivery. In a breech position, the baby’s feet or bottom face downward. Don't worry - this is not as common as you may think, but it is always good to be prepared. While your baby may be in a breech position at some point during the pregnancy, it usually resolves on its own as the fetus moves around. However, about 3 to 4 per cent of babies remain in a breech position even at the end of pregnancy,  making it a little more complicated.

Types of Breech Positions

Some babies settle into a ‘breech’ position, which isn’t ideal for delivery—but it doesn't always mean they’re upside down. While this can sound concerning, understanding the different types of breech positions can offer clarity and reassurance.

Frank Breech: The baby’s bottom faces the birth canal, with legs extended straight up toward the head. This is the most common breech position.

Complete Breech: The baby is in a sitting position with both knees bent, bringing its bottom and feet closest to the birth canal.
                  
Footling Breech: A footling breech occurs when one or both of the baby’s feet are positioned downward and closest to the birth canal, making the feet the first part to emerge during delivery.            

Diagnosis for Determining Breech Presentation

The diagnosis of the breech presentation is usually made based on a physical examination, fetal heartbeat location, ultrasound examination, and pelvic examination. Doctors use these methods to determine exactly where the fetus is and whether it is in complete breech, frank breech, or footling breech position.

Changes in maternal abdominal shape, palpation findings and abnormal ultrasound results are some of the signs of a breech baby in the womb.

If you’ve just found out that your baby is in a breech position, I know how overwhelming it can feel. I remember the moment my doctor told me the same during my second pregnancy—my mind was flooded with questions and concerns.

Let’s explore the different types of breech positions together, starting with the footling breech, and see what it means for you and your baby.

Risks to the Baby

While there are a few risks to the baby to be aware of when it comes to a breech delivery, knowing them can help you feel more prepared and supported:

• The primary concern with a breech position in the womb is cord prolapse, where the umbilical cord gets compressed, potentially reducing the baby's oxygen supply.
• Another challenge is head entrapment, since delivering the baby's head can be the most difficult part and may take longer than expected.
• There’s also a small risk of physical injuries, such as minor fractures or nerve stress, due to the baby’s position.

Risks to the Mother

A breech delivery can be challenging, often leading to longer, more uncomfortable labour. In some cases, assisted methods like forceps or an emergency C-section may be needed for a safe birth.

It also carries a higher risk of vaginal tearing or bleeding, requiring extra medical attention. Feeling anxious or uncertain is natural—I’ve been there too. But trust that your healthcare team is prepared to support you and your baby every step of the way.

Pregnancy is a vulnerable yet exciting time—I know this firsthand. Just months ago, I envisioned a picture-perfect day with smooth labour, love, and emotions. It was beautiful, but my baby boy had other plans, making labour far from easy!

If your baby is still breech near your due date, you may need to try natural or medical techniques to help them turn. Here are some strategies I was recommended:

External Cephalic Version (ECV)

It's a procedure where doctors try to turn a baby from a breech (feet or bottom first) position to a head-down position for delivery. The procedure is usually performed between the 36th to 38th week of pregnancy.

The doctor will put their hand on your belly and push, so hopefully, the fetus goes into a better position for delivery. It takes place in a hospital so they can watch the heartbeat of your fetus and monitor its progress with an ultrasound. Feeling a little pressure is normal, but always let your doctor know if you feel any more discomfort.

While ECV works for many women, it does not produce guaranteed results. The baby may sometimes return to breech or not turn at all. The procedure is carefully monitored because there are small risks, like early labour or changes in the baby’s heart rate.

Natural Methods for Encouraging the Baby to Turn

Babies in a breech position are often considered high risk, but there are gentle, natural ways to encourage them to turn their head down before delivery. While these techniques aren’t always successful, they can be safe and noninvasive methods that allow your baby more room to move.

However, it’s essential to discuss any of these techniques with your doctor first. If you decide to try them, do so under your doctor’s supervision or with their approval to ensure they are both safe and effective.

You might look a little comical, attempting these exercises (I sure was). In the moment, it seemed hard and complicated, but looking back, it allowed me to move my body and relax.

• Crawling Exercises: Crawling on your hands and knees can create more space in your pelvis, potentially encouraging your baby to turn. Try this exercise on a soft surface like a mattress to promote gentle movement.
• Pelvic Tilts: Sit on the floor with your knees bent, then lift your hips off the floor in a gentle tilt. This movement can help open up the pelvic area, giving the baby more room to shift position.
• Forward-Leaning Inversion: Kneel on a couch or bed and slowly lower your hips, keeping them higher than your head as your upper body moves toward the floor. This position may help lift the baby slightly out of the pelvis, allowing for a potential turn.
• Swimming: The buoyancy of water helps relax your muscles, creating more space for the baby to move. Try gentle swimming strokes, as they may aid in repositioning the baby naturally.

I completely understand how daunting a breech delivery can be, but being prepared and organised goes a long way! When you have a high-risk pregnancy, it's very easy to get lost amid medical jargon, but sit your doctor down and ask them all the questions you may have.  

There are two options when it comes to a breech delivery:

• Trying for a vaginal breech birth
• Planning an elective C-section

Vaginal Breech Delivery Techniques

If your baby is in a breech position, it’s still possible to have a vaginal delivery, but it does require extra care and preparation.

Your position during labour can make a significant difference. Using upright positions, such as standing, squatting, or kneeling, can help you use gravity to create more space, making it easier for your baby to descend.

If you’re planning for a vaginal breech delivery, it’s important to do so in a hospital, where you’ll have medical supervision to ensure both your safety and your baby’s. It’s also good to be prepared for the possibility of an emergency cesarean section, as complications can arise despite the best efforts and planning.

Caesarean Section for Breech Babies

Cesarean sections (C-sections) for breech babies can be split into two categories; planned or unplanned :

Planning an Elective Cesarean Birth: This is a scheduled procedure in which the baby is delivered through cesarean section. Since it's pre-planned, it is relatively low-risk as most breech babies are born without any major complications.

Emergency Cesarean Section: These are usually attempted if you choose you try a vaginal birth first. If complications occur, then you change course and go for an emergency C-section, like I did. While this option is rather stressful and scary, it helps to remember that it is only done when absolutely necessary. 

Immediate post-delivery care is crucial to ensure the stability of both the mother and the baby.

Once the baby is born, the doctor will first ensure the baby is breathing properly. This may involve clearing any fluid from the baby’s mouth and nose, or providing gentle breathing assistance if needed. If the baby shows signs of distress, such as difficulty breathing, real-time monitoring of heart rate and oxygen levels will be conducted to address any concerns swiftly.

Simultaneously, the mother’s health will also be carefully monitored. This includes checking for signs of excessive bleeding, managing pain, and monitoring for any complications, especially if a cesarean section was performed. Support for initiating breastfeeding and skin-to-skin contact will also be encouraged as part of early bonding and recovery.

The combined post-delivery care helps create a safer and more supportive environment for both the mother and the baby during this critical phase.

Looking back at my pregnancies, I see how much strength it truly takes to remain calm and get through the ordeal, while worrying about your baby and yourself. The journey, for me, and most likely, for you also, will be marked by several unforeseen challenges.

However, these are final words of advice to you: if you have a breech baby, remember to trust your instincts, and trust the journey, because you are doing a good job. Your body knows what to do, so let it guide you!