Turn, Baby, Turn!

Most babies are in the head down position and ready for a vaginal delivery by 36 weeks gestation.  However, what about those 4 percent (www.AmericanPregnancy.org) that refuse to flip? Does the diagnosis of a breech baby mean that a cesarean section is in your future? Not necessarily.  There are natural and medical techniques that can assist your infant in flipping.

Most babies will turn head down with no assistance. And although there are many reasons why a baby may fail to turn into position, the cause of many breech presentations remains a mystery. Before 30 weeks gestation, a breech presentation is normal and no cause for concern. So no intervention is needed at that stage. If at 30-32 weeks the baby is still breech, discuss with your health care provider which of these interventions are worth trying and which should be avoided due to your particular situation.

Two medical interventions are most common.  The first includes chiropractic care where the Webster technique is used to reduce stress on the pregnant woman’s pelvis, causing the uterus and surrounding ligaments to relax. The July/August issue of the Journal of Manipulative and Physiological Therapeutics reported an 82 percent success rate for the Webster technique. Further, the results of the study suggest performing the Webster technique in the eighth month of pregnancy is preferable.

The second common medical intervention is external cephalon version, performed at approximately 37 weeks gestation. This is a non-surgical technique to move baby in the uterus to the head down position. External version has a high success rate; however, complications can occur, and the health care provider will monitor the baby’s heart rate closely and stop the procedure if necessary.

Non-medical (natural) interventions are available, as well. Stephanie Carr, Olathe, is no stranger to these interventions. “At 30 weeks, I went to www.SpinningBabies.com and learned all about inversions and different positions to assist baby to turn,” she says. “I spent an hour a day doing these positions.”

The two most common positions are the forward leaning inversion and the breech tilt (see www.SpinningBabies.com for more direction). Forward leaning inversion, a modification of yoga’s downward dog, is used to help the baby stay out of the pelvis and tuck his chin so that he is able to flip.  Hold this for 30 seconds at a time. The breech tilt is where the woman lies at a slant with her head down and feet up in the air. This position should be held for 20 minutes if the mother is able to tolerate; it helps the baby tuck his chin to assist in flipping.

Many additional techniques can be tried. One is placing ice where the baby’s head is located to create a hostile environment and encourage the baby to flip. When talking about trying these exercises at home Carr says, “I felt ridiculous doing these exercises, but the farthest I went was moxibustion. I bought moxi sticks online. I’d light them and hold them to my pinky toes for 20 minutes twice daily. It stunk up the house, but I was desperate!”

What if these interventions do not work for you? Most physicians will require a cesarean delivery if the baby is breech at term. There are many reasons for this, but one of the main concerns is that the baby’s head is the largest part of the body, and even if the body is able to pass through the cervix, that doesn’t mean that the head will be able to pass. Another concern is cord prolapse, which is a medical emergency and can compromise the baby.

Most importantly, maintain an open discussion with your health care provider, speak your mind, state your feelings and be open to suggestions from the doctor. Mom’s and Baby’s safety are the most important things.

Jessica Heine, RN, lives with her husband and two young children in Olathe.

As always, please consult your health care provider with any questions or concerns.