Breech presentation

What is a breech baby?

A breech baby, or breech birth, is when your baby’s feet or buttocks are
positioned to come out of your vagina first. Your baby’s head is up closest
to your chest and its bottom is closest to your vagina. Most babies will
naturally move so their head is positioned to come out of the vagina first
during birth. Breech is common in early pregnancy and most babies will
move to a head-first position by 36 weeks of pregnancy. This head-first
position is called vertex presentation and is the safest position for birth.

What are the types of breech position a baby can be in?

There are several fetal positions your baby may present in. Ideally, your
baby is positioned head-down, facing your back, with their chin tucked to
their chest.

Breech babies can be in a few different positions:

 Frank breech: The baby’s buttocks are aimed at the vaginal canal
with its legs sticking straight up in front of their body and the feet
near their head.
 Complete breech: The baby’s buttocks are pointing downward and
both the hips and the knees are flexed (folded under themselves).
 Footling breech: One or both of the baby’s feet point downward and
will deliver before the rest of their body.
 Transverse lie: This is a form of breech presentation where your
baby is positioned horizontally across your uterus instead of
vertically. This would make their shoulder enter the vagina first.

What causes a baby to be breech?

It’s not always known why a baby is breech. Some factors that may
contribute to this position are:
  You are expecting multiples (twins or more). This makes it harder for
each baby to get into the right position.
 There is too much or too little amniotic fluid.
 The uterus is not normal in shape or has abnormal growths such
as fibroids. Most of the time, the uterus is shaped like an upside-
down pear. If it's shaped differently, there might not be enough room
for a full-grown baby to move into position.
 The placenta covers all or part of the cervix (a condition called
placenta previa).
 The baby is preterm. This means they are less than 37 weeks
gestation and may not have turned to a head-first position.
 SYMPTOMS AND CAUSES
 How can you tell if your baby is breech?
 You may be able to tell if your baby is breech, especially if you have
had past pregnancies where your baby was head-first. The places
where you feel lumps and kicks might indicate that your baby is
breech. Let your healthcare provider know where you feel
movement. They will feel your belly or do an ultrasound to confirm
that your baby is breech.

MANAGEMENT AND TREATMENT

What are the options for treating a breech baby?

If your baby is breech at 37 weeks of pregnancy, your healthcare provider

may:

 Try turning your baby in your uterus into the head-first position.
 Plan a C-section birth.
 Plan a vaginal breech birth.

What are some complications of having a breech baby?

The complications of having a breech baby usually do not occur until it's
time to deliver. Some breech babies can be safely delivered through the
vagina.

The risks of attempting a vaginal breech birth are:

 Injuries to your baby’s legs or arms such as dislocated or broken

bones.
 Umbilical cord problems. The umbilical cord can be flattened or
twisted during delivery. This can cause nerve or brain damage due to
a lack of oxygen.