During pregnancy, babies often twist and turn. By the time labour begins, most babies settle into a position that allows them to be born headfirst through the birth canal. However, that doesn’t always happen.
By 37 weeks most babies will turn into the headfirst position, but about 3% will stay bottom, knees or feet first.
Babies can be breech for several reasons. Sometimes a baby cannot turn due to:
- too much or too little fluid in the womb
- the position of the placenta or
- an issue with the pelvis or womb such as fibroids.
Sometimes it is just a matter of chance that the baby has remained breech rather than turning.
Most breech babies are healthy. Occasionally being breech can mean that there is a problem with the baby which has prevented it from turning. We will usually pick this up during antenatal screening and scans, but it may be discovered after birth.
Having a breech baby means you will need to make a few more decisions about your care. We will support you to do so you can have a safe and positive birth experience.
Your care options
Breech babies can turn to headfirst by themselves up to the point of labour. However, if your baby is breech after 36 weeks it is less likely to turn by itself.
External Cephalic Version (ECV)
We recommend you try an ECV from 36 weeks of pregnancy onwards. This involves an obstetrician trying to turn your baby through your tummy into a head down position.
If an ECV doesn’t work, you’ll need to discuss options with your midwife and obstetrician. Although breech babies can be born vaginally, you may be offered a caesarean section.
There is also some evidence that moxibustion, a herbal Chinese therapy, and acupuncture may help in encouraging your baby to move. This is not currently available from the NHS. You should use an appropriately qualified practitioner to give you advice and treatment if you choose this route.
Some clinicians advise optimal fetal positioning. This would involve you getting into some positions to maximise the space in your pelvis and encouraging your baby to move around. You may also read about chiropractic techniques and other complementary therapies for encouraging breech babies to turn. We would advise you take specialist advice before doing these.
We are here to support and advise you about your birth options so that you can make an informed choice. You will be referred to a consultant to discuss your options.
Planned (elective) caesarean section
The Royal College of Obstetricians and Gynaecologists (RCOG) currently recommend that you have a planned elective caesarean section at about 39 weeks pregnant. Research has shown that planned caesarean section is safer for your baby than a vaginal breech birth. Caesarean section carries slightly more risk for you than a vaginal birth.
Vaginal breech birth
If you choose to have a vaginal breech birth, you will need to be cared for by a team trained in delivering breech babies vaginally. Vaginal breech birth carries slightly more risk for your baby than a caesarean birth. You should plan to have your baby in one of our consultant-led units where you can have an emergency caesarean section if needed.
Most breech babies do very well after birth. Some babies keep their legs in the air for the first few days as this is the position they have been in the womb for some time. This may look a bit strange but it is nothing to worry about.
Breech babies have a higher chance of hip problems in early life due to their position in the womb. We will ensure your baby’s hips are checked within the first 3 days. We will also offer you a scan of the baby’s hips within the first few months. This appointment should be sent to you after you are home from the unit (usually within 6 weeks).