Baby is Breech! What can I do?

Jun 12

Breech presentation at term affects up to 4% of pregnancies, and in twin pregnancies it is common to have at least one twin be head-up. Due mainly to the infamous Term Breech Trial (2000), vaginal breech birth has generally been dropped from obstetric training and surgical birth is now the default. There has been an increasing demand for informed choice of birth options, with a resurgence in sharing maneuvers to assist physiological breech birth. Babies tend to move around in the womb, and at some point in pregnancy are likely to be breech but can flip to head-down (vertex) any time as labor approaches. After 36 weeks, it’s less likely for baby to turn on their own, at which point decisions need to be made.

So, what are the options?

Option 1: Do Nothing

Depending on provider, location, and timing, more than likely will end up in a C-section. When position has been confirmed breech and remains so at onset of labor, most states prohibit licensed midwives from attending it at home and require them to transfer to a higher level of care (Hospital Obstetrician). Generally OBs will not be willing to support a Vaginal Breech Birth and want to schedule a c-section, which can be done in a “gentle” or “family centered” manner when planned. Laboring spontaneously at home for a long time and showing up to the hospital while pushing and refusing to consent to a c/s makes VBB with a provider possible but stressful, and they may not have the training to assist the birth safely if it is not going smoothly during baby’s emergence.

Option 2: Try Turning Holistically

Moxibustion (Traditional Chinese Medicine/acupuncture technique) has good evidence to support turning a breech baby, especially combined with body work to create space in pelvis beforehand. Find a Webster Certified Chiropractor for care, and try the Spinning Babies Breech Protocol

Option 3: Try Turning Forcefully

External Cephalic Version, where a skilled provider attempts to physically turn the baby from the outside, is almost always done in a hospital with an epidural and monitoring due to risk of fetal distress, which could necessitate an immediate c/s. Body work from option 2 done beforehand can increase success of maneuver. Usually done at or after 37 weeks. Even if successful, there remains a chance baby could flip back to breech position.

Option 4: Find a Vaginal Breech Birth Provider

There are some occasional hospital providers with the training to attend a VBB, as well as traditional (unlicensed) home birth midwives skilled in breech delivery. Some families who can’t find someone directly in their area will find a midwife elsewhere and travel, staying in an Airbnb and birthing there, or others find someone who will virtually consult with them, offering preparation beforehand and be on a video call during the birth.

Breech Without Borders offers a directory of providers.

Option 5: Plan an Unassisted Home Birth

Trust the process, consider getting an overview of breech maneuvers via an online course like Breech 101 from Breech Without Borders or consult with an experienced breech provider for preparation, some options may include Blyss Young, Kristine Lauria, Brooke Atkinson, or Dr. Stu Fischbein. Birth often proceeds smoothly according to God’s design without much meddling, but when a possible complicating factor is known, it is wise to be prepared.

A Hearthmother’s Way

Pray - Lift up your situation to the Lord, praising Him for the wise design of your body and baby, and ask for discernment.
Wait Upon the Lord - Find rest in the fact that He is sovereign over all, and has a plan for this. What is He leading you toward?
Get Curious - Ask questions, consider why your baby may be choosing this position, what your options for birth choices are, etc.
Engage the Body of Christ - Request others to intercede in prayer, and ask for community experience and connections that could shift your birth plans, such as local breech providers.
Live as Designed - Align yourself to God’s design of good nutrition and hydration, balance the body with chiropractic care and spinning babies positions, relax and release tension with breathing techniques. Prepare yourself for the birth God has set on your heart.
Gentle Intervention - Consider moxibustion acupuncture or get curious about other potential remedies.
Forceful Intervention - If other steps have not been effective, prayerfully consider scheduling an ECV after evaluating the risks and benefits.
Invasive Intervention - When all else fails and there is peace from the Spirit about pursuing a surgical breech birth, discuss with the obstetric team the options around a family-centered cesarean (clear drape, personal music playlist, mother assisting in pulling baby to her chest, immediate skin-to-skin, delayed cord clamping, vaginal seeding, etc).