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Breech Baby

What is a breech presentation?
What factors increase the chance of breech presentation?
How can my health care provider tell if my baby is…
What is external cephalic version (ECV)?
How is ECV performed?
When is ECV done?
Can ECV be done for all breech presentations?
How successful is ECV?
How are most breech babies born?
What are the risks of having a vaginal breech birth?

What is a breech presentation?

  • By 3?4 weeks before the due date, most babies move so their heads are down near the birth canal (vagina)
    • If this does not happen, the buttocks, the feet, or both may be in place to come out first during birth
    • This is called a breech presentation
  • It happens in 3?4% of full-term births and requires special planning for how the baby will be born
  • If your baby is breech, your doctor may recommend cesarean delivery

What factors increase the chance of breech presentation?

  • It is not always known why a baby is in a breech position
  • Breech is more common when:
    • Woman has had more than one pregnancy
    • There is more than one fetus in the uterus (twins or more)
    • Uterus has too much or too little amniotic fluid (the liquid around the fetus inside the uterus)
    • Uterus is not normal in shape or has abnormal growths, such as fibroids
    • Placenta covers all or part of the opening of the uterus (placenta previa)
    • Baby is preterm

How can my health care provider tell if my baby is…

  • Breech presentation can be determined by doing a physical exam
    • Doctor can feel the shape of the baby by placing hands at certain points on your abdomen
      • By feeling where the baby?s head, back, and buttocks are, he or she can tell the position of the baby
    • An ultrasound exam may be used to confirm the position
      • In this test, a device is moved across the abdomen.
      • The sound waves it produces make an image of the baby that can be seen on a screen

What is external cephalic version (ECV)?

  • If the baby is breech, your health care provider may suggest external cephalic version (ECV).
    • ECV is a procedure in which the health care provider lifts and turns the baby from the outside
    • It can improve your chance of having a vaginal birth

How is ECV performed?

  • To turn the baby, the health care provider places his or her hands at certain positions on your abdomen, then lifts and turns
  • In some cases, a second person helps turn the baby

When is ECV done?

  • Most often, ECV is not tried until you are at least 36 weeks pregnant
    • If it is done before then, the baby may still change position

Can ECV be done for all breech presentations?

  • Your health care provider will assess your health and the state of your pregnancy to see if ECV is an option for you
  • Certain conditions may increase the risks associated with ECV or decrease the chance of its success
    • If you or your baby has any of these conditions, ECV may not be recommended

How successful is ECV?

  • More than half of ECV attempts succeed
  • Some babies move back into a breech presentation
    • If that happens, ECV may be tried again
  • ECV tends to be harder to do as the time for birth gets closer
    • As the baby grows bigger, there is less room for him or her to move

How are most breech babies born?

  • Most breech babies are born by planned cesarean delivery
  • Like any major surgery, cesarean birth involves risks
  • Risks occur in a small number of women and usually are easily treated such as:
    • Infection
    • Bleeding
    • Problems from pain relief medication
  • It is not always possible to plan for cesarean birth
    • The baby may move into the breech position just before labor begins
      • In that case, you will not know that you are going to have a cesarean delivery until you are in labor

What are the risks of having a vaginal breech birth?

  • The risk of harm to the baby may be increased in a vaginal breech birth
  • There also is more chance of a prolapsed umbilical cord
    • That is when the umbilical cord slips through the cervix into the birth canal before the baby does
      • This can cause the cord to be pinched, which can stop the flow of blood through the cord to the baby

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