Breech Birth

Breech is a variation of normal. 

Let me say that again, just in case it didn’t sink in the first time: 

Breech is a variation of normal. Your body is not messed up because the baby is not head down. 

In the womb a fetus flips and turns in all different directions until settling into a position around  34 weeks gestation, give or take. This position is what feels most comfortable for the fetus.  Ideally, the head will be down and facing the birthing person’s back; this position is referred to as occipito-anterior (OP) or cephalic presentation.  

If the baby’s head is up with their butt down toward the pelvis, the baby is considered breech.  There are three main forms of breech: 

⁃ Frank breech - butt first with legs and feet straight up in front of body. Looks like a  seated forward fold. Most common breech position. 

⁃ Complete breech - butt first with knees bent so feet are down by butt. Resembles knees to chest position.  

⁃ Footling breech - one or both legs stretched down below the butt. In a vaginal delivery, a  foot would come out first. 

Unfortunately, obstetricians are not trained in vaginal breech birth, which is why under their care a cesarean section is seen as the only option. There are very few OBs in the United States who will allow vaginal breech birth. Midwives on the other hand have greater knowledge,  expertise, and training in vaginal breech birth. 

If a fetus is breech, there are a few things to do that could flip the baby: 

⁃ Moxibustion - Find a trained, licensed acupuncturist for this treatment. This is highly effective! If in the Austin, Texas area, go to Sarah Johnson. She is an excellent baby flipper! 

⁃ External Cephalic Version - Using their hands, care providers manually attempt to flip the baby externally. This can be painful for the pregnant person and may or may not work.  This is usually an obstetrician’s preferred method, but is often not even offered according to Evidence Based Birth.

⁃ Spinning Babies - A great resource for all pregnant people, but the forward-leaning inversion described in “The Fantastic Four” or “The Four Sisters” can help a baby turn head down.  

⁃ Miles Circuit - A series of positions that can be used in pregnancy and in labor to help adjust baby positioning and relieve pain. Great to use in conjunction with Spinning  Babies techniques! 

⁃ Pelvic tilts - Think cat/cow but for the pelvis. While on hands and knees (or fists and knees if there is pain in wrists), tilt top of pelvis down toward the ground, butt/tailbone aiming high. Dome lower back to tilt top of pelvis up to the sky. Move back and forth between these movements. Add some rocks from side to side or any movement that feels good. Do this daily regardless of baby positioning. It helps pelvis move and shift! 

If you are early on in your pregnancy, consider asking your care provider (obstetrician or midwife) how they approach breech births. Is it an automatic cesarean? Is vaginal birth an option under their care? How many vaginal breech births have they assisted? Do they feel confident in supporting you through a vaginal breech birth? Based on their answers and your wants and needs, you have the power to change providers in order to have a birth team that supports your birth preferences. 

Learn more about breech births through Healthline here.