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Questions to Ask Doctors About a Breech Baby

by Sharon Perkins

Around 4 percent of babies deliver in a breech position, according to the American Pregnancy Association. Rather than head down, they present feet or buttocks first or cross-legged. Most babies turn head-down by around the 36th week of pregnancy; if your baby is breech before that, there's no need to worry about it. Most doctors deliver breech babies by Cesarean section, because breech babies can have a hard time navigating the birth canal. It's also possible to try to turn the baby manually before labor begins.

What Position Is He In?

The term "breech" describes several different positions a baby can get into before birth. Between 50 to 70 percent of breech babies are frank breech, meaning that their legs are straight up. Another 10 to 30 percent present as a footling breech, usually with one foot down and the other knee bent upward. Only 5 to 10 percent are in the complete breech position, also called a tailor position, with his legs crossed. There's always a possibility that a breech baby will turn by himself, although it's unlikely after 37 weeks. Before 28 weeks gestation, around 22 percent of babies are breech. By 32 weeks, all but 7 percent have turned, and between 1 to 3 percent remain in breech position at 27 weeks, obstetrician Dr. Richard Fischer reports.

Can We Help Him Turn?

You can try techniques at home to help a breech baby turn, such as lying on the floor with your hips elevated 12 inches for 10 to 15 minutes three times a day. Talk to your doctor before trying any turning techniques at home. Your doctor might also schedule a procedure called an external manual version, where he attempts to turn the baby using ultrasound guidance. This procedure works in around 58 percent of cases, according to the Web MD site. Success rates are highest before the baby drops into the pelvis and if the baby is in a complete breech position. Risks of version include damage to the umbilical cord, rupture of the uterus or placental abruption. If complications occur, an immediate Cesarean delivery might become necessary.

Can I Deliver Vaginally?

Few doctors still deliver breech babies vaginally. In some cases, depending on how your baby has positioned himself, it might be impossible or far too risky to try. A frank breech or complete breech baby has the best chance of vaginal delivery, MedlinePlus states. In the United States, doctors deliver just 10 percent of breech babies vaginally, nurse practitioner Dr. Rebecca Dekker reports on the Evidence Based Birth website, using data from the Centers for Disease Control and Prevention.

What Kind of Complications Can Happen to Breech Babies?

Breech babies have a higher risk of complications before and during labor than babies born head-first. As many as 17 percent of preterm breech babies and 9 percent of full-term breech babies have congenital birth defects, according to Dr. Fischer. Complications caused by breech delivery include cord prolapse, where the umbilical cord falls in front of the presenting part after the membranes rupture. This can decrease oxygen flow to your baby. In a vaginal delivery, the baby's head, which is the largest part of him, can get stuck after the doctor delivers the rest of the baby.

About the Author

A registered nurse with more than 25 years of experience in oncology, labor/delivery, neonatal intensive care, infertility and ophthalmology, Sharon Perkins has also coauthored and edited numerous health books for the Wiley "Dummies" series. Perkins also has extensive experience working in home health with medically fragile pediatric patients.

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