Baby Breech at 35 Weeks 5 Days Pregnant

A breech baby is lesser-down instead of head-down in the womb. Although breech position during pregnancy is common, about babies will settle into a head-get-go position past the end of pregnancy. The different types of breech positions include extended breech or frank breech, complete breech or flexed breech, fiddling breech or kneeling breech. Read on to find out well-nigh these different positions and what will happen if your baby's not in a head-first position by the end of your pregnancy.

What does it mean if my baby is in a breech position?

Breech ways that your baby is in a bottom-downward position (Jackson et al 2020). It's unremarkably a temporary position during your third trimester.

If your baby is breech, you may experience discomfort under your ribs, peculiarly at night, and you lot may go breathless as your baby'south head presses up nether the sheet of muscle that lies under your ribcage (diaphragm) (Jackson et al 2020). You may also feel some abrupt kicks to your bladder (Jackson et al 2020).

If this is your first infant, they'll probably settle into a head-down position in your pelvis by about 36 weeks of your pregnancy (RCOG 2017b). Although breech during pregnancy is common, at the cease of pregnancy, just about iii to iv in every 100 babies remain in a breech position at birth (Jackson et al 2020).

What should I do if my baby's in a breech position?

Learn what to do if your infant's in a breech position as yous near your due engagement. Encounter more than pregnancy videos

What are the different breech positions?

Frank/extended breech

Extended breech or frank breech is a lesser-showtime position. Babies in this position volition have their legs up and their feet past their ears. Around seven in 10 babies who are breech will exist in the extended or frank position (Jackson et al 2020, RCOG 2017b).

Incomplete breech and complete/flexed breech

In an incomplete breech (pictured above), ane of the babe's knees is bent so that the pes is tucked side by side to their bottom with the other leg extended, positioning that foot closer to their face (Martinez 2020). Complete breech or flexed breech describes a infant that is bottom showtime with their knees bent and their thighs confronting their tummy and breast (Jackson et al 2020, RCOG 2017b).

Piddling breech

Piffling breech is when a baby is feet-first. Either ane or both feet are below their lesser in this position (Jackson et al 2020, RCOG 2017b). This position is rare (Jackson et al 2020).

Kneeling breech

This is where your infant'south anxiety are in a kneeling position with the feet folded upward behind their thighs. This position is very rare (Jackson et al 2020).

What if my babe is breech near the end of my pregnancy?

If your infant has non turned into a caput-first position past 36 weeks of pregnancy, your midwife or doctor will discuss the following with yous:

Trying to turn your baby into a head-get-go position by a transmission process, called external cephalic version (ECV).
Planning a prophylactic delivery for your babe, by vaginal birth or caesarean.
(RCOG 2017b)

ECV

Your doc may offer you an ECV from around 36 weeks to 37 weeks, simply it can be performed right upwardly to the early stages of labour (RCOG 2017b).

Although considered generally safe, ECV does carry a one in 200 take chances of needing an emergency caesarean immediately afterward the procedure. That'southward why you volition have the procedure in a infirmary (RCOG 2017b).

Sometimes, information technology's not possible to deport out an ECV. For instance, if you lot've had vaginal bleeding recently, your waters have broken, or you are expecting twins or more than (RCOG 17b).

ECV is successful in turning a baby in around one-half of all breech births (RCOG 17b). It's more than probable to piece of work if, for example, y'all've had a previous vaginal nascence (RCOG 2017b). Sometimes, however, a infant doesn't turn, or rotates back into a breech position (persistent breech presentation) (RCOG 2017b).

Planning your nativity

Most breech babies in the Uk are built-in by caesarean every bit many experts consider this to be the safest way for breech babies to be born, although information technology does carry a slightly college risk for you (RCOG 2017b).

Still, more evidence is emerging that vaginal delivery of a breech infant can be perfectly safe for both you and your babe, if your midwife or medico is trained and experienced in delivering breech babies. (Jackson et al 2020, RCOG 2017b)

There are benefits and risks to having your babe by caesarean or vaginal birth. Your midwife or doctor should talk over your options fully with you lot before yous make your decision (RCOG 2017a).

Y'all may be advised to have a planned caesarean if:

Your baby'south foot or feet are below their bottom (footling breech).
Yous're expecting twins and the offset twin is breech.
You have pre-eclampsia or some other condition that means the health of either you or your infant is at risk.
Your babe is larger or smaller than boilerplate.
Your baby's position makes vaginal commitment more than difficult, such as a very tilted dorsum (hyper-extended) neck.
Y'all take a low-lying placenta.
(NHS 2020, RCOG 2017a, RCOG 2017b)

Having a planned caesarean for your breech baby gives you time to plan your infant's birth. Bated from the position, it's likely that your baby is otherwise healthy and well. And then the birth is likely to be straightforward and relatively relaxed.

There should be fourth dimension for the obstetrician and midwives to expect at your nativity programme with you. This could include a music playlist for the nativity, or for your partner to denote the sex of your infant, if y'all don't already know. Y'all can also inquire for pare-to-skin while in theatre and delayed cord clamping if you lot wish.

A planned breech caesarean is much the same as other planned caesareans, except that when your baby is born, your baby's bottom or legs will be delivered first rather than the head. If y'all decide to accept a planned caesarean just you go into labour at home before your operation, call the hospital straightaway. Your medical team will discuss with you whether it's safer to try for a vaginal birth instead (RCOG 2017a).

Is there anything I tin can do to plough my breech baby?

Some parents-to-be recommend natural methods of turning their babe, such as kneeling on all-fours, acupuncture, or burning a Chinese herb called mugwort (moxibustion) (BJM 2018). Although at that place isn't a dandy bargain of bear witness that these natural methods piece of work, yous won't be doing any harm to your baby, or yourself, if you lot endeavor them.

If you do want to effort moxibustion, make sure you practise it under the intendance and management of a registered healthcare practitioner (RCOG 2017b).

What will increment my chances of having a vaginal birth?

If you'd like a vaginal birth, your doctor may exist more than supportive of your choice if:

A midwife or physician trained and experienced in breech birth will exist nowadays at the nascency (RCOG 2017b).
Facilities for an emergency caesarean are available nearby (RCOG 2017b).
There are no other factors that would brand giving birth vaginally more risky (RCOG 2017b).

You and your medico or midwife should hash out the possible risks and benefits of caesarean department and vaginal birth. This should also include a discussion of the type of vaginal birth that you lot'd be likely to have every bit there are different approaches (Jackson et al 2020).

Staff in most units are likely to exist more experienced in assisted breech delivery with the woman lying on her back with her legs in stirrups (RCOG 2017a). Even so, if you lot would prefer to accept a vaginal breech birth in a more upright position, it may be possible to ensure that experienced midwives are on standby for you. One time you've fully explored your options, a decision tin can be made about what's best for you and your baby.

How can I find experts in breech vaginal births?

Information technology may be hard to find a midwife or obstetrician who has the skills and cognition to aid your breech baby to be built-in vaginally.

Talk to the midwifery abet for your local maternity unit if you're unsure. They will ensure that you're offered the right intendance for you and your baby (NMC 2009).

If your local hospital doesn't have an obstetrician or midwife who is experienced in breech vaginal births, yous should be referred to a hospital where this option is available (RCOG 2017a).

If y'all tin afford it, you may want to consider having an independent midwife who is experienced in vaginal breech births. This will cost betwixt most £2,000 and £v,000 (Independent Midwives Great britain nd). You lot can find an independent midwife near yous through IMUK.

Can I have a dwelling birth if my baby is breech?

It's possible to have a safe vaginal birth at home, if you accept a midwife or doctor attending who is skilled and experienced in delivering breech babies (Fischbein and Freeze 2018, Jackson et al 2020). But considering of the risk of complications, including needing an emergency caesarean, home birth is not recommended for breech babies.

However, many maternity units try to back up women in their choices, provided that they are aware of all the risks involved. So it's a practiced thought to contact a midwifery advocate about your options. These are experienced midwives who are able to support women to get the care that is best for them. Information technology may be possible for a team of experienced and willing midwives to be on standby for y'all. Alternatively, yous might consider paying for an contained midwife to attend your babe's nativity.

What else exercise I need to be aware of if my baby stays breech?

There are two things that you demand to be enlightened of. One may happen before the birth, although it is not common, and the other should happen after the nativity.

Before the nativity

Commencement, if your waters break with a gush before your baby's lesser is engaged, there's a risk that your babe'southward umbilical string may be swept downwardly into your vagina (cord prolapse). This happens in well-nigh one in 100 breech pregnancies so it'due south uncommon (RCOG 2014), but something to be aware of.

If your waters break and you can feel or see the umbilical string, contact the hospital midwives straight away, and then that they tin ship an ambulance out to you and prepare for your arrival. Go on your hands and knees with your head down and your bottom up, while you lot await for help to make it (RCOG 2014). This isn't the almost dignified position, merely it volition tip your baby's weight off the cord and then that your infant tin can still go oxygen via the placenta. Don't endeavour to touch the string or push it back in.

In one case you're in the ambulance, information technology's safe for you lot and your baby to lie down on your left side (RCOG 2014). The paramedic or midwife will place two fingers onto your baby's bottom to continue them from pushing on the string. This position is maintained until you get to theatre. When you arrive at the hospital, it's very likely that you'll become directly to theatre for a caesarean section (RCOG 2014).

After the birth

2nd, all babies that are in breech position at or after 36 weeks of pregnancy, or who are born in breech position after 28 weeks, should take an ultrasound scan to check for developmental dysplasia of the hip within six weeks of their birth (NHS 2018). This includes all babies in a multiple pregnancy even if only one of them was breech (NHS 2018).

References

BJM. 2018. Moxibustion: An alternative option for breech presentation. British Journal of Midwifery. world wide web.britishjournalofmidwifery.com [Accessed December 2021]

Fischbein SJ and Freeze R. 2018. Breech birth at abode: outcomes of lx breech and 109 cephalic planned home and nascence center births. BMC Pregnancy and Childbirth. Article nos: 397. world wide web.bmcpregnancychildbirth.biomedcentral.com [Accessed Dec 2021]

Contained Midwives Britain. nd. Frequently asked questions. world wide web.independentmidwives.org.uk [Accessed December 2021]

Jackson K, et al. 2020. Physiology and Care During the Outset Stage of Labour. In: Marshall J, Raynor Thousand. eds. Myles textbook for midwives. 17th ed. Elsevier, 447-499 [Accessed December 2021]

Martinez Fifty. 2020. Types of breech presentation. MedlinePlus. medlineplus.gov [Accessed February 2022]

NHS. 2018. Developmental dysplasia of the hip. NHS, Health A-Z. www.nhs.uk [Accessed December 2021]

NHS. 2020. What happens if your baby is breech?. NHS, Wellness A-Z. www.nhs.uk [Accessed December 2021]

NMC. 2009. Support for parents: how supervision and supervisors of midwives can help you. Nursing & Midwifery Council. London: NMC www.nmc-united kingdom of great britain and northern ireland.org [Accessed December 2021]

RCOG. 2014. Umbilical string prolapse. Royal College of Obstetricians and Gynaecologists, Green-summit guideline, 50. London: RCOG press. www.rcog.org.uk [Accessed December 2021]

RCOG. 2017a. Direction of breech presentation. Purple College of Obstetricians and Gynaecologists, Information for you lot. world wide web.rcog.org.uk [Accessed December 2021]

RCOG. 2017b. Breech babe at the end of pregnancy. Royal College of Obstetricians and Gynaecologists, Green-elevation guideline, 20b. www.rcog.org.uk [Accessed December 2021]

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Source: https://www.babycentre.co.uk/a158/breech-birth