Breech presentation in pregnancy

What is a breech presentation? Ideally for childbirth, a baby is positioned so that the head will deliver first during a vaginal birth. A breech presentation is when your baby’s bottom, feet or both are in position to come out first during birth. Most babies will turn to a headfirst position by 36 weeks, however if the baby hasn’t turned by 37 weeks, it will be a breech baby.

How common are breech babies?

Breech babies are not common and account for around 3-4% of childbirths each year.

What are the different types of breech presentation. 

There are a number of types of breech presentation. These are:

·       Frank breech – when baby’s buttocks or bottom is aimed at the vaginal canal and its legs are sticking straight in from of their body with the feet near to the head.

·       Complete breech – when baby’s buttocks or bottom is pointing downward, and the hips and knees are flexed, or folded under them.

·       Footling breech- when one or both of baby’s feet are pointing downward.

·       Transverse lie – when the baby is positioned horizontally across the uterus. When in this position, the baby’s shoulder will enter the vagina first.

What causes a breech presentation?

It’s not always known what causes a breech presentation, but some factors that are believed to contribute are:

·       Multiple birth pregnancy (twins or more). This makes it more difficult for each baby to get into the right position.

·       There is either too much or not enough amniotic fluid.

·       The mother’s uterus is not normal in a shape (an upside-down pear), or has abnormal growths such as fibroids. If it’s shaped differently or is obstructed by growths, there may not be enough room for a full-grown baby to change position.

·       Placenta previa. This a condition where the placenta covers all or part of the cervix.

·       You go into labour preterm (less than 37 weeks gestation) and baby may not yet have turned into a head-first position.

·       The baby has a birth defect which causes them not to turn head-first.

Are breech babies’ high risk?

In general breech babies are not high-risk during pregnancy but do become dangerous at childbirth. This is because there is an increased risk for the baby to get stuck in the birth canal and for their oxygen supply to get cut off.

How is a breech baby diagnosed?

At your 36-week consultation, Dr Parashar will examine you by placing her hands at certain places on your abdomen and feeling where the baby’s head, back and buttocks are. This makes it possible for her to find out what part of the baby’s body is positioned to come out first during a normal vaginal birth. Sometimes it might be necessary for an ultrasound to be performed to confirm the baby’s position.

How is a breech baby delivered?

Due to the dangers involved in a normal vaginal delivery when a baby (or babies) is in a breech position, there will likely need to be changes made to your birth plan, as Dr Parashar will recommend a caesarean section delivery.

A caesarean section is a relatively safe surgical procedure where a surgical cut is made in the abdominal wall and uterus through which the baby is born. 

If it is discovered that your baby is breech at your 36-week consultation, Dr Parashar will discuss the implications and the best delivery options available to keep both you and your baby safe.

Planning a pregnancy?

If you are pregnant or planning a pregnancy, Dr Parashar is a specialist trained obstetrician. She and her team will provide you with the individualised support and assistance you need throughout your pregnancy and when your baby is delivered.