Breech Birth

Most babies are born head first because they are in a head-down position in the mother's uterus. When a baby is positioned so that the feet are first to exit the womb, it is called a breech birth or breech baby. About 3 to 4 percent of babies are in a breech presentation at the onset of labor. Many babies are breech early in pregnancy, but most of them turn to the headfirst position near the end of the pregnancy. Babies who are born early are more likely to be breech. In the case of twins or triplets, the likelihood of a breech baby is increased. Abnormal levels of amniotic fluid around the baby may also result in a breech birth. As the due date approaches, a physician can determine if the fetus is breech by performing a physical exam, an ultrasound, or both.

There are many complications associated with a breech birth delivered vaginally, and therefore, physicians typically suggest cesarean delivery, also called a C-section. The risks involved with cesarean delivery include bleeding, infection, and a longer hospital stay for both the mother and her baby.

A baby who is breech may be very small or may have birth defects. Breech babies may also have accidents during delivery that can damage the umbilical cord, leading to asphyxia, a condition caused by inadequate oxygen intake. When the umbilical cord becomes compressed, there is diminished oxygen flow to the baby. The baby must be delivered immediately (usually by C-section) so that he or she can breathe. If there is a delay in delivery and oxygen deprivation is prolonged, the brain can be damaged, leaving the baby with permanent neurological damage or even causing death. In some cases, a breech birth may even cause the death of the mother, baby, or both.

To prevent harm to the fetus and/or mother, it is important for pregnant women to see a doctor early and regularly. This way, the physician can tell if the baby is breech and can help plan the necessary course of action. Some doctors plan to deliver the baby by C-section, while others give their patients exercises to do at home that may help turn the baby to the headfirst position. For women who prefer a normal vaginal delivery, their physician may use the external cephalic version procedure to try to turn the baby from breech position to vertex (head-down) position while the fetus is still in the uterus. The physician will use his or her hands on the outside of the expecting mother's abdomen to try to orient the baby, so that the head is first to exit the vagina. External cephalic version is performed at the end of pregnancy, after about 37 weeks of gestation. The success rate of external cephalic version depends on several factors, with an average success rate of about 65 percent. Even if the procedure works at first, there is still a chance that the baby will turn back around to the breech position.