What does it mean if my baby is breech?
What if your doctor tells you that your baby is in the breech presentation?  Normally, babies at term are in the cephalic or head-first position.  However, 3-4% of babies are in the butt-first position late in pregnancy.  Remember that it’s not uncommon for a baby to be in the breech presentation earlier in pregnancy.  In fact, 25% of babies are breech at 32 weeks.  Therefore, it is important at each visit to ask your doctor or midwife about the presentation of your baby.  If your baby is still breech at 37 weeks, there is an 85-90% likelihood that it will be breech when labor begins.  Most of today’s obstetricians will choose to deliver breech babies by cesarean because of concern about potential birth injury with a vaginal breech delivery. 

Turn, baby, Turn
However, there is an alternative.  A procedure called external cephalic version can be done in late pregnancy.  It is done in the labor and delivery suite.  After a brief ultrasound evaluation and fetal monitoring, the doctor (often with an assistant) gently turns the baby by placing his/her hands on the mother’s abdomen.  Most patients describe minimal discomfort, but the procedure is not perceived as painful.  In fact, many doctors use an epidural to eliminate discomfort.  The success rate is 80-90% for women who have had prior term pregnancies and 40-50% for women in their first pregnancy.  If the procedure is successful, most patients can then anticipate a normal vaginal delivery.  The risk of fetal distress and emergency cesarean is less than 1%.  Most patients are willing to take a minimal risk in order to avoid the risks associated with cesarean and its longer recovery.

Ask your doctor
So, remember to ask your doctor about your baby’s presentation and ask about the possibility of turning the baby late in pregnancy if the baby maintains a breech presentation.

by:  J. Peter VanDorsten, M.D.

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