Midwife Cath Curtin is used to seeing women get upset when she tells them their baby is in the breech position – that is, head up instead of head down.
“If they’re 20 weeks or 23 weeks, you wouldn’t say anything,” she tells Mamamia. “But it’s usually around 34, 36 weeks that we’d start to say, ‘Your baby is breech and it’s going to stay there.’”
Curtin says before 34 weeks, babies can turn themselves around. But after that, they normally stay in the position they’re in, especially if it’s what’s called a “frank breech”.
“That means their bottom is really wedged down into the pelvis,” Curtin says. “They don’t move.”
A lot of mums-to-be aren’t happy to get the news.
“These days, most doctors choose to do a caesarean section for a breech presentation. That is what can be upsetting. But once you explain it properly, the women are usually fine about it.
“You explain that it’s okay to have a caesarean section.”
Women often ask if it’s possible for the doctor to turn the baby. Curtin says it depends on the baby’s position.
“If it’s sitting down in that frank breech, it’s very hard to actually turn it. But if it’s sitting like a Buddha, with its legs crossed, it’s easier to do the turning.”
However, she says it’s not that common anymore.
“It’s very painful for the mother in some situations, and because we’re so good at doing caesarean sections these days and the risk is lower, most doctors don’t choose to do the turning of the baby.
“Often, the baby would be turned and the doctor would walk out and the baby would just turn right back into the breech position. Sometimes it just is what it is.”
The internet is bursting with suggestions for women who want to turn their babies themselves. Doing handstands in a swimming pool. Getting the woman’s partner to shine a torch towards the pelvis and sing. Putting a heat pack at the base of the pelvis and an ice pack on the rib cage. There’s also the traditional Chinese practice of moxibustion, which involves burning a herb near the small toe.
Curtin has heard them all, including shining a torch.
“These things don’t work,” she says. “You could have the MCG lights but the baby’s not going to turn.
“There are two ways a baby will turn: one, by itself, and two, manually, by a doctor.”
She believes it’s not even worth trying the other methods.
“Please don’t Google. It sets women up to fail and that’s not fair. We’ve got to support women and help them feel like they trust us as medical professionals. It’s not right to inform women that this is a chance of turning a baby. It just lets them down and they feel very sad and they feel like they’ve failed. I like to build women up and make them feel empowered.”
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Plus, there’s always the chance that the baby will turn by itself.
“You never say never in obstetrics. The body is a wondrous thing.”
Occasionally, when that does happen, the response from women is surprising.
“I’ve seen women all ready for a caesarean section and then the baby’s turned and they’ve so got their head around having a caesarean section that they go ahead with it.
“It’s a mindset.”
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Top Comments
How about it's okay to have a breech birth?
I had vaginal birth with my twins. Twin B was breech. Is there a reason why women have to have a c-section if their baby is in the breech position? I was never advised to have a c-section. The obstetrician helped gently guide my baby out by his foot while I pushed. He had zero issues from the birth.
It is really difficult to get an Obgyn who will deliver a breech baby vaginally - many just won't do it. It's very rare now so I think they have lost the art, but it's great you were able to find one! I think some obgyns are more likely to deliver if it is twins with one head down though, as I've had friends who delivered this way, but for some reason the same doctor would not do a single breech birth - I'm not sure why!
That was what happened with my Twin B - she was footling and had to be hauled out as her head was (painfully) wedged under my ribs. I had roomful of med and midwife students as no one gets to deliver breech anymore.
There was a study a number of years ago that 'proved' that it was safer for breech babies to be born via elective caesareans. This study has now been completely debunked, but not before every doctor and hospital changed all of their policies and procedures around it.
The upshot of this is that breech birth is now terribly rare to see, but still accounts for about 5% of pregnancies. When you get a situation where a woman comes in with a very quick labour, the baby is breech and you have unskilled attendants (because none of them have seen / performed more than a very few breech babies) handling the birth, this can absolutely result in the worst possible outcome.