5 Signs Your Baby Is Going To Be Breech
As your due date approaches, the number of exams you experience will increase. They're annoying, sure, but they also ensure your labor and delivery goes as smooth as possible by checking for potential issues. For example, there are more than a few signs your baby is going to be breech that can help you and your health care team prepare for childbirth as best as humanly possible.
A baby is considered breech when their “buttocks, feet, or both,” are positioned to come out of the birth canal first, according to the American College of Obstetricians and Gynecologists (ACOG), which the organization reported happens in approximately 3 to 4% of full-term births. But, a breech position doesn’t mean you can’t have a safe delivery.
“Breech babies can be safely delivered either vaginally or by cesarean section,” Dr. Michael Cackovick, M.D., a maternal fetal medicine physician at the Ohio State University Wexner Medical Center, tells Romper. “The limiting factor with vaginal delivery is physician experience and skill, so that is a conversation that you must have with your physician once the breech is diagnosed in the late third trimester. Unfortunately, this is a declining skill set in the United States.”
Not all breech babies present the same, however. Three different types of breech positionings are possible, according to a report by the University of Michigan Health System — completed breech, frank breech, and footlong breech. Each breech position comes with its own set of concerns for care providers.
“Confirming that a baby is down by 36 weeks is good news if you are hoping for a vaginal delivery,” Megan Davidson, author of Your Birth Plan: A Guide to Navigating All of Your Choices in Childbirth, tells Romper. “If a baby is still breech, meaning not head down in the birth canal, which occurs about 3 to 4% of the time, then you may be offered the option of attempting an external cephalic version (or ‘version’), where an OB or midwife manually turns a baby into a head-down (vertex) position.”
Rest assured, your OB-GYN or midwife will be studying the position of your baby in order to assess the risks, consider childbirth options, and, in some cases, work to successfully turn your baby. So with that in mind, here are a few early signs that you might be in for a breech birth.
1. You're Pregnant With Multiples
Carrying multiple babies sometimes means one (or both, or all), may be breech. “Multiple pregnancies are at risk for prematurity and sometimes small for gestational age babies, both of which are risk factors for malpresentation,” Cackovick tells Romper.
Not only is the size of the babies an issue when carrying multiples, but the space that multiple babies take up could create a sort of traffic jam-like situation. “Also, one baby takes up position in the pelvis and the other one is above with limited room, thus creating a scenario where that baby has little room to turn once it’s time,” Cackovick adds.
2. You Have Low Amniotic Fluid
According to The Mayo Clinic, low amniotic fluid, also known as oligohydramnios, is "a condition in which the amniotic fluid measures lower than expected for a baby's gestational age." Amniotic fluid is meant to protect your baby, even helping them breathe in the second trimester, so low amniotic fluid can sometimes present a problem.
“Babies want to be head down as the head is their heaviest part. Once they become head down, or cephalic, in the third trimester, they generally stay that way,” Cackovick tells Romper. “Low amniotic fluid sometimes limits their ability to turn on their own.”
Low amniotic fluid means your baby has reduced room to move around, or not enough fluid available to help them move, which could prevent a breech baby from being able to turn. If you're diagnosed with low fluid and your baby is breech, your doctor may want to discuss the possibility of an induction and/or cesarean to prevent further complications during delivery.
3. Your Uterus Is Oddly-Shaped
Those with a "heart-shaped" uterus — also known as a bicornuate uterus — are at a higher risk of having a breech baby. This occurs because your uterus becomes two sections divided by a septum, or wall of tissue, according to Spinning Babies, a website focused on helping improve fetal positioning.
“Having a uterus that has a septum or is heart-shaped can limit the room that the baby needs to turn on its own,” Cackovick tells Romper. “That is why a uterus that is shaped differently sometimes predisposes to breech presentation.”
If your doctor determines this is the case early on, you'll be able to utilize early techniques to help turn the baby (the aforementioned site recommends before 30 weeks gestation) such as soft tissue work, forward-leaning inversions, and gentle stretching to help guide your baby where they need to be. Your doctor should be able to assist in which is the best option for you and your baby.
4. You Have A Premature Birth
If you go into labor too early, there is a chance that your baby could be in the breech position. A 2012 Loyola University study found that out of 569 women whose water broke for varying reasons between 24 to 34 weeks gestation, 111 of them had breech babies. Of those that were breech, 65% were also found to have low amniotic fluid levels.
“Prior to the third trimester, the baby’s body and head are very similar in size and weight. Because of this, the baby can be in almost any position,” Cackovick tells Romper. “Only when the head outsizes the body does it give it the opportunity for the head to ‘weigh’ it down into the pelvis.”
5. You Feel Kicking In Your Lower Belly After 37 Weeks
While the only true way to know your baby's position is via ultrasound, feeling most of any movement or kicking in your lower belly/cervix area can indicate a breech baby.
“Depending on the type of breech, the fetal small parts, or limbs, may be low in the pelvis,” Cackovick tells Romper. “This is especially true with what are known as footling breech presentations and often occur with extreme prematurity.”
While not always the case, it is important to keep track of changes in your baby’s movement and alert your physician to anything out of the ordinary for you. “It’s often useful to start paying attention to the position of your baby around 32 weeks,” Davidson tells Romper. “A care provider might be able to show you on a sonogram what position they are in or they may be able to feel the position with their hands (and help teach you how to do the same).”
Dr. Michael Cackovic, M.D., maternal fetal medicine physician at The Ohio State University Wexner Medical Center
Megan Davidson, Ph.D., labor doula, lactation counselor, and author of Your Birth Plan: A Guide to Navigating All of Your Choices in Childbirth
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