BREECH POSITION OF BABY
Generally during birth, the baby comes with it’s head ahead and later the body comes out. Close to the delivery date when it is found out that the baby’s head is not in its position and it is THE BABY”S BUTTOCKS that is occupying the position below, it is called as breech presentation.
A full-term pregnancy lasts about 40 weeks from the first day of the last menstrual period. In the first 36 weeks the baby changes position many times. In the last weeks the baby shifts less because there is less room to move around.
By 3–4 weeks before the due date, most babies move so their heads are down near the birth canal (vagina). If this does not happen, the buttocks, the feet, or knees may be in place to come out first during birth. It happens in 3–4% of full-term births and requires special planning for how the baby will be born. If your baby is in a breech position, your doctor may recommend caesarean delivery.
Most breech babies are born healthy. But they have a higher risk for certain problems than babies born head first. Your doctor will talk with you about the best plan for you and your baby.
Related Factors
It is not always known why a baby is in a breech position. Breech is more common when:
• The woman has had more than one pregnancy.
• There is more than one foetus in the uterus (twins or more).
• The uterus has too much or too little amniotic fluid (the liquid around the foetus inside the uterus).
• The uterus is not normal in shape or has abnormal growths, such as fibroids.
• The placenta covers all or part of the opening of the uterus (placenta previa).
• The baby is pre term.
In some cases, a birth defect may be one of the reasons why a baby has not turned into the head-down position before birth.
Finding the Baby’s Position
To plan for delivery of a breech baby, your doctor will find out how the baby is positioned. One way for your doctor to tell which way your baby is facing is by doing a physical exam. Placing his or her hands at certain points on your abdomen, the doctor feels the shape of the baby. By feeling where the baby’s head, back, and buttocks are, he or she can tell the breech position of the baby.
An ultrasound exam may be used to confirm the position. In this test, a device is moved across the abdomen. The sound waves it produces make an image of the baby that can be seen on a screen.
Delivery
If your baby is in a breech position, your doctor will talk with you about the options of whether to go for vaginal birth or opt for caesarean birth. Your doctor will go over the risks and benefits in detail. Together you will decide on the best plan for you and your baby.
Vaginal Birth
Vaginal birth can be more difficult when a baby is in breech position. This is because, at birth, the head is the largest and firmest part of the baby’s body. In the head-down position, the head comes out first. In most cases, it is then easy to guide the rest of the body through the birth canal. In the breech position, the body comes out first, and it may be hard to guide the baby’s head out of the mother’s body. This is because the baby’s body may not stretch the cervix enough to allow room for the baby’s head to come out easily.
The risk of harm to the baby may be increased in a vaginal breech birth. This may include trauma to the baby, asphyxia ( in common man’s language.. baby unable to breathe) There is also more chance of a prolapsed cord. That is when the umbilical cord slips through the cervix into the birth canal before the baby does. This can cause the cord to be pinched, which can stop the flow of blood through the cord.
Caesarean Birth
Most breech babies are born by planned caesarean delivery.
Your obstetrician may strongly advise you against a vaginal birth if:
• your baby is a footling breech.
• your baby is large (over 3800 grams).
• your baby is small (less than 2000 grams).
• your baby is in a certain position: for example, if the neck is very tilted back (hyper-extended).
• you have had a caesarean delivery in a previous pregnancy.
• you have a narrow pelvis (as there is less room for the baby to pass safely through the birth canal).
• you have a low-lying placenta or if you have pre-eclampsia.
What you need to understand
The breech position is not very common at term. Till then the baby’s position keeps on changing. Most patients and doctors prefer the caesarean as safer mode of delivery.
You are welcome to attend our antenatal lectures and solve your queries regarding this subject.
