It is not always known why a baby is in a breech position. Breech position occurs in 3-4% of babies at term and is more common when:
- The woman has had more than one pregnancy
- There is more than one fetus in the uterus (twins or more)
- The uterus has too much or too little amniotic fluid (the liquid around the fetus 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 preterm
You doctor will usually be able to determine the baby’s position on clinical examination in the last weeks of your pregnancy. An ultrasound will be helpful if he or she is unsure.
If your baby is breech at 37 weeks, we will encourage you to consider a procedure to turn your baby called “external cephalic version” in order to improve your chances of a vaginal birth.
The exact position of your baby, the amount of amniotic fluid and the placental position will be determined by ultrasound in the hospital. Your baby’s heart rate will be monitored and you may be given a shot of a small dose of terbutaline to relax the uterine muscle. Then your doctor will try to get the baby to do a forward or backward roll by elevating the bottom and using firm pressure on your uterus.
It can be quite uncomfortable for a few moments while attempting to get the baby to turn. A tearful patient once remarked after her baby turned successfully “Dr. Callen, you are a lot stronger than you look”.
The success rate for version is about 60% and the complications are rare but include:
- premature rupture of the membranes
- abnormal fetal heart rate changes
If unsuccessful, we will likely recommend a cesarean section as the safest route of delivery for your baby. Most of the doctors at Golden Gate are trained in vaginal birth of the breech, and there are situations where we would give you that option, however.