Breech Birth

Most babies are born headfirst, but at the end of pregnancy, around 3% to 4% are found to be breech. Before 37 weeks of pregnancy, breech presentation is much more common - about 20% of babies at 28 weeks are breech, and 15% at 32 weeks. Before term, which is defined as 37 weeks, it doesn't matter if the baby is breech, as there is always a good chance that she will turn spontaneously. Some babies do turn by themselves after this time, but it is much less likely, and some preparations should be made to decide how delivery is going to take place. About 10% to 15% of breech babies are discovered for the first time late in labour! Before 37 weeks, the only time that it does matter if the baby is breech is if labour begins. There are many factors that will be taken into account before advising on how to have your baby if this happens. Frequently, a caesarean section will be advised, particularly if your baby is between 27 and 30 weeks, but this is not always the case. Some obstetricians feel very strongly that a caesarean is always safer, others advise a vaginal delivery if there are no other problems. It is generally accepted that the studies which have tried to find the safest delivery for the baby have been subject to much bias. The problems babies have when they are born early are very much related to prematurity, rather than the type of birth. Unfortunately, it is unlikely that an adequate study to discover the best type of delivery for a premature breech baby will ever be done. There has been a suggestion that spending 15 minutes every 2 hours of the waking day in the knee-chest position will help the baby to turn (Elkin's manoeuvre). Although the first report of this was very encouraging, subsequent studies have not found it to be useful. There is some evidence that hypnotherapy may be useful, though only one study has looked at this. Acupuncture has been suggested and the results of a more formal study are awaited.