What to Do for a Baby in Breech Position

During the last few weeks of pregnancy, most babies are positioned with their heads near the cervix in a "vertex" presentation. Yet 4% of infants assume a breech position, meaning their bottom or feet are near the cervix instead.

Breech position complicates labor and delivery since the baby's feet can get tangled with the umbilical cord. The baby's arms, body, or legs might slide out of the cervix before fully dilating, but the head could get stuck inside the mother's birth canal. This could cause the baby injury or even death.

Doctors can confirm breech position through physical touch and ultrasound. The diagnosis is usually made around the 36th week of pregnancy when the baby establishes their final birthing position (babies tend to move around in the womb before this time). Your chances of having a breech baby are higher if you previously gave birth to twins or have too much or too little amniotic fluid, a uterine abnormality like multiple fibroids, previous premature delivery, or placenta previa (placenta covering the cervix).

So, how do doctors deal with infants in the breech presentation? As it turns out, there's a lot you can do to get your baby to move into the correct position—or to cope if they don't turn at all.

How to Fix Breech Position

Fortunately, there are several safe and effective methods that you can try to help encourage your baby to get into the correct birthing position. In this vertex or anterior presentation, your baby faces your back with their head near the birthing canal.

Schedule a “version”

At 37 weeks, if your baby is breech, your doctor should suggest an external cephalic version (a "version"), in which your doctor applies pressure to your abdomen with their hands to try to get your baby to turn. "Sometimes, we relax the uterus with medication. Then we lift the baby's body with one hand, get the opposite hand on the baby's head and encourage a somersault," explains says Heather Weldon, M.D., an OB-GYN in Salinas, California.

"Almost every patient who has a baby in the breech position should be offered this option unless there's another contraindication to vaginal delivery," adds Andrew S. Gardner, M.D., clinical assistant professor of obstetrics and gynecology at New York University Langone Medical Center.

A typical version has more than a 50% success rate. The risks of a serious complication, such as premature rupture of membranes, are low, but it should be done in an acute-care facility in case you need a cesarean.

A version is not recommended for those who have any of the following complications:

• Vaginal bleeding,
• A placenta that covers the opening of the uterus
• Abnormally small baby
• Low level of amniotic fluid
• Abnormal fetal heart rate
• Premature rupture of the membranes
• Pregnancy with multiples.

Note that a version should not be tried before 37 weeks because it may stimulate labor.

Get Moving

Taking walks and stretching your calves can help loosen the ligaments and connective tissue that support the uterus and pelvis. This can create more space so that a posterior baby may rotate their body and tuck their chin to ease birth, says Gail Tully, a midwife in Minneapolis and founder of Spinning Babies, an organization that helps pregnant parents move their babies into better birth positions.

As long as your doctor approves, squats may help the baby descend correctly. With your back straight, feet shoulder-width apart, and heels on the floor, bend your knees until they're over your toes. Hold for 10 to 30 seconds, then slowly stand back up. Do five reps and work up to more.

You might also tweak the way you lounge. Instead of leaning back in a big comfy seat, try leaning forward while keeping your back straight; this can help encourage your baby to flip.

Do Breech Tilts

Use cushions on the floor or an ironing board propped up against your couch seat to create a plank with one end on the floor and the other high enough to elevate your hips about 1½ feet above your head.

Stay in this position for 10 to 15 minutes three times a day, preferably when your baby is active. There are no reliable statistics, but according to Spinning Babies, the method works by taking advantage of balance and gravity to help your baby move into the correct birthing position.

The Webster Technique

"This is a gentle chiropractic adjustment to the pelvis and sacrum that reduces uterine torsion [twisting] and balances the pelvic muscles so that the baby can move into a more optimal position for birth," says Heather Yost, D.C., a chiropractor at Yost Family Chiropractic in Urbandale, Iowa. "It usually takes four to 10 adjustments, but some babies turn after just one attempt." The Journal of Manipulative and Physiological Therapeutics reports the technique has a success rate of 82%.

What If My Baby Is Still Breech?

Is your baby still in the breech position after trying these methods? Many hospitals require babies in the breech position to be delivered by cesarean section to decrease the odds of complications. Talk to your provider for more information.