Breech Baby

Breech baby or breech birth is the condition wherein the baby is in a bottom-down position, inside the womb. In normal births, a baby settles down into a head-down position, in the pelvis of mother, around the eighth month of pregnancy. However, in case of breech birth, this does not happen and the baby remains in bottom-down position only. Usually, a method known as external cephalic version (ECV) is used to turn the baby into a head-down position, manually. However, there may be cases when the baby refuses to budge or rotates back into a breech position. In such a case, the baby is delivered in the breech position only.

Causes of Breech Baby

Premature delivery
Multiple (or multi-fetal) pregnancy, such as twins, triplets or more
Excessive amounts of amniotic fluid
Fetal anomalies, like hydrocephaly, anencephaly and other congenital abnormalities
Uterine abnormalities

Categories

Frank Breech

In this case, baby's bottom comes first. The legs are flexed at the hip and extended at the knees, with feet near the ears.

Complete Breech

Hips and knees are flexed in such a way that the baby is in a cross-legged position and his/her feet are beside the bottom.

Footling Breech

In such a case, one or both feet of the baby come first. His/her bottom is at a higher position. This is relatively common with premature fetuses.

Kneeling Breech

One of the very rare conditions, it has the baby in a kneeling position. One or both legs are extended at the hips and flexed at the knees.

Delivering Breech Baby

If you are carrying a breech baby, there are a number of conditions that would decide whether your doctor opts for vaginal birth or goes for a caesarean.

Vaginal Birth

The doctors allow vaginal delivery of a breech baby, only if the following conditions are completely met:

The mother has given birth vaginally before
A doctor trained and experienced in breech birth is present at the time of delivery
The facilities for a caesarean are available nearby, to be availed if needed
There are no specific features of the pregnancy that would make vaginal birth more risky

Caesarean Birth

The doctors prefer to go for caesarean birth, in case of a breech baby, if the following situations arise:

The baby is a footling breech (baby's foot or feet are below its bottom)
The baby is a kneeling breech (baby is in a kneeling position)
The baby is large (over 3.8 kilos or 8lb 6oz)
The baby is too small (less than 2 kilos or 4lb 6oz)
The baby is in a dangerous position (for instance, the ultrasound shows that the neck is tilted back too much i.e. hyper-extended)
The mother has had a previous caesarean earlier also
The mother has a narrow pelvis
The mother has a low-lying placenta
The mother has pre-eclampsia or another condition, which puts either her health or that of her baby at risk

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