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How to turn a breech head-down.
R. called me with the message that her baby is breech. She was 37 weeks pregnant and about to give birth to her first baby. During our first prenatal meeting, R. had told me that she has a bi-cornuate uterus and that makes her chance on a breech much higher, so I was not very surprised.
R. sees a doctor that I like very much, but is too biased towards the Bikur Cholim hospital in my opinion. No wonder, he's affiliated with them himself. So I was not surprised to hear that he had sent R. to another Bikur Cholim doctor to do an ECV (external cephalic version) to turn the breech head-down.
I told R. to hold her horses and check out her options first. She was 37 weeks which means that there wasn't much time. The fetus is already big at 37 weeks, and the bigger they get, the harder it will be to turn them.
Normally when a lady finds out that her baby is breech, it's a little earlier (around 33-34 weeks) and there is time to try some less invasive techniques first.
A known technique is this one:
Technorati Tags: birth, breech, ECV, external version, c-section
R. sees a doctor that I like very much, but is too biased towards the Bikur Cholim hospital in my opinion. No wonder, he's affiliated with them himself. So I was not surprised to hear that he had sent R. to another Bikur Cholim doctor to do an ECV (external cephalic version) to turn the breech head-down.
I told R. to hold her horses and check out her options first. She was 37 weeks which means that there wasn't much time. The fetus is already big at 37 weeks, and the bigger they get, the harder it will be to turn them.
Normally when a lady finds out that her baby is breech, it's a little earlier (around 33-34 weeks) and there is time to try some less invasive techniques first.
A known technique is this one:
Lie on the floor and pace your feet against the wall, pelvis up in the air. Support yourself well with pillows. Do this for about 10-15 minutes, twice a day. Alternatively, you can place an ironing board against the couch or your bed and lie on it head-down. Put some pillows under your head.
Another pose is this one:
Also known as the knee-chest position. Kneel down on the floor (rest your knees and head on a pillow or sit on a yoga mat). Make sure that your pelvis is higher than your chest by placing your chest on the floor as well. Sit like this for 15-20 minutes, a couple of times per day.
Well-known alternative treatments for turning a breech include moxibustion (acupressure/shiatsu) and the Webster technique (chiropractics).
Only when these techniques don't work and the baby is still breech by 37 weeks, I advice my ladies to do an ECV, or external version.
I sent R. to the most experienced ECV doctor in Israel, Dr. Kanetti. He has a very high success rate.
Unfortunately, it didn't work for R. Her baby was still breech.
She went to several doctors and professors in the field to ask their professional opinion on how she could best give birth. On the one hand, outcomes for first babies who are breech who are born by c-section are slightly better than for first babies who are breech who are born vaginally. But a c-section has a lot of implications for subsequent pregnancies and births. Mothers who deliver their first babies by c-section, have a higher chance of ending up with subsequent c-sections than mothers who have already given birth vaginally.
But all the doctors R. turned to said unanimously that in her specific case, because she has a bi-cornuate uterus, a c-section was the only option. A c-section was scheduled.
Another pose is this one:
Also known as the knee-chest position. Kneel down on the floor (rest your knees and head on a pillow or sit on a yoga mat). Make sure that your pelvis is higher than your chest by placing your chest on the floor as well. Sit like this for 15-20 minutes, a couple of times per day.
Well-known alternative treatments for turning a breech include moxibustion (acupressure/shiatsu) and the Webster technique (chiropractics).
Only when these techniques don't work and the baby is still breech by 37 weeks, I advice my ladies to do an ECV, or external version.
I sent R. to the most experienced ECV doctor in Israel, Dr. Kanetti. He has a very high success rate.
Unfortunately, it didn't work for R. Her baby was still breech.
She went to several doctors and professors in the field to ask their professional opinion on how she could best give birth. On the one hand, outcomes for first babies who are breech who are born by c-section are slightly better than for first babies who are breech who are born vaginally. But a c-section has a lot of implications for subsequent pregnancies and births. Mothers who deliver their first babies by c-section, have a higher chance of ending up with subsequent c-sections than mothers who have already given birth vaginally.
But all the doctors R. turned to said unanimously that in her specific case, because she has a bi-cornuate uterus, a c-section was the only option. A c-section was scheduled.
Technorati Tags: birth, breech, ECV, external version, c-section
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posted by Michal @ 11:50 AM
8 Comments:
This was very interesting. Thankyou.
I was lucky in that my daughter went head down at 22 weeks and stayed that way throughout, but it is good info to know.
Funny, I just posted about this method on my blog. The research about it actually showed no difference between those who tried and those who didn't. (http://www.blackwell-synergy.com/doi/abs/10.1046/j.1523-536x.1999.00071.x) Do you have any statistics from women who you've advised to do this - just wondering since my baby is currently breech (but it's still too soon to try to flip it).
Ha, I was almost a breech, they had to use forceps on me and I may have had an injury as a result. We're not sure. Anyway, I just wanted to say Long Time No See. Rebecca
Do you use moxibustion on your breech ladies? Not sure about using it on a bi-cornate uterus, but i'd love to hear if you do!
I don't have personal stats, but there are general stats for all the methods I've written about.
Personally I don't use moxibustion at all, but I refer my ladies if necessary. Would there b a problem with moxibustion for a lady with a bi-cornuate uterus?
You know - I can't see why there would be a problem - I can't see it doing any harm - it either works or it doesn't.
I've personally seen in work on two women in their homes - it was breathtaking - a HUGE uncomfortable, sudden movement - but very distinct, like the baby knew just where it was going & what it was doing.
I think it's interesting how reluctant we are nowadays to use external cephalic version... I was a breech baby myself & my mothers elderly GP performed ECV on her/me at 36 weeks.... all alone, in his office - imagine that happening now???!!!
My first child was breach at 34 wks. I was instructed to try the kneeling position and to arch my back and then slowly unarch it. My doc also suggested to try putting headphones as low on my belly as possible. Supposedly it would peak the babys curiousity and it would turn to hear better or something like that. I tried both as often as I could each day. I don't know if those techniques worked or not, but at my next appointment she had turned.
I've heard of the headphones technique... & shining a bright, bright light onto your lower abdomen... apparently, fetuses like to follow the light!
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