Breech Presentation

Definition

Most babies move into a head-down position in the uterus before labor. The baby is in a breech position when its buttocks or feet are in place to come out first. There are three types:

  • Frank breech—the baby’s buttocks are down and the legs extend straight up in front of the body with the feet up near the head
  • Complete breech—the baby’s buttocks are down with the legs bent at the knees and the feet near the buttocks
  • Footling or incomplete breech—one or both of the baby’s feet are down

Almost all breech babies are delivered by cesarean section.

Complete Breech Birth Position

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Causes

It is not fully understood why a baby is breech.

Risk Factors

Things that may raise the risk of a baby being in this position are:

  • Having prior pregnancies
  • Being pregnant with two or more babies
  • Too much or too little amniotic fluid
  • Problems with the uterus or how it works
  • A placenta that covers the opening of the uterus—placenta previa
  • Early birth
  • Fluid around the baby's brain—hydrocephalus

Symptoms

There are no symptoms when a baby is breech. Some women feel kicking in the lower part of the belly. Others feel hiccups above the belly button. Babies move around often. It can be hard to tell which position a baby is in.

Diagnosis

The baby's position will be checked a few weeks before the due date. This is done with a physical exam. The healthcare provider can feel the position through the belly wall by moving their hands in different places. This helps find the baby's head, back, and buttocks. The baby's heartbeat can also help find its position.

An ultrasound can confirm a breech position.

Treatment

The baby may still be in a breech position during the last weeks of pregnancy. Options are:

External Cephalic Version (ECV)

The doctor will try to move the baby's head into a downward position by gently pushing on the belly. ECV is done about 3 to 4 weeks before the baby is due. It is not always effective.

Exercise

Exercises may be given during the last 8 weeks of pregnancy to help a baby turn into the correct position. They are usually done 2 to 3 times a day for 10 to 15 minutes.

Cesarean Section

A baby cannot always be turned before birth. The most common delivery method is by cesarean section.

Prevention

There is no way to keep a baby from moving into a breech position at the end of a pregnancy.

RESOURCES:

The American Congress of Obstetricians and Gynecologists
http://www.acog.org
Family Doctor—American Academy of Family Physicians
https://familydoctor.org

CANADIAN RESOURCES:

Canadian Women's Health Network
http://www.cwhn.ca
The Society of Obstetricians and Gynaecologists of Canada
https://sogc.org

References:

American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Obstetrics. Practice Bulletin No. 161: external cephalic version. Obstet Gynecol. 2016;127(2):e54-e61. Reaffirmed 2018.
Breech babies: What can I do if my baby is breech? Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/breech-babies-what-can-i-do-if-my-baby-is-breech. Accessed September 21, 2021.
Breech births. American Pregnancy Association website. Available at: https://americanpregnancy.org/labor-and-birth/breech-presentation. Accessed September 21, 2021.
Breech delivery. EBSCO Nursing Reference Center website. Available at: https://www.ebscohost.com/nursing/products/nursing-reference-center. Accessed September 21, 2021.
Breech presentation. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/breech-presentation. Accessed September 21, 2021.
Last reviewed July 2021 by Chelsea Skucek, MSN, BS, RNC-NIC
Last Updated: 9/21/2021

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